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Optimizing Routine and Disaster Prehospital Care Through Improved Emergency Medical Services Oversight

Published online by Cambridge University Press:  01 June 2020

Mahshid Abir ,
Jane Forman ,
Rekar K. Taymour ,
Christina Brent ,
Brahmajee K. Nallamothu ,
Jaqueline Scott  and
Kathy Wahl
Mahshid Abir*
Affiliation:
Department of Emergency Medicine, University of Michigan, Ann Arbor, MI Acute Care Research Unit, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI RAND Corporation, Santa Monica, CA
Jane Forman
Affiliation:
Acute Care Research Unit, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI
Rekar K. Taymour
Affiliation:
MMS Holdings, Canton, MI
Christina Brent
Affiliation:
Department of Emergency Medicine, University of Michigan, Ann Arbor, MI Acute Care Research Unit, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI
Brahmajee K. Nallamothu
Affiliation:
Acute Care Research Unit, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI Division of Cardiovascular Diseases and the Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI Michigan Integrated Center for Health Analytics & Medical Prediction (MiCHAMP), University of Michigan, Ann Arbor, MI
Jaqueline Scott
Affiliation:
Michigan Department of Health and Human Services, Lansing, MI
Kathy Wahl
Affiliation:
Michigan Department of Health and Human Services, Lansing, MI
*
Correspondence and reprint requests to Mahshid Abir, 2800 Plymouth Rd., North Campus Research Complex 014-G226, Ann Arbor, MI48109 (e-mail: mahshida@med.umich.edu).
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Abstract

Objective:

To identify modifiers of emergency medical services (EMS) oversight quality, including facilitators and barriers, and inform best practices and policy related to EMS oversight and system performance.

Methods:

We used a qualitative design, including 4 focus groups and 10 in-depth, 1-on-1 interviews. Primary data were collected from EMS stakeholders in Michigan from June to July 2016. Qualitative data were analyzed using the rapid assessment technique.

Results:

Emergent themes included organizational structure, oversight and stakeholder leadership, interorganizational communication and relationships, competition or collaboration among MCA stakeholders, quality improvement practices, resources, and needs specific to rural communities.

Conclusions:

EMS is a critical component of disaster response. This study revealed salient themes and modifiers, including facilitators and barriers, of EMS oversight quality. These findings were evaluated in the context of current evidence and informed state policy to improve the quality of EMS oversight and prehospital care for both routine and disaster settings. Some were particular to geographic regions and communities, whereas others were generalizable.

Keywords

disaster responseemergency medical servicesprehospital carequality improvement
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 15 , Issue 5 , October 2021 , pp. 595 - 607
Copyright
© 2020 Society for Disaster Medicine and Public Health, Inc.

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References

REFERENCES

Graham, R, McCoy, MA, Schultz, AM, eds. Strategies to improve cardiac arrest survival: a time to act. Washington, DC: The National Academies Press; 2015. https://www.nap.edu/read/21723. Accessed October 3, 2017.Google Scholar
EMS.gov. Preparedness: fostering collaboration across federal government to enhance readiness for catastrophic incidents. National Highway Traffic Safety Administration. n. d. https://www.ems.gov/preparedness.html. Accessed March 9, 2020.Google Scholar
Catlett, CL, Lee Jenkins, J, Millin, MG. Role of emergency medical services in disaster response: resource document for the national association of EMS physicians position statement. Prehosp Emerg Care. 2011;15(3):420–425.10.3109/10903127.2011.561401CrossRefGoogle ScholarPubMed
Taymour, RK, Abir, M, Chamberlin, M, et al. Policy, practice, and research agenda for emergency medical services oversight: a systematic review and environmental scan. Prehosp Disaster Med. 2018;33(1):89–97.CrossRefGoogle ScholarPubMed
Institute of Medicine. Emergency medical services: at the crossroads. Washington, DC: The National Academies Press; 2007. https://www.nap.edu/catalog/11629/emergency-medical-services-at-the-crossroads. Accessed July 19, 2018.Google Scholar
Kupas, DF, Schenk, E, Sholl, JM, et al. Characteristics of statewide protocols for emergency medical services in the United States. Prehosp Emerg Care. 2015;19(2):292–301.10.3109/10903127.2014.964891CrossRefGoogle ScholarPubMed
Hohmann, AA, Shear, MK. Community-based intervention research: coping with the “noise” of real life in study design. Am J Psychiatry. 2002;159(2):201–207.10.1176/appi.ajp.159.2.201CrossRefGoogle ScholarPubMed
Mendel, P, Meredith, LS, Schoenbaum, M, et al. Interventions in organizational and community context: a framework for building evidence on dissemination and implementation in health services research. Adm Policy Ment Health. 2008;35(1-2):21–37.10.1007/s10488-007-0144-9CrossRefGoogle ScholarPubMed
Beebe, J. Rapid assessment process: an introduction. Lanham, MD: AltaMira Press; 2001.Google Scholar
Hamilton, AB. Spotlight on women’s health: qualitative methods in rapid turn-around health services research. Presented at: Veterans Affairs Health Services Research and Development Service (HSR & D) Cyberseminar Spotlight on Women’s Health. Published December 11, 2013. https://www.hsrd.research.va.gov/for_researchers/cyber_seminars/archives/video_archive.cfm?SessionID=780. Accessed October 3, 2017.Google Scholar
Michigan Statewide Trauma System. Michigan Department of Health and Human Services. n. d. http://www.michigan.gov/mdhhs/0,5885,7-339-71551_69345---,00.html. Accessed October 3, 2018.Google Scholar
Lambert, SD, Loiselle, CG. Combining individual interviews and focus groups to enhance data richness. J Adv Nurs. 2008;62(2):228–237.10.1111/j.1365-2648.2007.04559.xCrossRefGoogle ScholarPubMed
Given, LM, ed. The SAGE encyclopedia of qualitative research methods. Volume 2. Thousand Oaks, CA: SAGE Publications; 2008.10.4135/9781412963909CrossRefGoogle Scholar
Miles, MB, Huberman, AM, Saldana, J. Qualitative data analysis: a methods sourcebook. 3rd ed. Thousand Oaks, CA: SAGE Publications; 2014.Google Scholar
What is NEMSIS. NEMSIS, National Highway Traffic Safety Administation Office of Emergency Medical Services. n. d. https://nemsis.org/what-is-nemsis/. Accessed July 19, 2018.Google Scholar
Kuehl, A, ed. Prehospital systems and medical oversight. Thousand Oaks, CA: SAGE Publications; 2002.Google Scholar
Pepe, PE, Curka, PA. Scene supervision of EMS. In: Swor, RA, ed. Quality Management in Prehospital Care. Toronto, ON: CV Mosby Company; 1993.Google Scholar
Stone, RM, Seaman, KG, Bissell, RA. A statewide study of EMS oversight: medical director characteristics and involvement compared with national guidelines. Prehosp Emerg Care. 2000;4(4):345–351.CrossRefGoogle ScholarPubMed
Ebben, RH, Vloet, LC, Verhofstad, MH, et al. Adherence to guidelines and protocols in the prehospital and emergency care setting: a systematic review. Scand J Trauma Resusc Emerg Med. 2013;21:9.10.1186/1757-7241-21-9CrossRefGoogle ScholarPubMed
Salerno, SM, Wrenn, KD, Slovis, CM. Monitoring EMS protocol deviations: a useful quality assurance tool. Ann Emerg Med. 1991;20(12):1319–1324.10.1016/S0196-0644(05)81074-1CrossRefGoogle ScholarPubMed
Henderson, AC. Examining policy implementation in health care: rule abidance and deviation in emergency medical services. Public Adm Rev. 2013;73:799–809.10.1111/puar.12146CrossRefGoogle Scholar
Aufderheide, TP, Yannopoulos, D, Lick, CJ, et al. Implementing the 2005 American Heart Association guidelines improves outcomes after out-of-hospital cardiac arrest. Heart Rhythm. 2010;7(10):1357–1362.CrossRefGoogle ScholarPubMed
Ailsby, RL. Transportation of the critically ill and injured. Can Fam Physician. 1987;33:1661–1664.Google ScholarPubMed
Landman, AB, Spatz, ES, Cherlin, EJ, et al. Hospital collaboration with emergency medical services in the care of patients with acute myocardial infarction: perspectives from key hospital staff. Ann Emerg Med. 2013;61(2):185–195.10.1016/j.annemergmed.2012.10.009CrossRefGoogle ScholarPubMed
Association of State and Territorial Health Officials. Quality improvement (QI) plan toolkit: guidance and resources to assist state and territorial health agencies in developing a quality improvement plan. Published 2014. http://www.astho.org/Accreditation-and-Performance/Quality-Improvement/QI-Plan-Toolkit/Home/. Accessed October 3, 2017.Google Scholar
Hormozdyaran, N. National Association of County and City Health Officials. Definitions of health project. Published 1999. https://www.naccho.org/. Accessed October 3, 2017.Google Scholar
Kingsbury, KJ, Natarajan, MK, Forsey, A, et al. A provincial approach to improving STEMI care in Ontario. Can J Cardiol. 2014;30(10):S81.10.1016/j.cjca.2014.07.073CrossRefGoogle Scholar
National Association of State Emergency Medical Services Officials. The organization, staffing and function of state and territorial EMS offices. Published 2005. https://www.nasemso.org/Resources/Monographs/documents/Staffing-OfcFunctionMonograph12-2005.pdf. Accessed October 3, 2017.Google Scholar
National Association of State Emergency Medical Services Officials. State Emergency Medical Services Systems: a model. Published 2007. http://www.nasemso.org/documents/modelplandraft_12-31-07_model_document.pdf. Accessed October 3, 2017.Google Scholar
National EMS Management Association. EMS 3.0: realizing the value of EMS in our nation’s health care transformation. April 5, 2016. https://www.nemsma.org/images/pdfs/EMS_3_0_Draft_Position_Paper.pdf. Accessed October 3, 2017.Google Scholar
National Highway Traffic Safety Administration. Emergency medical services performance measures: recommended attributes and indicators for system and service performance. Published 2009. https://www.ems.gov/pdf/research/Studies-and-Reports/EMS_Performance_Measures_2009.pdf. Accessed October 3, 2017.Google Scholar
National Highway Traffic Safety Administration. National emergency medical services education standards. Published 2009. https://www.ems.gov/pdf/education/EMS-Education-for-the-Future-A-Systems-Approach/National_EMS_Education_Standards.pdf. Published 2009. Accessed October 3, 2017.Google Scholar
National Highway Traffic Safety Administration. Emergency medical services education agenda for the future: a systems approach. Published 2000. https://one.nhtsa.gov/people/injury/ems/edagenda/final/index.html. Accessed October 3, 2017.Google Scholar
National EMS Management Association. The seven pillars of national EMS officer competencies. Published 2014. https://www.nemsma.org/page/TheSevenPillarsofNationalEMSOfficerCompetencies. Accessed October 3, 2017.Google Scholar
National Highway Traffic Safety Administration Office of Emergency Medical Services. Progress of evidence-based guidelines for prehospital emergency care. Published 2013. https://www.ems.gov/pdf/research/Research-Initiatives/EBG_for_Prehospital_Care.pdf. Accessed October 3, 2017.Google Scholar
National Highway Traffic Safety Administration. Advancing EMS systems: supporting the importance of developing EMS as a coordinated system of care. n. d. http://www.ems.gov/advancing-ems-systems.html. Accessed September 28, 2016.Google Scholar
Carriere, J, Bourque, C. The effects of organizational communication on job satisfaction and organizational commitment in a land ambulance service and the mediating role of communication satisfaction. Career Dev Int. 2009;14:29–49.CrossRefGoogle Scholar
Dyson, K, Bray, J, Smith, K, et al. A systematic review of the effect of emergency medical service practitioners’ experience and exposure to out-of-hospital cardiac arrest on patient survival and procedural performance. Resuscitation. 2014;85(9):1134–1141.10.1016/j.resuscitation.2014.05.020CrossRefGoogle ScholarPubMed
Zachariah, BS, Pepe, PE. The development of emergency medical dispatch in the USA: a historical perspective. Eur J Emerg Med. 1995;2(3):109–112.CrossRefGoogle ScholarPubMed
Delbridge, TR, Anderson, PB, Aufderheide, TP, et al. Emergency medical services agenda for the future: implementation guide. n. d. https://www.ems.gov/pdf/advancing-ems-systems/Provider-Resources/EMS_Agenda_Imp_Guide.pdf. Accessed October 3, 2017.Google Scholar
Herman, RD, Renz, DO. Advancing nonprofit organizational effectiveness research and theory: nine theses. Nonprofit Manag Leadersh. 2008;18(4):399–415.10.1002/nml.195CrossRefGoogle Scholar
Rojas, RR. A review of models for measuring organizational effectiveness among for-profit and nonprofit organizations. Nonprofit Manag Leadersh. 2000;11(1):97–104.CrossRefGoogle Scholar
Catlett, CL, Jenkins, JL, Millin, MG. Role of emergency medical services in disaster response: resource document for the National Association of EMS Physicians position statement. Prehosp Emerg Care. 2011;15(3):420–425. doi: 10.3109/10903127.2011.561401.CrossRefGoogle ScholarPubMed
Abir, M, Nelson, C. Lessons for first-responders on the front-lines of terrorism. The Conversation. Published July 9, 2017. https://theconversation.com/lessons-for-first-responders-on-the-front-lines-of-terrorism-79813. Accessed December 27, 2019.Google Scholar
Sobo, EJ, Simmes, DR, Landsverk, JA, et al. Rapid assessment with qualitative telephone interviews: lessons from an evaluation of California’s Healthy Families Program & Medi-Cal for Children. Am J Eval. 2003;24:399–408.Google Scholar
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