A recent study conducted by the Icahn School of Medicine at Mount Sinai has found that emergency medical service (EMS) systems in the United States are not consistently providing optimal care to patients who call 911, based on new national standards of quality. The study, published in Prehospital Emergency Care, suggests that there is a significant variation in EMS performance on key clinical and patient safety measures across urban and rural communities. The findings highlight areas for improvement in 911 responses, which could lead to better care and outcomes for patients nationwide.
Traditionally, EMS systems have relied on operational measures such as response times to assess their performance. However, lead author Dr. Michael Redlener, Associate Professor of Emergency Medicine at Icahn Mount Sinai, emphasizes that patient care and experience cannot solely be determined by the speed at which an ambulance arrives. While fast response times are crucial for critical incidents such as cardiac arrests or choking, the majority of patients benefit from condition-specific clinical care in the early stages of a medical emergency. Therefore, it is essential for EMS systems, government officials, and the public to be aware of the quality and safety of care being provided and to find ways to enhance it.
This is the first study to utilize specific safety and clinical quality measures to evaluate patient care throughout the entire 911 system in the United States. The research team analyzed over 26 million 911 responses from 9,679 EMS agencies in 2019. They assessed the adherence to specific quality measures outlined by the National EMS Quality Alliance, a nonprofit organization dedicated to developing evidence-based quality measures for EMS and healthcare partners with the goal of improving patient and care provider outcomes and experiences. The researchers also compared the performance of EMS agencies based on size and location, including urban, suburban, and rural areas. The study revealed significant differences in agencies that predominantly served rural communities compared to their urban and suburban counterparts. Agencies with responses in predominantly rural areas were less likely to provide appropriate treatment for low blood sugar or effectively manage pain for trauma patients. Moreover, they were more likely to employ lights and sirens unnecessarily, which increases the risk of accidents, injuries, and even fatalities.
Dr. Redlener emphasizes that the goal of this study is not to assign blame to underperforming EMS services but to identify opportunities for improving patient care. He suggests that the focus should shift from solely considering response times to evaluating performance measures that directly impact the individuals in need of treatment. By understanding these disparities and implementing changes in EMS protocols and practices, the quality and safety of care for all patients who call 911 can be enhanced.
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1. Source: Coherent Market Insights, Public sources, Desk research
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