Table 5 Final List of indicators to measure the quality of pre-hospital Emergency Medical Services (EMS) provided to Road Traffic Injuries (RTIs)
Dimension | Title of indicators | Numerators of indicators | Denominators of indicators | Description |
|---|---|---|---|---|
Structural indicators | 1. Urban emergency stations coverage rate | Number of urban stations | Number of required urban stations based on standards | One station for every 40 km with an ambulance |
2. Urban Emergency Stations Coverage rate | Number of available urban stations | Number of required urban emergency stations based on standards | – | |
3. Motorcycle ambulance coverage rate | Number of available motorcycle ambulance | Number of required motorcycle ambulance based on standards | In cities with a population of over 250,000 and one motorcycle ambulance unit for every 4 urban stations | |
4. Ambulance bus coverage rate | Number of available ambulance bus | Number of required ambulance bus based on standards | An ambulance bus for one million people covered | |
5. Number of backup ambulances | Number of available backup ambulances | Number of active stations | One backup ambulance for every 3 stations | |
6. The ratio of active ambulances to the total number of available ambulances | Number of active ambulances | Number of ambulances delivered to that center | An active ambulance means an ambulance that is currently serving in pre-hospital emergency stations. (Support ambulances, under maintenance, headquarters’ vehicles are not considered for this indicator.) | |
7. Active manpower | Number of employed manpower per station | Required Manpower for each station | Standard Number of manpower per station = 9.25 | |
8. Pre-hospital emergency building’ status | Number of pre-hospital emergency stations located in a building | Total number of pre-hospital emergency stations | The purpose of this indicator is to determine the building status, based on using the prefabricated building or Conex as a station. | |
9. Independence of pre-hospital emergency stations’ building | The number of pre-hospital emergency stations whose building (of any kind) is completely independent. | The total number of pre-hospital emergency stations. | Independence means that the station’s building is not part of a hospital, fire department, etc. | |
10. The ownership status of the pre-hospital emergency stations’ building | Number of pre-hospital emergency building owned by the country’s emergency services | Total number of pre-hospital emergency stations. | The purpose of this indicator is to measure the ratio of stations’ building owned by country’s emergency services to the stations which are rented by the country’s emergency services | |
11. Number of standard pre-hospital emergency stations in terms of building size | The number of standard pre-hospital emergency stations in terms of building size. | The total number of pre-hospital emergency stations. | Road station standard: at least 87 m | |
12. The ratio of manpower having an academic degree in emergency medicine | The number of manpower with an academic degree in emergency medicine in active pre-hospital emergency stations. | The total number of manpower employed in active pre-hospital emergency stations. | The purpose of this indicator is to measure the status of using manpower other than who have emergency medicine degree (nursing, anesthesia, etc.) | |
13. Number of standard pre-hospital emergency stations in terms of safety | The number of pre-hospital emergency stations that have at least one safety system/tool. | Total number of pre-hospital emergency stations | – | |
14. Number of pre-hospital emergency stations that have standard ambulance site | The number of pre-hospital emergency stations with ambulance nest. | Total number of pre-hospital emergency stations | – | |
Performance indicators | 1. The average time between the emergency call of 115 up to notification to 800 | Total time of emergency missions from call emergency 115 to notification to 800. | Number of missions announced | – |
2. The average time between receiving a mission by 800 to notify the stations | Total time between receiving the mission by 800 to notification of the mission to the emergency station | Number of missions announced | – | |
3. The average time between the mission announcement to stations until the departure of the ambulance | Total time between the mission announcement to the station until the ambulance leaves the station | Number of missions announced | – | |
4. The average time spent in the accident scene (Scene Time) | Total time spent at the scene of the accident | Number of missions announced | Scene Time: the time between reaching the scene of the accident and the time of leaving the scene of the accident toward the hospital | |
5. The average time between the ambulance departures from the scene of the accident to the hospital until the moment of arrival at the hospital on urban missions (Transport time) | Total time of emergency missions, between ambulance departures from the accident scene to arrival at the target hospital in urban missions. | Number of city missions leading to departure to the hospital | – | |
6. The average time between the ambulance departure from the scene of the accident to the hospital until the arrival at the hospital in the road missions (Transport time) | Total time of emergency missions between the departures from the scene of the accident to arrival at the target hospital in the road missions. | Number of road missions leading to hospitalization | – | |
7. Duration ambulance stop in hospital (Hospital time) | Total time of ambulance stops in the hospital | Number of missions leading to departure to the hospital | – | |
8. Per capita missions did for each active urban ambulance | The total number of urban missions in the specified coverage area. | Total number of active urban ambulances | – | |
9. Helicopter cover rate | The total number of missions performed by the helicopter. | The total number of air missions done in the covered area. | An area of two kilometers around the helicopter site in the emergency station | |
10. Patient satisfaction | The number of service recipients who are satisfied with pre-hospital emergency services. | All recipients of pre-hospital emergency services | – | |
11. Successful CPR rate | Number of successful CPR recorded in prehospital emergency | Total number of patients transferred by a pre-hospital emergency during cardiopulmonary resuscitation | – | |
12. The death rate during transfer | The number of deaths in traffic accidents during transfer to hospital by pre-hospital emergency | The total number of injured in traffic accidents who transferred by pre-hospital emergency. | All traffic injured died in the ambulance during transfer to the hospital | |
13. Number of consultations by the nurse | Total number of calls that have been given consultation by the nurse | Total number of calls with the pre-hospital emergency | – | |
14. The number of consultations transferred to the physician | Total number of calls that have been given consultation by the physician | Total number of calls with the pre-hospital emergency | – | |
15. The dispute between pre-hospital emergency personnel and hospital emergency personnel | Total Number of disputes between pre-hospital emergency and hospital emergency personnel. | The total number of missions leading to departure to the hospital. | The dispute refers to the cases in which that reception unit has been forced to intervene. | |
16. Number of return/hospital change | The total number of cases that have led to the change of hospital due to improper hospital selection. | The total number of missions leading to departure to the hospital. | Improper hospital: means that for any reason, such as the lack of empty beds, specialists, necessary facilities, etc., pre-hospital emergency technicians are forced to change hospitals. | |
Management indicators | 1. Management visits from pre-hospital emergency stations | The total number of pre-hospital emergency stations that is visited by management at least once a year (by a checklist). | Total number of pre-hospital emergency stations | – |
2. Training courses in the field of trauma care | Total number of personnel who have passed at least one training course in trauma care in one past year | Total number of personnel working in pre-hospital emergency stations | – | |
3. The average distance between pre-hospital emergency stations (kilometers) | – | – | – | |
4. Average Distance of Pre-hospital Emergency to nearest Red Crescent Emergency Center (kilometers) | – | – | – | |
5. Evaluate the performance of stations’ personnel | The total number of personnel whose performance has been evaluated at least once in one past year using a checklist. | Total number of personnel working in pre-hospital emergency stations | – | |
6. Personnel satisfaction assessment | Total number of personnel whose satisfaction rate has been assessed at least once in one past year | Total number of personnel working in pre-hospital emergency stations | – | |
7. number of personnel to the number of missions ratio | The total number of personnel working at each station. | The average number of missions performed by each station | – |