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ASTM F1224-89(1996)e1

(Guide)

Standard Guide for Providing System Evaluation for Emergency Medical Services

Standard Guide for Providing System Evaluation for Emergency Medical Services

SCOPE
1.1 This guide covers providing system evaluation for emergency medical services including authority, responsibility, objectives, approaches, data, applications, and implementation.
Note 1-This guide does not address evaluation for individual prehospital, hospital, or posthospital providers. (Related guides will be developed.)

General Information

Status
Historical
Publication Date
09-May-1996
ICS
11.160 - First aid
Technical Committee
F30 - Emergency Medical Services
Drafting Committee
F30.03 - Organization/Management
Current Stage
Ref Project

Relations

Replaced By
ASTM F1224-89(2004) - Standard Guide for Providing System Evaluation for Emergency Medical Services
Effective Date
01-Apr-2004

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ASTM F1224-89(1996)e1 - Standard Guide for Providing System Evaluation for Emergency Medical ServicesASTM F1224-89(1996)e1 - Standard Guide for Providing System Evaluation for Emergency Medical Services
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ASTM F1224-89(1996)e1 - Standard Guide for Providing System Evaluation for Emergency Medical Services
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NOTICE: This standard has either been superseded and replaced by a new version or withdrawn.
Contact ASTM International (www.astm.org) for the latest information
e1
Designation: F 1224 – 89 (Reapproved 1996)
Standard Guide for
Providing System Evaluation for Emergency Medical
Services
This standard is issued under the fixed designation F 1224; the number immediately following the designation indicates the year of
original adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. A
superscript epsilon (e) indicates an editorial change since the last revision or reapproval.
e NOTE—Section 12, Keywords, was added editorially in June 1996.
1. Scope 5. Authority
1.1 This guide covers providing system evaluation for 5.1 The authority for providing system evaluation for emer-
emergency medical services (1), including authority, respon- gency medical services rests with the entity that is utlimately
sibility, objectives, approaches, data, applications, and imple- legally responsible for system operation and evaluation.
mentation.
6. Responsibility
NOTE 1—This guide does not address evaluation for individual prehos-
6.1 The responsibility for providing system evaluation for
pital, hospital, or posthospital providers. (Related guides will be devel-
emergency medical services systems rests with the directors of
oped.)
the entities specified in 5.1.
2. Referenced Documents
6.2 The responsibility for providing adequate financial re-
sources and appropriate medical confidentiality for system
2.1 ASTM Standards:
evaluation for emergency medical services rests with the
F 1149 Practice for the Qualifications, Responsibilities, and
entities specified in 5.1.
Authority of Individuals and Institutions Providing Medi-
6.3 Independent evaluation of individual parts of the emer-
cal Direction of Emergency Medical Services
gency medical services system by prehospital, hospital, or
F 1177 Terminology Relating to Emergency Medical Ser-
posthospital providers must be integrated with and must not be
vices
substituted for system evaluation.
3. Terminology
7. Objectives
3.1 Definitions of Terms Specific to This Standard:
7.1 System evaluation of quality for emergency medical
3.1.1 system evaluation—a review of the performance of
services entails five objectives (2) including:
emergency medical services systems by qualified, experienced
7.1.1 Setting priorities,
individuals.
7.1.2 Assessing outcome,
3.1.2 minimum data set—the minimum number of data
7.1.3 Identifying problems,
elements required for system evaluation.
7.1.4 Effecting changes, and
3.2 Definitions—See Terminology F 1177.
7.1.5 Reassessing outcome.
4. Significance of Use
8. Approaches
4.1 This guide establishes system evaluation as an essential
8.1 System evaluation of quality entails approaches of
component of emergency medical services systems.
structure, process, and outcome, singly or combined (3).
4.2 This guide covers the methods and materials that are
8.2 The approaches specified in 8.1 should be applied at
necessary to evaluate quality for emergency medical services
both the system operations and patient care levels.
systems at both the system operations and patient care levels.
8.2.1 Applied at the system operations level (Table 1) these
approaches provide a means of identifying issues that require
This guide is under the jurisdiction of ASTM Committee F30 on Emergency
further attention, including:
Medical Services and is the direct responsibility of Subcommittee F30.03 on
8.2.1.1 System operation, and
Organization/Management.
8.2.1.2 Individual patients.
Current edition approved July 7, 1989. Published August 1989.
The boldface numbers in parentheses refer to the references at the end of this
guide.
Annual Book of ASTM Standards, Vol 13.02.
Copyright © ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959, United States.
e1
F 1224 – 89 (1996)
TABLE 1 Approaches and Methods for System Evaluation for
10. Applications
Emergency Medical Services
10.1 Patients who should be considered for evaluation by
Evaluation Approaches Evaluation Methods
emergency medical services systems include, but are not
Structure (standards) ASTM guides (to be developed)
limited to, those exhibiting the characteristics identified in
Process (care) Medical direction (Guide F 1149) (1)
Table 2.
Outcome (results) Intermediate: preventable morbidity (4)
Final: preventable morbidity 10.2 Emergency medical services systems incorporating
preventable mortality(5)
subsystems, such as those for burn, behavioral, cardiac, pedi-
Combined Preventable morbidity
atric, perinatal, toxicologic, or traumatic emergencies, may
Preventable mortality
Tracers (6) require categories in addition to those specified in Table 2.
Registries (7)
When required, such categories should be identified in their
Generic Screens (8)
respective subsystem standards.
11. Implementation
11.1 Implementation of system evaluation for emergency
8.2.2 Applied at the patient care level these approaches
medical services entails eight steps, including:
provi
...

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5.1 The emergency medical dispatcher should be a specially trained telecommunicator with specific emergency medical knowledge. Many of these personnel still perform in this role without the benefits of dispatch specific medical training and medically sound protocols. The majority perform their duties without appropriate medical management provided through a structured quality assurance/improvement environment. Training only prepares a new EMD for correct use of the EMDPRS. It cannot ensure that the EMDPRS is used as intended. Since the EMD is clearly defined as a prehospital medical professional, it is necessary to establish sound medical management processes through a multi-component QA/QI program administered by the EMD's agency in conjunction with the physician medical director. Prompt, correct, and appropriate patient care can be enhanced through the use of a standardized approach to quality assurance, especially the component of EMD performance assessment. This practice is intended for use by agencies, organizations, and jurisdictions having the responsibility for providing such services and assurances to the public through the correct management of the nation's emergency medical dispatchers.
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4.1 This guide is intended for use by those responsible for the development and implementation of training programs, that include competency evaluation, for triage in the prehospital environment.  
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