Performance Measures
About
The Emergency Medical Services for Children (EMSC) program performance measures are a set of standards that were developed to measure long-term progress at both state and national levels of the EMSC program in key areas of pediatric emergency care.
The measures were developed in accordance with the Government Performance and Results Act (GPRA), a results-oriented approach that requires federal agencies to establish performance measures that guide decisions and monitor program success.
The performance measures represent a systematic, uniform process of focusing and measuring program activities and promoting the permanence of EMSC programs at the state level.
Submission of NEMSIS Compliant Version 3.x Data
The degree to which Emergency Medical Services (EMS) agencies submit National Emergency Medical Services Information System (NEMSIS) compliant version 3.x data to the state EMS office.
Goal for Performance Measure by 2021
80% of EMS agencies in the state or territory submit NEMSIS version-compliant patient-care data to the State EMS Office for all 911 initiated EMS activations.
Why This Measure Matters
Valid data is a key part of healthcare improvement. By having data that accurately reflects the care that is needed and provided, the state and national EMS systems are able to identify opportunities for improvement and make sure that we are able to promote positive health outcomes for our population.
Pediatric Emergency Care Coordinator (PECC)
The percentage of EMS agencies in the state or territory that have a designated individual who coordinates pediatric emergency care.
Goal for Performance Measure by 2020
90% of EMS agencies in the state or territory have a designated individual who coordinates pediatric emergency care.
Why This Measure Matters
The Institute of Medicine recommends that all EMS agencies and Emergency Departments have an individual in charge of organizing pediatric education improvement initiatives, as it has been shown that the presence of a pediatric emergency care coordinator (or PECC) has been associated with improved pediatric readiness in Emergency Departments.
Some roles that the PECC may have that promote the health of children include promoting family-centered care, ensuring the consideration of pediatric populations in new protocols and policies, and advocating for pediatric resources.
Use of Pediatric Specific Equipment
The percentage of EMS agencies in the state or territory that have a process that requires EMS providers to physically demonstrate the correct use of pediatric-specific equipment.
Goal for Performance Measure by 2026
90% of EMS agencies will have a process that requires EMS providers to physically demonstrate the correct use of pediatric-specific equipment.
Why This Measure Matters
Because most EMS providers care for children so infrequently, they rarely have a chance to practice their pediatric-specific skills. If these skills are not properly practiced and assessed on a regular basis, they may be lost, and the appropriate technique might not be used when the time calls for it. By providing a regular schedule for pediatric-specific skill demonstration, the EMS agencies can make sure their staff is always prepared to respond to a pediatric emergency when it occurs.
Hospital Recognition for Pediatric Emergencies
The percent of hospitals with an Emergency Department (ED) recognized through a statewide, territorial, or regional standardized program that are able to stabilize and/or manage pediatric medical emergencies.
Goal for Performance Measure by 2022
25% of hospitals are recognized as part of a statewide, territorial, or regional standardized program that are able to stabilize and/or manage pediatric medical emergencies.
Why This Measure Matters
While most hospitals are more than equipped to manage emergency medical situations in adults, fewer are prepared to handle the unique challenges presented by pediatric medical emergencies. By providing a standardized format by which Emergency Departments may be measured, the state will be able to recognize these facilities for their achievement, as well as help facilities who are not recognized overcome their barriers to reach certification for themselves.
Hospital Recognition for Pediatric Trauma
The percent of hospitals with an Emergency Department (ED) recognized through a statewide, territorial, or regional standardized system that are able to stabilize and/or manage pediatric trauma.
Goal for Performance Measure by 2022
50% of hospitals are recognized as part of a standardized system that are able to stabilize and/or manage pediatric trauma.
Why This Measure Matters
Trauma patients often require highly specialized care that must be provided quickly and follow specific guidelines. Pediatric trauma is an even more unique set of circumstances that health providers will have to respond to, though usually on a fairly infrequent basis. By utilizing a standardized system for recognition and designation of facilities prepared to stabilize/manage pediatric trauma, hospitals will have a framework by which to focus their improvement efforts. In addition, this designation can aid hospitals with fewer pediatric trauma resources in identifying potential referral facilities in the event a transfer is necessary.
Interfacility Transfer Guidelines
The percent of hospitals with an Emergency Department (ED) in the state or territory that have written interfacility transfer guidelines that cover pediatric patients and that include the following components of transfer:
- Defined process for initiation of transfer, including the roles and responsibilities of the referring facility and referral center (including responsibilities for requesting transfer and communication)
- Process for selecting the appropriate care facility
- Process for selecting the appropriately staffed transport service to match the patient's acuity level (level of care required by the patient, equipment needed in transport, etc.)
- Process for patient transfer (including obtaining informed consent)
- Plan for transfer of patient medical record
- Plan for transfer of a copy of signed transport consent
- Plan for transfer of personal belongings of the patient
- Plan for the provision of directions and referral institution information to family
Goal for Performance Measure by 2021
90% of hospitals in the state or territory have written interfacility transfer guidelines that cover pediatric patients and that include specific components of transfer.
Why This Measure Matters
In an emergency situation, time is critical to reducing the risk of morbidity and mortality. When written interfacility transfer guidelines for children exist, it allows for expedient transfer and communication from the receiving facility to a facility better equipped and staffed to care for the complex patient situation presenting itself. These are also crucial in the event of a mass casualty or disaster event, so that facilities may reroute patients to the best possible care facility.
Interfacility Transfer Agreements
The percent of hospitals with an Emergency Department (ED) in the state or territory that have written interfacility transfer agreements that cover pediatric patients.
Goal for Performance Measure by 2021
90% of hospitals in the state or territory have written interfacility transfer agreements that cover pediatric patients.
Why This Measure Matters
In the event that a facility receives a critical pediatric patient that they are unable/unequipped to adequately care for, they need to transfer this patient to a facility able to better manage that patient, and they need to do so as quickly as possible. By having pre-written pediatric transfer agreements, facilities will be able to efficiently and expediently achieve this transfer while minimizing confusion and delay to establish a cooperative working relationship with tertiary pediatric care centers in their region.
Permanence of the EMSC
"The degree to which the state or territory has established permanence of EMSC in the state or territory EMS system."
Annual Goal for Performance Measure
The annual goal for this measure is to increase the number of states and territories that have established the permanence of EMSC in the state or territory EMSC system.
Components of This Measure
- A state or territory EMSC Advisory Committee that meets regularly
- A pediatric representative on the state or territory EMS Board
- A full-time EMSC program manager
Why This Measure Matters
By establishing permanence and building the infrastructure of the state EMSC program, the overall aims of reducing child mortality and promoting the health of children can be embedded as a priority on the state level. Pediatric representation is crucial so that the emergency medical concerns of children will have an advocate so that they may be addressed and improved upon.
The EMSC program relies upon collaboration with other engaged organizations and individuals for its success, and establishing a permanent place in the state will solidify the foundation upon which it is built.
Integration of EMSC Priorities into Statues or Regulations
The degree to which the state or territory has established permanence of EMSC in the state or territory EMS system by integrating EMSC priorities into statutes or regulations.
Goal for Performance Measure by 2027
EMSC priorities will be integrated into existing EMS or hospital and healthcare facility statutes or regulations.
Why This Measure Matters
To ensure the positive work that has been accomplished by the EMSC program will continue, it is important to enmesh key goals and priorities of the program into permanence through statutes/regulations. By utilizing the platform of state healthcare statutes/regulations, the state EMSC program can ensure the needs of its unique population are being addressed, and that the community will continue to be provided for in the years to come.