emergency medical services

Journal of Public Health and Development Vol. 7 No. 2 May - August 2009

The Performance Indicators Development in operational level for pre-hospital EMS

in Thailand Napisporn Memongkol Runchana Sinthavalai Nattapong Seneeratanaprayune

Weerawat Ounsaneha Chanisada Choosuk

ABSTRACT

The objective of this research is to develop the performance indicators (PIS)

in operational level for the Pre-hospital Emergency Medical Service (EMS) system in

Thailand. Nevertheless, Success Factor (SF) was identified by Strategic Map (SM),

which was analyzed from main objective in National Strategy Plan of developing EMS

(2008 - 2012) of Emergency Medical Institute of Thailand (EMIT). Then, PIS were

developed from SF and SM.

The results showed that only the first strategy of Infrastructure and information

technology development was suited for developing PIS in operational level. Besides, the

success factor was the development of various infrastructure (people can received stan-

dard and efficient EMS thoroughly both in regulation and disaster conditions). Finally,

twenty-eight performance indicators in operational level were developed using the analy-

sis of strategy map and success factors. Those PIS can be used as a guideline to improve

operational work.

Keyword Emergency medical services Performance indicators

Success factor

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Table1 Procedure of standard and weight determination

Procedure

Validity

Easily understood

Success ability

Availability and

Accuracy of data

Comparability of

KPI

Quantitative

Cause & Effect

Linkage

Tmly

Meaning Weight Reference Score (=I)

To evaluate real operation ability 0.30 [I]

To evaluate meaning or description 0.20 [21

communication for easily understanding

To evaluate application and success 0.10 111

possibility

To evaluate completion and sufficiency 0.10 [I]

in data collection

To evaluate comparability of KPI with 0.10 [I]

other provinces or in the past

To evaluate type of data in operation 0.10 [21

data collection

To evaluate cause and result relation 0.05 121

with goal of strategy plan

To evaluate suitability of frequency in 0.05 [I]

data collection

,---------------------- I I Man 1 I

I I

I I I I MachinrlMaterialI I

I I

I I

I I

I Equipmenr I I

I I I

I MethodlProcedure I I I Planning I I I I Conlrol I

I I Network I I I I Organization I I

I I

I I I Q u a n t i t y I I I I Q u a l i t y I I I I T i m e l y I I I I C o s t I I I I S a f e l y I I

I S a t i s f a c t i o n

Strategic n

Factor

Figure 1 Success factor analysis diagram


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Table 2 KPIs evaluation of Khon Kaen Province

Criterion 2 .d

1 . Ratio of service (FR : ALSI-BLS)

2. Percentage of informing on EMS number (1669)

3. Percentage of patient satisfaction ofthe service provided by community EMS

4. I n f m - Dspatdung s 2 minutes

5 . Dispatching - Depart from ambulance station s 60 seconds

6. From ambulance station to the scene r 10 minutes

7. Response Time at the scene care s 10 minute

8. Fromthescene tonearathospital s 10 minute

9. Percentage of successibility of cardiopulmonary resuscitation

10. Ratio of number of service compare with popul ati on

1 1. Percentage ofnon-appropnable care (air way protection, bleeding control, immobilization, TV fluid catheterizations)

12. Percentage of urban patient delivered to Emergency Room ~ t h EMS

13. Percentage of local administration cooperation with EMS


Figure 2 National strategy plan of developing EMS in 2008 - 2012 B.C.

Strategic

T o d e v e l o p n e t w o r k a n d p r o m o t e the re la ted par tner to d e s i g n , d e v e l o p a n d e \ ~ a l u a t e the E M S sys lem f o r a s tandard and ef f ic iency both in n o r m a l and d isas te r s i tua t ions

dimensions I . Inf ras t ruc ture and informat ion t e c h n o l o c y d e v e l o p m e n t

-b

T o d e v e l o p inf ras t ruc ture tha t people can rece ive a s tandard e m e r g e n c y m e d i c a l serv ice t h r o u g h o u t a n d ef f ic iency both in n o r m a l and d isas te r s i tua t ion a n d e m e r g e n c y m e d i c a l informat ion sys tem

+ D e v e l o p d a t a b a s e sys tem 8: IT

D e v e l o p e m e r g e n c y r o o m

D e v e l o p E M S

D e v e l o p d isas te r m a n a g e m e n t

+

-

b

-b

+

2 . D e v e l o p m a n a g e m e n t m e c h a n i s m a n d f inancia l sys tem

+ T o d e v e l o p a n d re inforce m a n a g e m e n t m e c h a n i s m o f s tandard e m e r g e n c y m e d i c a l a n d ef f ic iency

T o d e v e l o p f inancia l m e c h a n i s m to m a n a g e a e m e r g e n c y m e d i c a l thoroughly a n d ef f ic iency

3. S taf f d e v e l n p m e n t

-b

-b

T o dis l r ihute e m e r z e n c y m e d i c a l s ta f f t h r o u g h o u l a n d suf f ic ien t

T o i m p r o v e the capability o f the e m e r g e n c y m e d i c a l s u p p o r t i n g s ta f fs to t a k e care the e m e r g e n c y pa t ien t

+ 4. K n o w l e d ~ e cons t ruc t a n d m a n a g e m e n t

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T o d e v e l o p the n e t w o r k a m o n g research institutes, researchers , and k n o w l e d g e m a n a g e r s o f the E M S cont inui ty

b 5. D e v e l o p n e t w o r k s and p r o m o t e the par t ic ipants role

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Table 3 Minor objectives of infrastructure and information technology development

Components Minor ob-jectives

Pre-Hospital EMS To develop the staff by training and evaluation for increasing the number of staff to cover all local administration To develop the knowledge revision mechanism for staff To develop the tool and vehicle in order to have efficiency and safety standard To develop the system of efficiency revision of tool and vehicle To make the organization chart and job description of staff To satisfy staff To reduce the time to the scene according to the topography To develop the standard operation procedure To develop communication equipment, data collection and evaluation program To develop the easily calling number and the reserved network for informing To increase the number of people acknowledgment and accept the EMS system To develop the capability of people can evaluate and inform the situation To increase the number of doctor in command control center for controlling the staff and operational unit To develop the motivation mechanism for all hospitals to be the EMS network Management system in disaster condition

Management system To develop the staff for making the acknowledgment about in disaster condition disaster management, related law and operation obligation

To prepare the material, tool and vehicle ready for disaster condition operation To develop the operation and obligation approach for disaster condition To promote the hospitals and related organizations making the mitigation plan for disaster in each area To increase the training for operation in disaster condition To develop the communication system for help support in each area To set up the operation network system in disaster condition

Table 4 Performance indicators in operational level for EMS

T ~ e s Dimensions al

Perfarmanc e Indic abrs

(d P: rn

1. Percentge oflocal administration organizati on s m&ng staE for training and passed standard training course 2. Percentge ofregisteredlocal operati anal units 3. Percentge of operati onal unit having operaion results 4 . Percentge of operational units hming motivation system 5. Percentge of operation of local operational units a€ter informedfrom command control center 6. Percentge of operational unit h wing standard welfare system 7. Percentge of satisfiedstaffs in operation 8. Percentge of operational units passing the equipment and vehicle stm dard evaluation system 9. Percentge of operational units using equipment and vehicle standard manual 1 0. Percentage of operati ma1 unit having prepar;tion procedure 11. Percentage of operation having standard time to scene on the topography standard 1 2. Percentage of operation h wing standard time at scene according to injury level 1 3. Number of D ead Case conference 14. Percentage of ABC standard operati on


Table 4 Performance indicators in operational level for EMS (Cont.)

Types Dimensions Q) d

Per farmanc e Indicators

rn

15. Percentage of operation using standard time to definite c are 16. Percentage of reporting to emergency room before arriving the hospital 17. Percentage of operational unit and command control c enter having organization ch art 18. Number of 1 ate response calling fiom random check 19. Number of no response calling fiorn command control center 20. Number of EMSpublic relitionsplan 2 1. Percentage of people in province recogniz dEMS 22. Percentage of emergency call (1669) 23. Percentage of EMS in total

medical s ervi ces 24. Percentage of people remember EMS number (1669) 25. Percentage of reporting using provincial standard time 2 6. Percentage of command passing the standard (under triag e/over tri age) 27. Percentage of command

-

using provincial standard time 2 8. Responding by rad o receiver ritio

Remark : A = Provincial public he dth off1 ce B = Local admmstration C = Command control center D = Operational unit


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