Starting in January 2011, the Fire and Emergency Medical Services Department (FEMS) began submitting cardiac arrest data to the Cardiac Arrest Registry to Enhance Survival (or CARES). CARES was developed to help communities determine standard outcome measures for out-of-hospital cardiac arrest (OHCA) locally allowing for quality improvement efforts and benchmarking capability to improve care and increase survival. FEMS typically treats and/or transports between 500 and 700 cardiac arrest patients each year.
Starting in October, 2008, FEMS began to evaluate the effectiveness of pre-hospital patient care provided to patients treated and transported by FEMS first responders and Paramedics. To improve the quality of patient care, the FEMS EMS Continuous Quality Improvement (CQI) office reviews patient cases on a monthly basis. Starting in October, 2015, and later, FEMS began to define patient treatment elements required for cardiac arrest, STEMI, stroke and trauma cases. Each of these elements contributes to effective patient treatment and must be completed by FEMS first responders and Paramedics when treating and/or transporting patients. To better evaluate the success of pre-hospital patient care provided to such patients, the percentage of required patient treatment elements completed by FEMS personnel and the overall completion rate for all required elements (combined) for cardiac arrest, STEMI, stroke and trauma patients is compared monthly.
Starting in October 2008, FEMS began measuring patient satisfaction by mailing a survey to each patient transported by a Department ambulance. The FEMS patient survey uses a number of measures to evaluate patient satisfaction with FEMS response time, crew behavior and overall service. During the period of a year, FEMS typically reviews 2,000 returned surveys. Patient survey results have a margin of error of +/- 5% with at least a 95% level of confidence based on the number of FEMS patient transports and returned surveys during a year.
Patient outcome measures are essential for assessing and improving both product and service quality in healthcare. Product quality assessment focuses on measuring and improving timely, appropriate and successful treatment provided to patients. Service quality assessment focuses on measuring and improving employee professionalism, competence, attitude and empathy as perceived by patients.