Author/Editor		Žmavc, Andrej
Title		Parametri za ocenjevanje kakovosti v prehospitalni urgentni službi (PHE)
Translated title		Quality assessment parameters in prehospital EMS system
Type		članek
Source		In: Bručan A, Gričar M, editors. Urgentna medicina: izbrana poglavja 4. Zbornik 5. mednarodni simpozij o urgentni medicini; 1998 jun 17-20; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		1998
Volume		str. 181-9
Language		slo
Abstract		In spite of the fact that the EMS system in Slovenia as a whole is in the developing stage it is mandatory to begin to deal with the problem of quality measurement and quality assurance in the systems which are already running. Defining the relevant parameters for measuring the quality in prehospital EMS is difficult because of a great variability of conditions and circumstances of the emergency situations. Quality assessment parameters (QAP) can be divided into the indirect and the direct ones. The indirect QAP are related mostly to the state-of-the-art items, while the direct QAP are related to the outcome and therefore represent the effectiveness of the sys- tem. The indirect QAP are less relevant but are more easy to measure. Such QAP are the proportion of intubated trauma patients having the GCS 8 or less, the adequate vol- ume substitution in patients in shock, the sufficient analgesic therapy in severe pain and the correct immobilization of fractures. The adequate management of patients having an AMI, a severe cardiac arrhythmia, a pulmonary oedema, a hypertensive crisis, etc. can also be recognized as the indirect QAP. One of the most important indirect QAP is the average response time of the system. The indirect QAP are also the effective triage system, the adequate documentation protocols, the proportion of emergency and nonemergency interventions, the number of CPR performed by the system, the number of deaths without CPR, the range and quality of training of the personnel, the quality of the equipment and the system data quality. The most often analyzed direct QAP are the CPR results of out-of-hospital cardiac arrests. Perhaps this is so because the cardiac arrest is a very well defined condition and the results of CPR are easy to measure. However the problem is in the relative- ly small number of CPR, especially in a smaller systems where even a few cases can *completely change the performance of the system. (Abstract truncated at 2000 characters)
Descriptors		EMERGENCY MEDICAL SERVICES QUALITY OF HEALTH CARE