The study from the Icahn School of Medicine at Mount Sinai underscores the importance of scrutinizing clinical quality measures in emergency medical service (EMS) systems. Analyzing over 26 million EMS responses across the United States in 2019, the research revealed gaps in care quality, particularly in rural areas. Despite established benchmarks, disparities persist in the treatment of various medical conditions, highlighting the need for comprehensive improvement strategies. By prioritizing clinical excellence and addressing geographic health disparities, stakeholders can enhance patient outcomes and ensure equitable access to high-quality emergency care.
Access to quality emergency medical services (EMS) and efficient 911 responses is critical during times of crisis. However, recent analysis reveals concerning gaps in care quality, with disparities emerging between rural and urban areas.
Unfulfilled Care Quality in EMS & 911: Highlighting Rural Disparities
A comprehensive study conducted by the Icahn School of Medicine at Mount Sinai delved into the intricacies of EMS systems across the United States, shedding light on geographic health inequalities in clinical quality. Published in Prehospital Emergency Care, the study scrutinized over 26 million EMS responses from nearly 10,000 agencies in 2019.
Utilizing benchmarks established by the National EMS Quality Alliance, the research scrutinized various clinical quality measures, including the treatment of low blood sugar, seizures, stroke, pain management, trauma care, medication safety, and transport safety.
Despite efforts to adhere to established standards, the study revealed notable lapses and inconsistencies. For instance, only 16 percent of trauma patients experienced improved pain levels following EMS treatment, highlighting areas for improvement in pain management protocols. Additionally, a concerning finding indicated that 39 percent of children experiencing wheezing or asthma attacks did not receive necessary breathing treatments, a crucial intervention for symptom relief. Of particular concern was the revelation that nearly one-third of patients suspected of having a stroke did not undergo a comprehensive stroke assessment by EMS personnel. Early assessment and intervention are paramount for stroke patients, emphasizing the urgent need for protocol adherence and swift action to optimize outcomes.
Moreover, the analysis uncovered disparities in care quality between rural and urban areas. EMS agencies predominantly serving rural regions exhibited lower rates of treating low blood sugar and providing adequate pain management for trauma patients. Furthermore, rural EMS responses were more inclined to employ lights and sirens unnecessarily, despite associated risks such as accidents, injuries, and fatalities.
Dr. Michael Redlener, the lead author of the study and an associate professor of Emergency Medicine at Mount Sinai, underscored the significance of scrutinizing clinical quality measures alongside operational metrics. While rapid response times are crucial for critical incidents, focusing solely on operational efficiency overlooks the broader spectrum of patient care needs.
Redlener emphasized, “It is essential for EMS systems, government officials, and the public to understand the quality and safety of care being delivered and to identify avenues for improvement.” By prioritizing clinical quality measures, stakeholders can pinpoint areas for enhancement, fostering a culture of continuous improvement within EMS systems.
The study reframes the narrative surrounding EMS care, advocating for a shift towards comprehensive assessment and improvement strategies. Redlener clarified that the objective is not to assign blame but to unearth opportunities for enhancing patient outcomes and safety.
Overall, the study emphasizes the imperative of prioritizing clinical quality measures in EMS systems to ensure optimal patient outcomes. By acknowledging and addressing disparities in care provision between rural and urban areas, stakeholders can work collaboratively to bridge gaps in healthcare access. Moving forward, concerted efforts to enhance EMS protocols and promote a culture of continuous improvement are essential for delivering equitable, high-quality emergency medical services to all communities.
