Over the past several decades, there has been an effort to develop quality/performance measures for the EMS industry. In 2014, this effort was formalized in the EMS Compass Project funded by the National Highway Traffic Safety Administration (NHTSA)and led by the National Association of State EMS Officials (NASEMSO). This initiative engaged EMS stakeholders in the mission to develop a process for designing, testing and evaluating performance measures designed to improve patient care and safety. In late 2016, EMS Compass released 14 candidate measures for public testing in 6 content areas, however, the uptake and use by the EMS community was limited.
The drive for high impact, practical, evidence-based measures continued and again, NHTSA funded a second effort to support EMS quality measure development, this time through a self-sustaining platform for the continued development of EMS Quality measures. NHTSA and the HRSA EMS-C program has engaged the American College of Emergency Physicians (ACEP) to facilitate the development of a mechanism, organizational structure and sustainability model that enables meaningful assessment of performance of EMS called the National EMS Quality Alliance (NEMSQA). Tasked with completing the work of the EMS Compass Project, NHTSA funding supported this effort through 2019. NEMSQA then became an independent, 501(C)6 non-governmental organization that has evolved into the EMS standard bearer for EMS quality measure measures.
The National EMS Quality Alliance is established work will continue to:
- Promote a culture of quality improvement through a collaborative, sustainable process.
- Enhance the value of EMS systems and develop awareness among interested parties about the measures, how best to use them and to advocate for improvement.
History of Compass
Begun in 2014, there was an open, collaborative two-year effort, funded by the National Highway Traffic Safety Administration (NHTSA) led by the National Association of State EMS Officials (NASEMSO) which was called EMS Compass. Over this two-year period, the initiative engaged a wide range of EMS stakeholders to develop initial performance measures that are relevant to EMS agencies, regulators, and patients. The measures are based on the latest version of the National EMS Information System (NEMSIS) and allow local and state EMS systems to use their own data meaningfully.
Due to the increasing availability of standardized data, the initiative sought to lay the groundwork for agencies and the EMS community to measure and evaluate performance.
EMS Compass established a system for creating performance measures based on the principles established by the National Quality Forum (NQF). The NQF is a highly regarded non-profit organization that works to improve healthcare by endorsing performance measures through a consensus-building, evidence-based process.
Through an initial month-long “Call for Measures,” members of the public submitted suggestions for more than 400 measures to EMS Compass. With input from stakeholders, the EMS Compass leadership prioritized the measures for development. The EMS Compass Measurement Design Group worked to ensure the measures were designed in a way that was feasible to use and consistent with the best science and evidence available.
To design measures that were consistent with data being collected by EMS systems today, the Technology Developer Group reviewed the measures and the measures were tested in the field using actual data from EMS agencies. After testing and validation, the measures were approved by the EMS Compass Steering Committee as candidate measures, which were released in late 2016.
The EMS Compass Steering Committee and the EMS community anticipated that the EMS community would continue to develop performance measures using the initiative’s process.