ASTM_F_1224_-_89_2004e1.pdf

Designation:F 1224 89(Reapproved 2004)e1Standard Guide forProviding System Evaluation for Emergency MedicalServices1This standard is issued under the fixed designation F 1224;the number immediately following the designation indicates the year oforiginal adoption or,in the case of revision,the year of last revision.A number in parentheses indicates the year of last reapproval.Asuperscript epsilon(e)indicates an editorial change since the last revision or reapproval.e1NOTEParagraph 10.1 was editorially revised in June 2004.1.Scope1.1 This guide covers providing system evaluation foremergency medical services(1),2including authority,respon-sibility,objectives,approaches,data,applications,and imple-mentation.NOTE1This guide does not address evaluation for individual prehos-pital,hospital,or posthospital providers.(Related guides will be devel-oped.)2.Referenced Documents2.1 ASTM Standards:3F 1149 Practice for the Qualifications,Responsibilities,andAuthority of Individuals and Institutions Providing Medi-cal Direction of Emergency Medical ServicesF 1177 Terminology Relating to Emergency Medical Ser-vices3.Terminology3.1 Definitions of Terms Specific to This Standard:3.1.1 system evaluationa review of the performance ofemergency medical services systems by qualified,experiencedindividuals.3.1.2 minimum data setthe minimum number of dataelements required for system evaluation.3.2 DefinitionsSee Terminology F 1177.4.Significance of Use4.1 This guide establishes system evaluation as an essentialcomponent of emergency medical services systems.4.2 This guide covers the methods and materials that arenecessary to evaluate quality for emergency medical servicessystems at both the system operations and patient care levels.5.Authority5.1 The authority for providing system evaluation for emer-gency medical services rests with the entity that is utlimatelylegally responsible for system operation and evaluation.6.Responsibility6.1 The responsibility for providing system evaluation foremergency medical services systems rests with the directors ofthe entities specified in 5.1.6.2 The responsibility for providing adequate financial re-sources and appropriate medical confidentiality for systemevaluation for emergency medical services rests with theentities specified in 5.1.6.3 Independent evaluation of individual parts of the emer-gency medical services system by prehospital,hospital,orposthospital providers must be integrated with and must not besubstituted for system evaluation.7.Objectives7.1 System evaluation of quality for emergency medicalservices entails five objectives(2)including:7.1.1 Setting priorities,7.1.2 Assessing outcome,7.1.3 Identifying problems,7.1.4 Effecting changes,and7.1.5 Reassessing outcome.8.Approaches8.1 System evaluation of quality entails approaches ofstructure,process,and outcome,singly or combined(3).8.2 The approaches specified in 8.1 should be applied atboth the system operations and patient care levels.8.2.1 Applied at the system operations level(Table 1)theseapproaches provide a means of identifying issues that requirefurther attention,including:8.2.1.1 System operation,and1This guide is under the jurisdiction of ASTM Committee F30 on EmergencyMedical Services and is the direct responsibility of Subcommittee F30.03 onOrganization/Management.Current edition approved Apr.1,2004.Published April 2004.Originallyapproved in 1989.Last previous edition approved in 1996 as F 1224 89(1996)e1.2The boldface numbers in parentheses refer to the references at the end of thisguide.3For referenced ASTM standards,visit the ASTM website,www.astm.org,orcontact ASTM Customer Service at serviceastm.org.For Annual Book of ASTMStandards volume information,refer to the standards Document Summary page onthe ASTM website.1Copyright ASTM International,100 Barr Harbor Drive,PO Box C700,West Conshohocken,PA 19428-2959,United States.8.2.1.2 Individual patients.8.2.2 Applied at the patient care level these approachesprovide a means of evaluating care for patients that arespecified in 8.2.1.2.8.3 Audits performed using the approaches specified in 8.1should examine two aspects of care,including:8.3.1 Compliance with system standards,and8.3.2 Appropriateness of system standards.9.Data9.1 Systemwide uniform recordkeeping constitutes an es-sential element of medical evaluation of emergency medicalservices systems.9.2 Emergency medical services system data sources sub-ject to uniform recordkeeping include:9.2.1 Prehospital care:dispatches,first responders,prehos-pital providers,base stations;9.2.2 Facility care:nonhospital-based emergency facilities,hospitals;9.2.3 Posthospital care:rehabilitation facilities,home careprograms;and9.2.4 Government agencies:medical examiners.9.3 Each source specified in 9.2 must collect and report thedata contained in the minimum data set as determined by theentity specified in 5.1.9.3.1 Data comprise three types,including:9.3.1.1 Patient demographic data such as patient origin,etiologic factors,condit