Quality Indicators in Prehospital Care

Background Quality indicators are very important particularly in the missions of the prehospital emergency physician, since they often have life-saving character. Aim of the Study The aim was to determine the treatment period and the agreement between the suspected diagnosis by the prehospital emergency physician and the hospital discharge diagnosis in order to check whether they could be used as quality indicators. Material and Methods 708 patient care reports of the EMS center Bad Belzig in the period from 01.07.2013 to 30.06.2014 and 01.01.2015 to 31.12.2015 were included. The diagnostic agreement (DA) was determined by the consensus of three experienced emergency physicians. The treatment period was calculated as the time of arrival of the prehospital emergency physician and his departure from the location of his prehospital mission. The treatment period was tested for significant results with further variables using the Mann-Whitney-U-Test. The prehospital diagnostic efficiency (phDE) was determined from the DA and the treatment period. Results The DA was present in 69.4% of cases. The average treatment period of all cases lasted 21 minutes. The phDE showed an average value of 3,3/min. The best value for the phDE among the 5 investigated prehospital mission-related hospital discharge diagnoses amounted to 13/min for apoplexy and the worst value to 1,15/min for hypertensive crisis. The correctness of the diagnosis by the prehospital emergency physician seemed to be independent of the treatment period. Discussion The phDE, calculated from DA and treatment period, can be used as a quality indicator in prehospital medical care. With its help, problematic treatment cases can be identified.