Introduction
The National EMS Quality Alliance (NEMSQA) maintains a set of EMS performance measures, including measures that were originally developed by the EMS Compass initiative, to support measurement and improvement in the quality of EMS care at the local, regional, state, and national levels. Some NEMSQA performance measures are based on NEMSIS data elements that are available in the national EMS database ("national" elements). The NEMSIS TAC is implementing those performance measures one-by-one and making them available nationally for analysis via two tools:
- V3 Public Performance Measure Dashboard (for the public)
- V3 Public Performance Measure Web Service (for software developers)
Each currently-available performance measure is documented here. The NEMSIS TAC was careful to implement the performance measures exactly as defined by NEMSQA, even if NEMSIS TAC staff perceived weaknesses or limitations in the definitions. As each performance measure is released, it will be added to this page.
In all measures, the numerator criteria implicitly include the denominator criteria. In other words, the numerator can only select records that are selected in the denominator. The number of records contributing to the numerator can never be larger than the number of records contributing to the denominator.
Some measures that were originally developed by EMS Compass were re-specified (modified) by NEMSQA after they were initially implemented by the NEMSIS TAC. Details about re-specifications are noted below.
Seizure
Seizure-01 Blood Glucose Evaluation
ID | Seizure-01 |
Measure Title | Blood Glucose Evaluation |
| NEMSQA Package | None (see note) |
Description | Measure of seizure patients who received an evaluation of their blood glucose |
| Numerator Statement | Patients receiving a blood sugar evaluation |
| Denominator Statement | Patients with ongoing status seizure activity (also known as status epilepticus, defined as seizing for 5 minutes or more or two or more status seizures in a 5-minute period without regaining consciousness) originating from a 911 request |
| Denominator Exclusions | None |
Numerator Pseudocode | eVitals.18 Blood Glucose Level is not null |
Denominator Pseudocode | ( |
Note: This measure was retired by NEMSQA, but the NEMSIS TAC continues to make it available.
Note: If the intent is to capture all seizures with status epilepticus, the code G40.901 in the denominator is overly restrictive and should be replaced with the pattern G40.??1. However, the measure is implemented as defined by EMS Compass.
Stroke
Stroke-01 Suspected Stroke Receiving Prehospital Stroke Assessment
ID | Stroke-01 |
Measure Title | Suspected Stroke Receiving Prehospital Stroke Assessment |
| NEMSQA Package | |
Description | To measure the percentage of suspected stroke patients who had a stroke assessment performed by EMS |
| Numerator Statement | Number of suspected stroke patients who had a stroke assessment performed (CPSS, LAMS, etc.) |
| Denominator Statement | Patients with a provider impression of stroke originating from a 911 request |
| Denominator Exclusions | None |
Numerator Pseudocode | eVitals.29 Stroke Scale Score is not null |
Denominator Pseudocode | (eSituation.11 Provider's Primary Impression matches /^(I60)|(I61)|(I63)|(G45)|(G46)/ |
Note: The NEMSQA measure uses eVitals.23 Total Glasgow Coma Score, which is not in the national database. The NEMSIS TAC modified the denominator to use the sum of eVitals.19 Glasgow Coma Score-Eye, eVitals.20 Glasgow Coma Score-Verbal, and eVitals.21 Glasgow Coma Score-Motor.
Trauma Pain
Trauma-01 Pain Assessment of Injured Patients
ID | Trauma-01 |
Measure Title | Pain Assessment of Injured Patients |
| NEMSQA Package | |
Description | Recognizing that pain is undertreated in injured patients, it is important to assess whether a patient is experiencing pain |
| Numerator Statement | Patients with pain scale value present |
| Denominator Statement | Patients with injury originating from a 911 request |
| Denominator Exclusions | None |
Numerator Pseudocode | eVitals.27 Pain Scale Score is not null |
Denominator Pseudocode | eSituation.02 Possible Injury is 9922005 ("Yes") |
Note: The NEMSQA measure uses eVitals.23 Total Glasgow Coma Score, which is not in the national database. The NEMSIS TAC modified the denominator to use the sum of eVitals.19 Glasgow Coma Score-Eye, eVitals.20 Glasgow Coma Score-Verbal, and eVitals.21 Glasgow Coma Score-Motor.
Vehicle Operations Safety
Safety-01 Use of Lights and Sirens During Response to Scene
ID | Safety-01 |
Measure Title | Use of Lights and Sirens During Response to Scene |
NEMSQA Package | |
Description | EMS responses originating from a 911 request during which lights and sirens were not used. |
Numerator Statement | EMS responses originating from a 911 request during which lights and sirens were not used. |
Denominator Statement | EMS responses originating from a 911 request. |
Denominator Exclusions | None |
Numerator Pseudocode | eResponse.24 Additional Response Mode Descriptors is 2224019 ("No Lights or Sirens") |
Denominator Pseudocode | eResponse.05 Type of Service Requested is 2205001 ("911 Response (Scene)") |
Safety-02 Use of Lights and Sirens During Transport
ID | Safety-02 |
Measure Title | Use of Lights and Sirens During Transport |
NEMSQA Package | |
Description | Percentage of EMS transports originating from 911 requests in which lights and sirens were not used during patient transport. |
Numerator Statement | EMS transports originating from a 911 request during which lights and sirens were not used. |
Denominator Statement | All EMS transports originating from a 911 request. |
Denominator Exclusions | None |
Numerator Pseudocode | eDisposition.18 Additional Transport Mode Descriptors is 4218015 ("No Lights or Sirens") |
Denominator Pseudocode | eResponse.05 Type of Service Requested is 2205001 ("911 Response (Scene)") |
The disposition code in the denominator excludes some patient transport dispositions, such as “Patient Dead at Scene-Resuscitation Attempted (With Transport).” However, the NEMSIS TAC implemented the measure as defined by NEMSQA.
Contact Info
Any questions, comments, concerns or suggestions with regard to this or other reports made available by the NEMSIS TAC, please contact us or leave a comment below!
Contact information is also available on our website.
| Kevin White, BS University of Utah School of Medicine NEMSIS Technical Assistance Center Phone: (801) 213-3408 Fax: (801) 581-8686 Email: kevin.white@hsc.utah.edu | Laurel Baeder, BA, MStat University of Utah School of Medicine NEMSIS Technical Assistance Center Phone: (801) 587-5337 Fax: (801) 581-8686 Email: laurel.baeder@hsc.utah.edu |
Add Comment