Table 2 Domain-wise sample questions and indicators of EMS framework
No. | Domain | Sample questions/indicator |
|---|---|---|
1 | EMS service delivery | • Is the service organized at state level or national level? • Number of organizations registered for EMS delivery • Distribution of vehicles • Basic vs. advance life support services |
2 | Health workforce | • Is there certified training curriculum and licensing mechanism? • Average experience and turn over in EMS organizations • EMS crew configuration • EMS workforce demography (sex and age composition) |
3 | Information systems | • Radio communication, dispatch system • GPS trackers, location identifiers • Transfer of information from ambulance to receiving service |
4 | Medical products | • Availability of life-saving medications • Availability of aspirin, analgesia, oxygen in the vehicle |
5 | Financing | • Proportion of EMS covered by public funds • Do private insurance companies cover emergency care and EMS? • Other tax mechanisms to provide for EMS funds |
6 | Governance | • Is there a lead agency? • What is the legislative framework? • Are their regulatory bodies for setting and monitoring EMS standards? |
7 | Access | • Availability of Universal access number • Availability of alternate emergency services |
8 | Coverage | • Proportion of population covered by the ambulance services • Are there differences in coverage in rural vs. urban areas? • Proportion of towns or villages covered through EMS services all the time |
9 | Quality | • Use of standardized documentation • Audits, benchmarks, and indicators to track performance and outcomes, reporting frequency • Quality improvement initiatives • Standards for ambulance and crew configuration |
10 | Safety | • Availability of clear guidelines, protocols for assessment, treatment, and transfer; hands-off protocols • Medical direction • Working conditions; injury prevention policies and working hours of the ambulance crew • Enforcement of regulations |
11 | Improved Health | • Trends in pre-hospital survival of select emergency condition for ambulance- transported patients |
12 | Responsiveness | • Responsiveness of EMS services, average response time |
13 | Risk protection | • Availability of emergency care insurance plans through employers or private companies • Out-of-pocket expenditure for EMS care |
14 | Improved efficiency | • Efficient field triage • Use of technology and data to improve services such as real-time electronic run sheets |