Measuring Prehospital Response Times and A

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Measuring Pre-hospital Response Times and A E
Department Performance in Norway to improve
quality

• Ingvild Gulbrandsen and Stig Eliassen
• London 12. July 2006

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Organisation of the Norwegian Specialist Health
Service
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National health care

• Objective
• To provide the population with good
• health care and equal access
• throughout the country.

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Why is time crucial in emergency medicine?

• More lives can be saved
• Faster and more complete recovery

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Lack of government targets

• A governmental report in 1998 suggested
  pre-hospital response time target
• 90 percent within 12 minutes in high population
  density areas
• 90 percent within 25 minutes in low population
  density areas

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Lack of national reporting

• No reporting of actual performance in
  pre-hospital response times
• No reporting of the length of time the patients
  have to wait in Accident Emergency Departments
  (A E)

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Performance measurement

• In Norway just 1 out of 25 examined hospitals is
  systematically collecting data on the length of
  time the patients spend in the A E Departments.
• Statistical data on response times of dispatch
  centres and ambulance services are being
  collected in 14 of a total of 30 emergency
  districts.

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Percentage of Category A calls (immediately life
threatening calls) with response times within 12
minutes, 25 minutes and longer,by various
regions.
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Percentage of Category A calls (immediately life
threatening calls) with response times within 12
minutes in selected urban areas
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Cumulative distribution of response times (for
Category A calls) in counties according to
population density
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Pre-hospital response times divided between time
spent by the dispatch centres and by the
ambulances before and after the arrival at the
scene of the incident (Mean, Category A calls)
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The period of time patients spend in A
E-departments. Mean

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Impact

• Chairman of The Standing Committee on Health and
  Care Services have committed to developing an
  ambulance service with acceptable quality
• The Northern and Central Norway Regional Health
  Authority have promised to take action to better
  the situation

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Impact (II)

• The Norwegian Board of Health is going to monitor
  the length of time patients are waiting in the A
  E Departments
• The Norwegian Board of Health has found that
  there is a lack of quality in the communication
  centrals interviewing techniques during
  emergency calls, and are going to monitor the
  development

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Impact (III)

• National Centre on Emergency Health-Care
  Communication (KoKom) are going to propose
  national performance indicators on response times
  of dispatch centres and ambulance services

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Follow-up after three years

• All performance audits that are reported to the
  Norwegian Parliament (the Storting) must normally
  be followed up and reported to the Storting three
  years later.
• The purpose of the follow-up is to ensure that
  the government administration has implemented the
  measures required by the Storting after its
  consideration of the performance audit report.