Air ambulance outcome metrics: A systematic review of quality attributes and service delivery domains
Kristin Edwards / Richard Franklin
James Cook University, Townsville, Australia
LifeFlight Australia, Brisbane, Australia,
LifeFlight Australia, Queensland Health, Retrieval Services Queensland, Brisbane, Australia,
Queensland Health, Retrieval Services Queensland, Brisbane, Australia
Kristin is a transplant from the Colorado Rocky Mountains. She's passionate about retrieval medicine - it's the reason she became a critical care nurse more than 20 years ago. Her mixed methodology research is grounded in Complex Adaptive System and Decision theories. Kristin and her team are grateful to acknowledge the grant support from Emergency Medicine Foundation and Central Queensland Health and Hospital Service.
Quality is a highly complex construct (Harteloh, 2003; Saver et al., 2015). Finding a metric or element to measure quality is equally complex (Bigham, 2013). For example, a challenge in measuring air ambulance quality performance is rooted in the interconnectedness of emergency systems (Newgard, 2011). However, the pathway to quality must begin with accurate, reliable, and valid measurement of health service performance (IOM 2006). Consensus for specific quality measurements reduces duplication, inconsistencies, and gaps in performance and eliminates metric ‘cherry-picking’ which highlights stakeholder self-interests (IOM 2006). Failure to establish consensus of meaningful and valid performance measures hinders the ability to recognize disparity and variations of care. Institutes of Medicine (IOM) have created a comprehensive quality framework built on important quality elements. Donabedian theoretical definition and Complex Adaptive Systems theory provide further clarity to the construct of quality healthcare delivery in this presentation.
This presentation aims to discuss the systematic review results, the measures of patient, process and structure outcomes, according to Donabedian and the IOM quality domains; safe, efficient, equitable, timely, patient-centered and effective interventions, and identify current gaps of these measures in recent air ambulance literature.