Evidence-based performance measures for emergency medical services systems: A model for expanded EMS benchmarking

J. Brent Myers, Corey M. Slovis, Marc Eckstein, Jeffrey M. Goodloe, S. Marshal Isaacs, James R. Loflin, C. Crawford Mechem, Neal J. Richmond, Paul E. Pepe

Research output: Contribution to journalReview articlepeer-review

93 Scopus citations


There are few evidence-based measures of emergency medical services (EMS) system performance. In many jurisdictions, response-time intervals for advanced life support units and resuscitation rates for victims of cardiac arrest are the primary measures of EMS system performance. The association of the former with patient outcomes is not supported explicitly by the medical literature, while the latter focuses on a very small proportion of the EMS patient population and thus does not represent a sufficiently broad selection of patients. While these metrics have their place in performance measurement, a more robust method to measure and benchmark EMS performance is needed. The 2007 U.S. Metropolitan Municipalties' EMS Medical Directors' Consortium has developed the following model that encompasses a broader range of clinical situations, including myocardial infarction, pulmonary edema, bronchospasm, status epilepticus, and trauma. Where possible, the benefit conferred by EMS interventions is presented in the number needed to treat format. It is hoped that utilization of this model will serve to improve EMS system design and deployment strategies while enhancing the benchmarking and sharing of best practices among EMS systems.

Original languageEnglish (US)
Pages (from-to)141-151
Number of pages11
JournalPrehospital Emergency Care
Issue number2
StatePublished - Apr 1 2008


  • Asthma
  • Emergency medical services
  • Evidence based medicine
  • Paramedics
  • Performance improvement
  • Pulmonary edema
  • Quality assurance
  • STEMI, acute myocardial syndrome
  • Status epilepticus

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency


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