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Performance Measures
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Process for Developing the New EMS Performance Measures


In 2004, the Health Resources and Services Administration (HRSA) Emergency Medical Services for Children (EMSC) State Partnership Program implemented standardized performance measures to assess the quality of pediatric emergency care provided in the prehospital and hospital settings in all states and U.S. territories.

These performance measures were the first steps to assess the degree to which systems are in place to ensure optimal care of children in the emergency care setting.

Data have been collected from 56 states and territories three times since 2004. The findings from the data collection show that the majority of EMS agencies have medical direction and equipment, but there is still room for improvement in the hospital measures. In addition, the EMS and hospital measures concentrated on availability of services and equipment. While availability is an important first step, systematically measuring processes is the logical next step.

Developing the New Measures

In 2013, the federal EMSC Program tasked NEDARC to review the current data available, interview experts in the field of prehospital emergency care, hold expert in-person meetings, conduct a comprehensive literature review, and facilitate the development of the next generation of performance measures.

NEDARC conducted cognitive interviews with individuals from stakeholder organizations during the first quarter of 2013 and then convened a group of experts, known as the Performance Measure Advisory Committee (PMAC), in August 2013. PMAC members reviewed the current measures, assessed suggestions made during key stakeholder interviews, held in-person meetings, continued to review the latest research, and reviewed suggestions from additional stakeholders. NEDARC drafted recommendations for three new Performance Measures for HRSA review. The process was an interative one conducted over a three-year period.

From this group, with the support of HRSA, three new EMS-based performance measures were developed:

  • EMSC 01 - Submission of NEMSIS Compliant 3.X Data
  • EMSC 02 - Pediatric Emergency Care Coordinator (PECC), and
  • EMSC 03 - the Use of Pediatric Specific Equipment.

As a result, beginning March 2017, the EMS for Children Program will no longer collect data from EMS agencies on pediatric medical direction, pediatric equipment carried on ambulances, or pediatric education requirements for EMS personnel. However, these specific areas of focus are critical components of pediatric systems of care and will remain as priorities in EMS for Children performance measure EMSC 09.


Performance Measure Advisory Committee

PMAC members included State Partnership Grantees, representatives from key stakeholder organizations, and EMS researchers. For a list of PMAC members click here and for a list of professional organizations represented in the process click here.

For additional questions about the process please contact your HRSA Project Officer.




rev. 04-Aug-2022




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