The structure and process level determinants of improved clinical outcomes in prehospital cardiac arrest and major trauma

Emergency Medical Services (EMS) systems provide care to complex patients under less than ideal circumstances. Paramedics treat patients without knowing much about the patient’s medical history or the cause of the emergency. This makes it very difficult to know how to evaluate the care provided to them. Generally, quality of care in medicine is evaluated by measuring the effect of various components of the system and the interaction between the clinician and the patient, to see the effect on the patient’s health. EMS managers evaluate factors such as the number of ambulances per population, the level of training of paramedics and 911 call response times. Recent research has called into question the theoretical relationship between improved quality of care and the level of training for paramedics, leaving EMS system managers with the difficult task of re-evaluating their assumptions about how to improve the quality of their systems. Douglas Andrusiek’s research will help managers by exploring the relationships between each component of the Emergency Medical System. He will conduct a statistical analysis to determine which structural and care components contribute to better patient care. While most research evaluates only cardiac arrest performance, this project is also examining EMS care of major trauma patients. Andrusiek’s research will lead to the development of strategies that will improve patient care for all British Columbians who suffer acute injury and illness.