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179 Copyright 2012 National Fire Protection Association INFPA). Licensed, by agreement, tar Individual use and single download on August 10, 2012 to SMP14EN ALLAN of SOLUTIONS FOR LOCAL GOVERNMENT. No other reproduction or transmisslon In any form permitted without written permlasion of NFPA, For Inquires or to roporl unauthoritod use, contact t'rcensing@nfpa . org. 450 -12 LMERGi:NCY MEDICAL SERVICES AND SYSTEMS (10) Exlriralion capability measure. Percentage of calls requir- ing an extrication tool having one delivered to the scene within 8 minutes of call dispatch. (11) A *nbployee illness and injury measure. Percentage of employ- ees acquiring an illness or injury as a result of participat- ing in an EMS call_ (12) Eviplayee turnover measure Percentage turnover of EMS - trained employees per year. (13) Quality pruptirn measure: Determination of whether- an overall quality program, as described in (1) through (12), exists within the EMS system. (14) System userapinion rneasuir• Mail /phone survey to assess the satisfaction of system users with the system's performance. (15) Mullicosualiy event response plan measurr- An established plan to mitigate a multiple casualty disaster while main- taining sufficient resources to respond to the normal vol- ume of emergency calls within the jurisdiction. 5.5.3.2.2 NHTSA. The National Highway Traffic SafetyAdmirt- istration (N141 SA) has published the document EMSPerformanre Measures. Recommended Afeasures for System and Se-mire Performance using a consensus process to develop performance m". ores R-ir EMS, The document contains indicators and attributes that EMS pmCtitioners identified as critical for performance measurement and evaluation of any emergency medical services system. This resource describes the sources of regttired data, the formulas or questions necessary to examine critical components as well as other evaluation criteria parameters. 5.5.3.2.3 Other Measurement Methods. Accrediting bodies such as the Commission on Fire Accreditation International, the Commission on Accreditation ofAmbulance Services, and others have published measurements anti criteria for EMS systems. The nature of time presents a classic problem in semantics: The same term can have different meanings to different people. Additionally, tradition and unique EMS system design have created a language of time incomparability. The NFPA 450 EMS time template, shown in Table 5,6, is an attempt to solve this problem with consensus terms. The key to this time template is to differentiate clearly between discrete points versus intervals of time. Column A repre- sents discrete points in Lime or Lime stamps that occur during an EMS call, Columns B and C label uniquely the elapsed time or intervals between the time stamps. 5.6.1 The lists in Table 5.6 arc nciL exhaustive but represent typical core points in time and common operational situa- tions. it is not expected that every time stamp be reported. Depending on the EMS system's complexity and level of technology, it is understood that a function interval may be long or instantaneous. However, when reporting EMS sys. tem performance, these consensus teens should be used. 5.6.2 Discrete Time Stamp. The term time stamp refers to the historical tradition in EMS during which call events were re- corded by stamping a card that printed the hour and minute that was displayed at that moment on that clock. 'Today, times are often recorded automatically by cofripuLerized dispatch sysLerns in (tours, minutes, and seconds and are synchronized using the U.S. Naval Observatory's atomic clock. These time stamps define discrete moments at which certain events occur, recorded in hour:minute:second [hh:mm:ss] format. Discrete time stamps, collected in this way, allow the user to measure the interval hettveen events. The system must have the ability to capture Linos stamps in a reliable, consistent, and accurate manner. Not all time stamps are available or collectible, while 101 2019 Edilion others are reported with varying degrees of accuracy, Sharing time stamp data across system components and synchronizing time recording devices are critical to establishing an accurate and reliable measurement process. 5.6.2.1 Function Intervals. An interval is the elapsed lime be- tween two discrete Lime stamps. Function intervals are the in- tervals between consecutive time stamps. The function inter- val describes the activity occurring at the task level of a single call. Function intervals allow analysis of each function that is taking place throughout the continuum of the event. Certain groups of consecutive funcLions describe processes. 5.6.2.2 Process Intervals. A process interval is made up of multiple, consecutive function intervals. A process interval is used to describe the elapsed time required to complete the agency's or system's objective. The process interval allows de- cision makers to establish baselines, monitor changes, bench- mark to other systems, and create long; -terin plans, 5.6.3 Reporting System Data. When decision makers com- pare systems to benchmark performance, they must use con- sistent language to describe the function and process inter- vals. For example, the term response lime is commonly used but not commonly defined. "Therefore caution must be exercised to ensure that the term describes the identical functions or processes. Yet even when common definitions are used, re- sponse times may not be accutately compared. For example, some systems report "average" response times, which fail to adequately describe performance. Comparisons should there- fore be based on "fraclile" reporting, which, for example, may describe time performance with 90 percent reliability, 5.6.4 The terms defined in 5.6_4.1 through 5.6.4.3 are used in Table 5.6. 5.6.4.1 Column A Definitions. (1) Incident m- onset tune, The time the incident occurred or the time that the symptoms developed. (2) 1 ime of discovery of met a, The time that a third party or the patient becomes aware of the need for assistance. (3) Call for held. The time that a third party or the patient first attempts to contact outside assistance. (4) First PSAPcall thine. The time the telephone begins to ring in the first public safety answering paint (or other desig- nated entity). (5) Phone "of hook" (answered in first PSAP. The time that the telephone is answered in the first PSAP center. (6) Serorrdary dispatch phone rings — secondwy MAP (ij"rappiro- pfiale). The time the telephone begins to ring in the sec - ond public safety answering point (or the call screener). Many systems will not use secondary dispatch centers. (7) Secondary disjiatrh phone "off =hook "answered (if appmpriate). The time that the second PSAP or second dispatcher answers the phone, begins the interview, collects caller data, begins prearrival instritctions. (8) Inlemiew ends. The time that the PSAP telecommunicator completes the interview with the caller. This time stamp may occur before or after resources are identified, or before or after units arrive on the scene. (9) Response •resazerres are identified. The time that the PSAP telecommunicator, through computer -aided dispatch or other means, identifies the appropriate resources to send to the scene of the emergency, For example, the telecommunicator may identify ambulance, fire appara- tus, quick - response vehicles, police vehicles, specialty ve~ hicles, or other appropriate resources.