Technology Transfer Series
The National Highway Traffic Safety Administration (NHTSA) has developed the Technical Assessment Team (TAT) program for states to measure the effectiveness of their existing and proposed emergency medical services (EMS) programs. Effective EMS systems ensure that highway crash victims receive prompt medical care by trained professionals, and are safely and rapidly transported to the most appropriate treatment facility. The TAT team, comprised of 5 to 6 individuals who have broad experience in EMS system development, evaluates the state EMS system using ten standard components. They prepare a written report that includes specific recommendations for improving the EMS program.
EMS SYSTEM COMPONENTS
1. Regulation and Policy2. Resource Management3. Human Resources and Training4. Transportation5. Facilities6. Communication7. Public Information and Education8. Medical Direction9. Trauma Systems
Between February 1988, and July 1993, 35 states had participated in the technical assessment process. By August 1994, this number increased to 40 states, 2 territories, and the Indian Health Service. NHTSA reported last year on an evaluation of the TAT program, identifying the strengths and weaknesses of the assessment program and noting accomplishments of individual states as a result of the assessment. NHTSA also identified areas for improvement within its own programs so that it can be more responsive to state needs. A new report summarizing and updating this evaluation with 1994 information is available.
ACCOMPLISHMENTS FOLLOWING EMS TECHNICAL ASSESSMENTS
This report summarizes information gathered during the statewide assessments, and documents the impact of the TAT program on the states' ability to improve EMS systems. At the time of the assessments, the teams found that fundamental problems existed in all components of statewide EMS systems. Most importantly, 63 percent of the states had not passed legislation that provided central authority for establishing and managing the entire EMS system. Over 60 percent did not have adequate funding or personnel to carry out all of their required duties. In addition, none of the states had pre-established standards by which to evaluate the EMS system and the vast majority of states (90 percent) did not collect enough data to measure the quality of service or patient care.
The state EMS directors have used the assessments to make impressive EMS system improvements. They identified the EMS system components that should receive primary attention, and educated legislators and the public about what the EMS system needs to operate properly. These states have been pleased with the practical benefits of the assessment process and NHTSA expects that most of the states who have not yet completed an assessment will eventually request one.
The report also indicates the importance of NHTSA's current EMS activities, including the development of model EMS data collection systems, expansion of public information and education programs, and improved EMS communication systems. NHTSA's future projects will be aimed at specific problems cited in this report - primarily guidelines for EMS system evaluation and development of related EMS system outcome measures. The report will be useful to State EMS directors and others interested in EMS improvements.
For more information about the program or to obtain a copy of EMS System Development: Results of the Statewide EMS Assessment Program (1995 Update), contact: Emergency Medical Services Division, NHTSA, NTS-42, 400 Seventh Street, S.W., Washington, DC 20590, (202) 366-5440 or send a fax to (202) 366-7721.
400 Seventh Street, S.W. NTS-33
Washington, DC 20590
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Linda Cosgrove, Ph.D., Editor,
Evaluation Staff Traffic Safety Programs