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How You Eat an Elephant: First Course

Last month, we acknowledged the complex, monumental task of addressing the current issues facing the fire service. The wicked problems are still here, and I suspect many fire departments are still looking at a full plate. So let’s take a byte: data.

We’ve always collected data because we’ve always documented the services we provide, EMS or fire. Documentation serves as part of a patient’s medical record and insurance billing, and it provides us (and lawyers) with accounts of events past. I think it’s fair to say that historically documentation has been commonly thought of largely as a “CYA” necessity.

The difference between then and now is that now we can actually do something with the information we’ve documented. With improvements and innovations in our ability to collect and manage clinical and operational data, we now have access to almost immeasurable amounts of information that contains answers to as many questions as we can generate.

For example, the EMS Compass Initiative is currently developing standardized performance measures based on data entered into the National EMS Information Systems (NEMSIS) by local EMS agencies. EMS Compass describes the efforts concisely on their website:

The EMS Compass initiative has engaged a wide range of EMS stakeholders to develop performance measures that are relevant to EMS agencies, regulators, and patients. The measures will be based on the latest version of the National EMS Information System (NEMSIS) and will allow local and state EMS systems to use their own data meaningfully.

But before we can use data meaningfully, a crucial component to ensuring we get good data out of a system is to ensure that good data goes into the system.

So even though we’ve been collecting data via documentation for decades, it’s becoming an increasingly critical component of our jobs as professional healthcare providers and not simply a record of events past: data is the new documentation.

So how do we improve the quality of EMS patient data collected by local and state agencies? Agencies that succeed definitely focus on the outcomes of data collected.

But how much focus do we put into the front end? Human factors will always be associated with strong and weak data. Thus, we must educate and train our EMTs about data entry, the reasons behind the data points we define and collect and why valid data points are crucial to finding answers to the questions posed.

It’s up to us to reduce the human factors associated with weak data and strengthen the factors associated with quality data.

Start small; choose one data point. Define it, set a benchmark and train your EMTs. Then go back and evaluate and reevaluate the validity of the data going in.

Do one thing at a time. Do it convincingly and with strong, validated inputs and outputs.

Documentation isn’t an exercise in CYA; it’s harnessing the power of information to find ways of improving the quality of our care and performance on the street, where it matters.

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