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Computer-aided dispatch (CAD), electronic patient care records (ePCR), patient satisfaction surveys, billing systems, medical devices, etc as data collection have become more prevalent in EMS agencies, so does the opportunity to use that data to more effectively manage the organization. Understanding the types of data available, and how that data are best used to measure performance, is essential to the success of an EMS agency.

The majority of efforts in measuring EMS performance fall into three categories: clinical, operational, and financial. EMS leaders find it increasingly necessary to balance these categories in order to maintain a healthy organization. In addition to maintaining equilibrium among these areas, many of the measures described in this chapter have some level of correlation to other measures. One can easily see that poor financial performance might lead to an inability to fund clinical advancements, or that longer response times might impact the survival rate of out-of-hospital cardiac arrest (OHCA) patients. The more we study EMS performance measures, the more we see new examples of not only correlation, but in some cases direct causal relationships. Although clinical measures may be the area that the medical director is called upon for more guidance, it is important for anyone in that position to understand all measures used to manage an EMS agency and how they relate to the overall success of the organization.


  • Define key terminology used in EMS performance measures.

  • Describe the value of monitoring EMS performance measures as related to the strength of an EMS agency.

  • Outline the most commonly used clinical performance measures in EMS.

  • Describe the components of response time compliance monitoring.

  • Describe the unit hour utilization formula, and its use.

  • Describe the demand analysis process used to match staffing levels with EMS call volume.

  • Describe the concept of developing and utilizing a vehicle deployment plan.

  • Outline common safety related performance measures.


Terminology used in EMS performance measurement can vary from one source to another. For the purposes of understanding the contents of this chapter, as well as understanding performance measures shared among EMS agencies, the following is offered as a clarification.

Key performance indicators (KPIs) are specific areas of measurement determined to be valuable to monitor. This is the “what” in terms of measuring EMS Performance Measurement. Medication errors, response time reporting, and cash collections are examples of clinical, operational, and financial components of KPIs. Specific examples of the most commonly used clinical and operational KPIs in EMS will be the focus of this chapter.

A benchmark may be used to describe one of two things. More commonly, the term benchmark is used to define a goal to aim for, or a level to try to achieve. This use of the term is often derived from identifying best practices, or a measure that has been ...

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