STATUSRAPPORT FOR NORDISK SAMARBEID OM STANDARDISERING, DATAINNSAMLING OG BENCHMARKING AV PREHOSPITALE TJENESTER Saksnummer i 360: Versjonsnummer: 02 14/878-36 Utgitt: Rapporteringsperiode Utarbeidet av prosjektkoordinator: 7. juni 2016 1. juni 2015 01. juni 2016 Janne Kristin Kjøllesdal Prosjektleder: Steinar Olsen 1
1. STATUSOVERSIKT Under vises overordnet status i prosjektet pr mai 2016. Nordic collaboration on standardization, collecting and benchmarking EMS-data Project leader Steinar Olsen - Not started Coordinator Janne K Kjøllesdal 1 Ready Updated 02.05.2016 2 According to plan 3 Delayed, no affect on the delivery 4 Delayed, affects the delivery Milestone ID Description of milestones Planned ready date Date of delivery Responsible person 1 Mandate, timeplan, aktivities, letter of invitation 1. sep. 2014 13. nov. 2014 Janne 1 Status Comments 2a Common nordic timepoint, intervals and Qis is defined 1. des. 2015 14. okt. 2014 Jim 1 2b Data on Common nordic timepoint, intervals and Qis presented 1. des. 2015 30. sep. 2015 Dag 1 KI under 2 og 3 slått sm. 3a Key statistics on EMS in Nordic countries is defined 1. des. 2015 30. sep. 2015 Dag 1 3b Data on Key statistics of EMS in Nordic countries is presented 1. des. 2017 Dag 2 Testing of pilot data 4a "Treat and leave"- patients are defined 30. des. 2015 30. sep. 2015 Erika 1 4b Data on "Treat and leave"- patients is presented 31. des. 2017 Erika 3 Testing of pilot data 5a Medical codes for STEMI, cardiac arrest and stroke is defined 8. apr. 2015 11. apr. 2016 Jon Erik 2 5b Data on Medical codes for STEMI, cardiac arrest and stroke is presented 31. des. 2018 Jon Erik 3 Testing of pilot data 6 Datacollection defined and data presented 31. des. 2018 Håkon 3 Rolling out national dashboards 7 Final Nordic EMS-report 31. des. 2018 Janne 2 Yearly report to Helth Director Generals Meeting 2. DENNE RAPPORTERINGSPERIODEN Status viktigste oppgaver som er fullført i perioden. Prosjektet har utviklet en felles tidslinje for behandlingsforløpet i den akuttmedisinske kjede og felles definisjoner for fire prosessindikatorer, kliniske indikatorer for hjertestans, hjerteinfarkt og hjerneslag og er utvalg av indikatorer for pasientgruppen «Treat and leave», se vedlegg 1. Prosjektet har avholdt to møter i perioden, i september 2015 i København og april 2016 i Reykjavik. Sverige har utpekt sin myndighetsrepresentant fra Socialstyrelsen, men har ikke endelig besluttet om og hvordan de vil involvere seg i dette arbeidet. Prosjektet presenterte sitt arbeid i EMS Compass i USA og i en egen workshop på European Emergency Medical Congress EMS2016 Copenhagen. Gjennomført anbudskonkurranse om validering av kvalitetsindikatorer som prosjektet har utviklet. Tre leverandører deltok i konkurransen og Helseplan Consulting Group AS vant konkurransen. 2
3. NESTE RAPPORTERINGSPERIODE De viktigste arbeidsoppgavene som skal utføres i den neste perioden i prosjektet: Forankring av ansvaret for leveranse av data til prosjektet hos de enkelte myndighetsrepresentatnene i de deltagende landene. Gjennomføre møter med ansvarlig dataleverandører i de enkelte landene for å kvalitetssikre leveransene, definisjoner og metode. Prosjektet vil utarbeid forslag til avtale om deling av data mellom landene (MOU) for godkjenning av helse- og sosialdirektørene i de nordiske landene, se vedlegg 2. Utarbeide rapport mal, struktur og innholdselementer for den endelige prosjektrapporten. 4. RISIKO Utfordringene i prosjektet speiler utfordringene mht datatilgjengelighet i de enkelte landene. Tilgangen begrenser seg i dag til noen deler av tjenesten, som for eksempel responstid, mens data til resultatindikatorer vil først være tilgjengelige om noen år. Imidlertid pågår det reform- og utviklingsprosesser i alle landene som på sikt vil kunne bidra med data til benchmarking av de prehospitale tjenestene i Norden. Det er en utfordring å få nasjonal forankring av ansvaret for dataleveranse i alle landene. 3
5. MYNDIGHETSREPRESENTANTENE I PROSJEKTET Vedlegg 1: Liste over nordiske kvalitetsindikatorer. Vedlegg 2: Forslag til intensjonsavtale for deling av data (MOU) 4
Vedlegg 1: Nedenfor presenteres kvalitetsindikatorene som prosjektet arbeider med. På bakgrunn av denne listen vil prosjektet velge ut de kvalitetsindikatorer som vil ligge til grunn for benchmarking av de nordiske landene. No Nordic Quality Indicators Type of Indicator 1 EMCC reaction time Process 2 EMCC reaction time Process 3 EMCC time to Scene Process 4 EMS prehospital time Process 5 Unit reaction time Process 6 Unit response time Process 7 Unit mission time Process 8 Bystander CPR Process 9 ROSC to hospital Result 10 30 days survival after cardiac arrest Result 11 STEMI Structure 12 Ischemic stroke Structure 13 30 days mortality by diagnosis for the STEMI, stroke, cardiac arrest Result 14 Incidents where no ambulance is dispatched Process 15 Incidents where no ambulance is dispatched after advice by MD Process 16 Incidents where no ambulance is dispatched according to EMCC Process protocol 17 Patients left on scene Process 18 Patients left on scene assessed by a MD on scene Process 19 Patients left on scene assessed after telephone consultation MD* Process (not on scene, e.g. EMCC MD) consulted 20 Patients left on scene assessed without MD involved (not on scene, Process e.g. EMCC MD) 21 Patients that are calling back, within 4 hours and 24 hours Result 22 Patients assessed by ambulance personnel and delivered to primary Process care 23 Patients assessed by ambulance personnel and delivered to hospital Process 24 Calls to EMCC for health assistance Structure 25 Incidents Structure 26 Ambulance (unit) missions Structure 27 Ambulance (unit) acute missions Structure 28 Available ambulance hours per a year and a week Structure 29 Work ambulance work hours per a year and a week Structure 30 Inhabitants per nation (or regional) Structure Forklaringer: EMCC: Emergency medical communication centre EMS: Emergency medical services CPR: Cardiopulmonary Resuscitation ROSC: Return of spontaneous circulation MD: Medical doctor 5
Vedlegg 2: Memorandum of Understanding between The Norwegian Directorate of Health, Norway and The Finish Department of Health and Social services and The Danish Department of Health and Social services and The Swedish Department of Health and Social services and The Icelandic Department of Health and Social services (hereafter Partners) 6
In order to promote cooperation and the advancement of academic exchanges between the Partners, we have agreed as follows: Within fields of Emergency Medical Services (EMS) that are mutually acceptable, the following forms of cooperation will be pursued: A joint comparison of EMS quality- and key performance indicators in the Nordic countries Exchange of statistical data and other information The purpose of this Memorandum of Understanding is to express the intentions of the Parties and are not intended to be legally binding on either party. The terms of cooperation for each specific activity contemplated under this Memorandum of Understanding shall be mutually discussed and agreed upon in writing by all parties prior to the initiation of that activity. Any such activities agreed upon will be recorded and governed by a separate legally binding agreement executed by all parties. Each institution shall designate a liaison officer to develop and coordinate the specific activities agreed upon. Each party will cover their own financial obligations due to this Memorandum. This Memorandum of Understanding will remain current for three years with the understanding that either party may terminate it by giving the other party three months written notice, unless an earlier termination is mutually agreed upon. Each party recognizes that the other party has, may have or will have arrangements of a similar or different nature with other institutions whether in each party s respective countries or elsewhere in the world, during the currency of this Memorandum of Understanding. Each party shall not make any public announcement or statement or publish or release any information in relation to any proposed activity or proposed collaboration without the prior notification to all parties. Each party shall keep confidential any information that it receives from the other party which is marked confidential or which a party notifies the other party is confidential. 7
Oslo, xx.yy.15 Bjørn Guldvog The Norwegian Directorate of Health, Oslo, Norway The Finish Directorate of Health, Helsinki, Finland The Danish Directorate of Health, Copenhagen, Denmark The Swedish Directorate of Health, Stockholm, Sweden The Icelandic Directorate of Health Reykjavik, Iceland 8