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EMS Based TIPI-IS Cardiac Care QI-Error Reduction System

Project Final Report (PDF, 1.05 MB) Disclaimer

Project Details -
Completed

This project developed, implemented, and measured the impact of an emergency cardiac care quality improvement (QI) and error reduction information system. The Emergency Medical System Time Insensitive Predictive Instrument Information System, (EMS TIPI-IS) collected and fed back the results of quality measures. ACI-TIPI/TPI decision support assisted paramedics in identifying patients with acute coronary syndrome (ACS). The impact of a prehospital/hospital quality improvement and error reduction system was demonstrated in two cities and included the two EMS agencies, five community hospitals, and three referral hospitals serving those communities. The approach used multiple information technology strategies including ACI-TIPI capable electrocardiogram(ECG) computation of prehospital patients' 0-100 percentprobability of having ACS and a Web-based data collection and feedback reporting system; a before after time series design assessed impact. Information was collected on prehospital and hospital care, combined in to a single database and used for feedback reporting. To improve quality, TIPI-IS provided real-time decision support, retrospective feedback, and Web-based QI review. It electronically collected and distributed clinical information and quality measure results on more than 4,300 prehospital/hospital patients focusing on adherence to ACS treatment protocols. The intervention period showed improvement in prehospital obtainment of ECGs needed for STEMI identification, adherence to treatment protocols, and shorter hospital door-to-balloon times.