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Alternatives to Traditional EMS Dispatch and Transport: A Scoping Review of Reported Outcomes

  • Jan L. Jensen (a1) (a2), Alix J.E. Carter (a1) (a2), Jennifer Rose (a1), Sarah Visintini (a3), Emmanuelle Bourdon (a4) (a5), Ryan Brown (a1), Jennifer McVey (a1) (a2) and Andrew H. Travers (a1) (a2)...
Abstract
Objectives

Emergency medical services (EMS) programs, which provide an alternative to traditional EMS dispatch or transport to the emergency department (ED), are becoming widely implemented. This scoping review identified and catalogued all outcomes used to measure such alternative EMS programs.

Data Source

Broad systematized bibliographic and grey literature searches were conducted.

Study Selection

Inclusion criteria were 911 callers/EMS patients, reported on alternatives to traditional EMS dispatch OR traditional EMS transport to the ED, and reported an outcome measure.

Data Extraction

The reports were categorized as either alternative to dispatch or to EMS transport, and outcome measures were categorized and described.

Data Synthesis

The bibliographic search retrieved 13,215 records, of which 34 articles met the inclusion criteria, with an additional 10 added from reference list hand-searching (n=44 included). In the grey literature search, 31 websites were identified, from which four met criteria and were retrieved (n=4 included). Fifteen reports (16 studies) described alternatives to EMS dispatch, and 33 reports described alternatives to EMS transport. The most common outcomes reported in the alternatives to EMS dispatch reports were service utilization and decision accuracy. Twenty-four different specific outcomes were reported. The most common outcomes reported in the alternatives to EMS transport reports were service utilization and safety, and 50 different specific outcomes were reported.

Conclusions

Numerous outcome measures were identified in reports of alternative EMS programs, which were catalogued and described. Researchers and program leaders should achieve consensus on uniform outcome measures, to allow benchmarking and improve comparison across programs.

Objectif

Les programmes de services médicaux d’urgence (SMU), qui offrent une solution de rechange à la répartition traditionnelle des SMU ou au transport classique des malades aux services des urgences (SU), gagnent de plus en plus de terrain. Dans l’examen d’établissement de la portée décrit ici, les auteurs ont relevé et classé tous les résultats utilisés pour mesurer l’efficacité de ces programmes novateurs de SMU.

Sources des données

Les auteurs ont entrepris une vaste recherche systématisée de références bibliographiques, et effectué des recherches méthodiques dans la documentation parallèle.

Sélection des études

Les critères de sélection comprenaient les appels faits aux services d’urgence 911 ou les malades examinés par les SMU, inscrits dans les rapports de solutions de rechange à la répartition traditionnelle des SMU OU au transport classique des malades au SU par les SMU, ainsi que l’existence d’un critère d’évaluation.

Extraction des données

Les rapports ont été classés soit dans la catégorie des solutions de rechange à la répartition des services, soit dans la catégorie des solutions de rechange aux transports effectués par les SMU; quant aux critères d’évaluation, ils ont été classés et décrits.

Synthèse des données

La recherche dans les références bibliographiques a permis de relever 13 215 documents, dont 34 articles répondaient aux critères de sélection; à cela s’ajoutent 10 autres documents provenant d’une recherche manuelle dans des listes de références (n=44 documents sélectionnés). Quant à la recherche dans la documentation parallèle, elle a permis de relever 31 sites Web, dont 4 répondaient aux critères de sélection; ils ont tous été extraits (n=4 sites Web sélectionnés). Dans 15 rapports (16 études), il y avait une description des solutions de rechange à la répartition des SMU, et, dans 33 rapports, une description des solutions de rechange au transport par les SMU. Les résultats indiqués le plus souvent dans les rapports de solutions de rechange à la répartition des SMU étaient l’utilisation des services et la justesse des décisions; se sont dégagés des documents 24 résultats différents. Les résultats indiqués le plus souvent dans les rapports de solutions de rechange au transport par les SMU étaient l’utilisation des services et la sécurité; se sont dégagés des documents 50 résultats différents.

Conclusions

De nombreux critères d’évaluation ont été relevés dans les rapports de programmes de SMU novateurs, critères qui ont été classés et décrits. Les chercheurs et les responsables des programmes devraient établir un consensus sur des critères uniformes d’évaluation afin de permettre l’établissement de normes de référence et d’améliorer les comparaisons entre programmes.

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Copyright
Corresponding author
Correspondence to: Jan L Jensen, 239 Brownlow Avenue, Suite 300, Dartmouth Nova Scotia B3B2B2; jan.jensen@emci.ca
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