{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T17:12:09Z","timestamp":1776445929400,"version":"3.51.2"},"reference-count":55,"publisher":"BMJ","issue":"11","funder":[{"name":"The Norwegian Air Ambulance Foundation"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,10,11]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>A consensus study from 2017 developed 15 response-specific quality indicators (QIs) for physician-staffed emergency medical services (P-EMS). The aim of this study was to test these QIs for important characteristics in a real clinical setting. These characteristics were feasibility, rankability, variability, actionability and documentation. We further aimed to propose benchmarks for future quality measurements in P-EMS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>In this prospective observational study, physician-staffed helicopter emergency services registered data for the 15 QIs. The feasibility of the QIs was assessed based on the comments of the recording physicians. The other four QI characteristics were assessed by the authors. Benchmarks were proposed based on the quartiles in the dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Nordic physician-staffed helicopter emergency medical services.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>16 physician-staffed helicopter emergency services in Finland, Sweden, Denmark and Norway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The dataset consists of 5638 requests to the participating P-EMSs. There were 2814 requests resulting in completed responses with patient contact. All QIs were feasible to obtain. The variability of 14 out of 15 QIs was adequate. Rankability was adequate for all QIs. Actionability was assessed as being adequate for 10 QIs. Documentation was adequate for 14 QIs. Benchmarks for all QIs were proposed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>All 15 QIs seem possible to use in everyday quality measurement and improvement. However, it seems reasonable to not analyse the QI \u2018Adverse Events\u2019 with a strictly quantitative approach because of a low rate of adverse events. Rather, this QI should be used to identify adverse events so that they can be analysed as sentinel events. The actionability of the QIs \u2018Able to respond immediately when alarmed\u2019, \u2018Time to arrival of P-EMS\u2019, \u2018Time to preferred destination\u2019, \u2018Provision of advanced treatment\u2019 and \u2018Significant logistical contribution\u2019 was assessed as being poor. Benchmarks for the QIs and a total quality score are proposed for future quality measurements.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-030626","type":"journal-article","created":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T07:46:24Z","timestamp":1572853584000},"page":"e030626","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Testing quality indicators and proposing benchmarks for physician-staffed emergency medical services: a prospective Nordic multicentre study"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5869-6675","authenticated-orcid":false,"given":"Helge","family":"Haugland","sequence":"first","affiliation":[{"name":"Norwegian Air Ambulance Foundation, Oslo, Norway"},{"name":"Department of Emergency Medicine and Pre-Hospital Services, St. Olav University Hospital, Trondheim, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Olkinuora","sequence":"additional","affiliation":[{"name":"Research and Development Unit, FinnHEMS Ltd, Vantaa, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2542-565X","authenticated-orcid":false,"given":"Leif","family":"Rogn\u00e5s","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Aarhus University Hospital, Aarhus N, Denmark"},{"name":"Danish Air Ambulance, Aarhus, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Ohlen","sequence":"additional","affiliation":[{"name":"Airborne Intensive Care Unit, Department of Anaesthesia, Perioperative Management and Intensive Care Medicine, Uppsala University Hospital, Uppsala, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Kr\u00fcger","sequence":"additional","affiliation":[{"name":"Norwegian Air Ambulance Foundation, Oslo, Norway"},{"name":"Department of Emergency Medicine and Pre-Hospital Services, St. Olav University Hospital, Trondheim, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,11,3]]},"reference":[{"key":"2025121409211832000_9.11.e030626.1","doi-asserted-by":"crossref","first-page":"2477","DOI":"10.1056\/NEJMp1011024","article-title":"What is value in health care?","volume":"363","author":"Porter","year":"2010","journal-title":"N Engl J Med Overseas Ed"},{"key":"2025121409211832000_9.11.e030626.2","unstructured":"Institute of Medicine . 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