Assignment: Federal Interagency Committee
Summary and future directions
Clinical standards drive value in health care by improving quality of care: removing unwanted variation in a system drives reductions in waste, minimizes error, and improves throughput. Systematically developed guidelines can be implemented effectively utilizing best evidence for leveraging known enablers and eliminating barriers to adoption. Across the EMSC continuum, wide variations in practice have demonstrated opportunities for clinical standards to improve value. These strategies may include system- based clinical decision support and local analytics platforms to drive iterative improvement centered on such a shared baseline of care.
Across the EMSC continuum, we anticipate a continued growth in clinical standards activities and improvement science initiatives to develop and implement them as stakeholders demand greater transparency in data, and attribution models for best practices illustrate new opportunities for spread. Efforts to support prehospital clinical standards development and implementation have been driven and supported by a number of agencies such as the National Highway Traffic Safety Administration, the Health Resources Services Administration through the EMSC program, the Federal Interagency Committee on EMS, and the National EMS Advisory Council. Strategies included the creation of a prehospital guidelines consortium, the development, promotion and implementation of prehospital evidence-based guidelines, education and research on prehospital evidence-based guidelines, and standardization of evaluation methods for prehospital evidence-based guidelines.41 The greatest potential for establishing value of clinical standards in prehospital work will likely emerge from standardization of evaluation strategies to link outcomes to local, regional, state, and federal efforts at implementing pediatric prehospital evidence-based guidelines.
This illustrates that collection, analysis, and timely dissemination of accurate clinical and throughput data aligned with clinical pathways changed behavior and improved care outcomes.48 Across the Texas Children’s Hospital continuum, from ED to inpatient units to discharge, the total cost savings across a subset of 21 diseases for which guidelines were available in fiscal year 2016 was a net difference of $33.5 million in variable direct costs, or the costs directly attributable to the additional burden of care for the patient calculated relative to the personnel time and resources consumed.
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