In relation to EMS workflow, metrics/KPI’s are a way to evaluate how your own organizational processes are performing.
Are they working to the highest level possible, or is there room for improvement? Are you providing timely patient care? Is your response time up-to-speed? Is the turnaround time from dispatch to trip to bill to reimbursement acceptable? Are you meeting cash flow thresholds throughout the month?
We will look at these questions and more, in the following overview of metrics/KPI’s and their role in the 5 critical phases of an optimized EMS workflow. The purpose of metrics in process/quality improvement is to develop measurable service delivery standards and evaluate/benchmark EMS organizational performance against those standards.
Without key metrics for Call to Dispatch, how can operational leads tell if they have enough active trucks available or crews able to meet response time goals? For example, metrics for this phase may include:
During this phase, there must be clear communications between dispatch and EMS crews. Crews need to know when they are assigned a call, there must be fast and efficient transfer of data from dispatch to the ePCR, and compliance with regulations must be maintained. For example, metrics for this phase may include:
In the third phase of EMS workflow, communication between field crews and quality assurance staff is critical to ensuring complete and accurate patient care reports. If crews aren’t getting their patient care reports turned in on time, if key state reporting and billing data is missing or inaccurate, it may mean delayed state reporting and, more importantly, delayed reimbursement. For example, metrics for this phase may include:
Percentage of ePCR’s that did not have to be returned to crew for correction, for a set period of time, with alerts if over the user-defined threshold.
As we have observed before, the QA/QI to Billing phase is a cooperative effort, above all else. It is crucial, at this stage, to make sure that the QA/QI process is completed, in a timely manner, so that there are no delays in the billing process. For example, metrics for this phase may include:
The number of incomplete ePCR’s sitting in the QA queue, with alerts if over the user-defined threshold.
Obviously, billing must be accurate and optimized, in order to stay compliant and maintain a healthy cash flow for your EMS business. Electronic submission of claims is key here, as well as keeping tabs on denials and appeals. For example, metrics for this phase may include:
Average time from when the ePCR was released to billing until the time the bill was transmitted, for a certain period of time, with alerts if over the user-defined threshold.
Average time from when the ePCR was released to billing until the time that the first payment was posted, for a certain period of time, with alerts if over the user-defined threshold.
Average time from when the ePCR was released to billing until the time the ePCR was closed, for a set period of time, with alerts if over the user-defined threshold.
The total cash amount posted month-to-date, with alerts if under a set dollar amount for aggregated monthly average.
In summary, a defined EMS workflow is the critical, first step in achieving efficiency and quality dispatching, patient care reporting, and billing. However, just because you have a defined EMS workflow process, doesn’t guarantee the steps in the process are getting executed in an efficient and quality manner.
Furthermore, it is important to define and monitor metrics/KPIs to be able to measure the efficiency and quality of your EMS workflow process. This will allow EMS organizations to monitor, measure, and make changes that optimize the efficiency and quality of EMS workflow on a continuous basis.
AIM Online Software and Services offers end-to-end integrated EMS workflow, which gives EMS providers the ability to monitor, measure, and optimize the efficiency and quality of your EMS organization.