National Prehospital Evidence-Based Guidelines Strategy: A Summary for EMS Stakeholders

Multiple national organizations have recommended and supported a national investment to increase the scientific evidence available to guide patient care delivered by Emergency Medical Services (EMS) and incorporate that evidence directly into EMS systems. Ongoing efforts seek to develop, implement, and evaluate prehospital evidence-based guidelines (EBGs) using the National Model Process created by a multidisciplinary panel of experts convened by the Federal Interagency Committee on EMS (FICEMS) and the National EMS Advisory Council (NEMSAC). Yet, these and other EBG efforts have occurred in relative isolation, with limited direct collaboration between national projects, and have experienced challenges in implementation of individual guidelines. There is a need to develop sustainable relationships among stakeholders that facilitate a common vision that facilitates EBG efforts. Herein, we summarize a National Strategy on EBGs developed by the National Association of EMS Physicians (NAEMSP) with involvement of 57 stakeholder organizations, and with the financial support of the National Highway Traffic Safety Administration (NHTSA) and the EMS for Children program. The Strategy proposes seven action items that support collaborative efforts in advancing prehospital EBGs. The first proposed action is creation of a Prehospital Guidelines Consortium (PGC) representing national medical and EMS organizations that have an interest in prehospital EBGs and their benefits to patient outcomes. Other action items include promoting research that supports creation and evaluates the impact of EBGs, promoting the development of new EBGs through improved stakeholder collaboration, and improving education on evidence-based medicine for all prehospital providers. The Strategy intends to facilitate implementation of EBGs by improving guideline dissemination and incorporation into protocols, and seeks to establish standardized evaluation methods for prehospital EBGs. Finally, the Strategy proposes that key stakeholder organizations financially support the Prehospital Guidelines Consortium as a means of implementing the Strategy, while together promoting additional funding for continued EBG efforts.

众多国家级组织已推荐并支持国家投资，以增加指导紧急医疗服务（EMS）提供的患者护理可用的科学证据，并将该证据直接纳入EMS系统。持续的努力旨在通过联邦紧急医疗服务委员会（FICEMS）和全国EMS咨询委员会（NEMSAC）召集的多学科专家小组创建的全国模型流程，开发和实施评估院前基于证据的指南（EBG）。然而，这些及其他EBG努力相对孤立地进行，国家项目之间的直接合作有限，且在个别指南的实施过程中遭遇挑战。有必要在利益相关者之间建立可持续的关系，以促进共同愿景，进而推动EBG工作的进行。在此，我们总结了全国急诊医师协会（NAEMSP）制定的关于EBG的全国战略，该战略涉及57个利益相关者组织，并得到国家公路交通安全管理局（NHTSA）和儿童EMS项目的财务支持。该战略提出了七个行动项目，以支持推进院前EBG的协作努力。第一个提出的行动是创建一个代表对院前EBG及其对患者结果益处感兴趣的全国医疗和EMS组织的院前指南联盟（PGC）。其他行动项目包括促进支持创建和评估EBG影响的研究，通过改善利益相关者的合作促进新EBG的发展，以及提高所有院前提供者基于证据医学的教育。该战略旨在通过改善指南的传播和纳入协议中，促进EBG的实施，并寻求建立院前EBG的标准化评估方法。最后，该战略提出，关键利益相关者组织应通过财务支持院前指南联盟作为实施战略的手段，同时共同促进对持续EBG努力的额外资金支持。