Developing Quality Indicators for Helicopter Emergency Medical Services Coordination in Norwegian Emergency Medical Communication Centrals: A Consensus Process

Abstract

Objective Efforts to optimize the use, availability, and safety of helicopter emergency medical services (HEMS) is important. A lack of consistent and comprehensive flight dispatch procedures and a lack of use of safety technology are recurring safety problems. Reports after several major incidents pointed toward a possible gain by coordinating Norwegian HEMS from regional emergency medical communication centrals. Our objective was to develop and implement relevant quality indicators before such implementation in central Norway. Methods We recruited an expert panel of 24 persons representing Norwegian health authorities, emergency medical communication centrals, and HEMS bases and performed a 3-step e-mail–based Delphi process to develop relevant quality indicators. Each indicator was assessed according to their feasibility, rankability, actionability, and variability. To reach a consensus, a median score of 5 or more on a 6-point Likert scale in step 3 was needed. Results A total of 61 quality indicators were proposed. Of the 14 indicators that reached a consensus, 12 of these were considered process indicators, and 2 were bordering to outcome indicators. Conclusion We applied a Delphi process method to develop quality indicators for HEMS coordination and flight following. An experienced and heterogeneous expert panel suggested and reached a consensus on which quality indicators should be applied.