British example gives hope for standardizing care

Researchers in the U.K. were able to implement consistent prehospital practices for stroke and MI nationwide — can we import to the U.S.?

As we continue to reboot EMS in the United States, international developments in field care can provide insights as to how we might affect our health care system in positive ways. British EMS providers are working to standardize prehospital approaches to stroke and myocardial infraction care, using standardized checklists and other techniques to improve reliability and timelines of possibly critical interventions.

It might seem obvious that we should be able to rapidly and identify key signs and symptoms of these conditions and implement the appropriate care. The British study revealed care had been quite variable. By training providers to use one standardized approach, the researchers were able to demonstrate that prehospital treatment improved in application consistency across the nation.

Whether this translates to improved morbidity and mortality isn’t addressed by the researchers, and that is what really counts. But what’s intriguing about this study is that the guidelines were applied nationwide, and all participating systems showed some level of improvement. Moreover, the techniques that were employed appear simple, easy to train and replicable to other medical conditions.

Many U.S. systems are involved with research designed to improve care implementation and outcomes; the Resuscitation Outcomes Consortium is perhaps one the best-known projects that aims to perform research across multiple systems. Nationwide research may be much harder to perform here in the states, compared to the U.K. — we are a much more fractured network of service providers, with gaps of coverage and poor levels of care. But that should not keep us from keeping our collective eyes on the prize: being part of an integrated health care system providing an array of services that improve patient outcomes. Large-scale research will help us reach that lofty goal.

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