The Delta-MEES is used as a parameter to collect data on the quality of the results of an emergency service operation, but it is not very practical. Psychological finding and its change—for example, stabilization as a result of crisis intervention—are not captured.
To determine the MEES, technical equipment is needed in 5 out of the 7 items. To be able to calculate the Delta-MEES, all parameters have to be documented at the beginning and at the end of the emergency care. It is questionable whether an electrocardiogram should be taken (without a medical indication), solely for the purpose of the Delta-MEES.
I see the deficits in the documentation compliance of the MEES in the data from Baden-Württemberg as a result of these difficulties. Furthermore, this showed a downward trend (relative to the total number of patients) from 53.7% (2005) to 46.4% (2008). Even the listed percentages for “Delta-MEES available” are unsatisfactory: a corresponding quality parameter should be collected for all operations in the ideal case scenario.
A simpler instrument is the “acknowledging number” (Rückmeldezahl, RMZ) (1). A technical-quantitative measurement is not compulsory in order to categorize the 5 items—consciousness, breathing, circulation, pain, and paralysis—in 5 quantitative expressions. However, psychological problems are currently not captured by this confirmation number either. I have therefore proposed adapting the confirmation number accordingly (2).
The study from Hesse (3) compares the confirmation number with the MEES. Since the results are highly consistent, the confirmation number is recommended to capture the quality of results for the emergency services for Hesse because of its greater practical applicability.
If state-wide quality assurance is introduced in Bavaria, I recommend adopting the confirmation number (modified to include psychological diagnoses) as the primary quality parameter.
References
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