Performance Assessment of Sri Lankan Pre-Hospital Ambulance Service

Ischemic Heart Disease (IHD) is the leading cause of mortality that raised demand for pre-hospital emergency care in Sri Lanka. Understanding the performance of Sri Lanka's 1990 ambulance service is essential to improve its quality and to reduce morbidity and mortality associated with the disease. This study aims to describe socio-demographic characteristics, evaluate the clinical assessment and management process of patients presenting with acute chest pain of cardiac in origin. A descriptive study conducted in Gampaha District, of the Western Province of Sri Lanka. A total of 154 records of patients rang the 1990 call centre over three months with acute chest pain were selected. Composite values for treatment and examinations as a percentage were plotted on run-charts to assess performance and its variations over the study period. 47.4% of the study group were in 35-65 age group, 53.2% were males and 81.8% had a typical presentation. The median for composite value for examination as a percentage was 89.5% indicating substantial control and alignment with the reference package with normal cause variation. The median composite value for treatment as a percentage was 9.96%, a low value with normal cause variation. A good control of the processes of clinical examination and treatment is apparent. A higher median for composite value for examination as a percentage attributed to the formal training process of the ambulance staff. Although a low median was obtained for the composite value for treatment as a percentage, it was stable and pointed room for improvement.