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Abstract
This case study illustrates practical strategies for implementing a participatory approach to generating frontline-level interest in and support for a service-wide performance indicators report. The specific case involves Boston Emergency Medical Services (Boston EMS) and the development of a performance indicators report on cardiac arrests treated via the city's 911 system. The article highlights approaches used to involve and engage frontline emergency medical technicians and paramedics in the design and use of the report during their required in-service training. The cooperation of these personnel is key, since they must provide the necessary patient data, are a source of valuable technical insights, and ultimately are the implementers of any changes that may result from assessment of the indicators report or ad hoc analysis of the underlying data. The case illustrates how certain presentation strategies within a participatory context may be an effective way to generate frontline interest and support for the development and use of a service-wide performance indicators report in EMS systems and other public service systems.