This version of the State EMS Forms was posted on this site on 04/11/2007, and revised by the state on 7/31/2006. Last reviewed on 1/11/2010.

Per the Arizona EMS website:

The Premier EMS Agency Program is a voluntary initiative, open to any EMS agency in the State of Arizona that is dedicated to improving the care provided to their patients/customers by implementing a four-part program:1. Documenting agency leadership commitment 2. Developing a robust quality improvement program 3. Collecting and submitting electronic EMS patient care reports 4. Ensuring the data are fed back into the quality improvement program to inform the analysis and improvement of care.

The Premier EMS Agency Program is not mandatory - Participation is voluntary; the State provides technical assistance, reporting and a centralized database to assist the agency and regions in accomplishing their goals.  The BEMSTS database is separate and we never share data with the NEMSIS database unless the agency requests that we do so in writing. BEMSTS has adopted many of the NEMSIS standards as these are now the norm for most commercially available electronic patient care report programs. BEMSTS encourages every interested agency to participate.

Per the 2009 Annual Report to the Director:

Arizona State EMS Registry

The Bureau is developing a Quality Assurance (QA) Program as well as a web-based Arizona EMS Database designed to capture standardized prehospital care data in a format consistent with the National EMS Information System (NEMSIS) of the National Highway Traffic Safety Administration (NHTSA). The quality assurance component and the EMS Database comprise the Arizona Premier EMS Agency Program (PEAP). The PEAP is essentially a quality improvement program centered on four diseases:

Out–of–Hospital Cardiac Arrest
Stroke
STEMI
Trauma

Participating agencies must ensure administrative support for the QA process, review all cases associated with the target diseases, use the information gleaned from the case reviews to educate staff and if possible, submit electronic patient care reports to the Arizona EMS Database. The Arizona EMS Database, in its final configuration, will have interoperability with the Arizona State Trauma Registry (ASTR, the Arizona Department of Health Services (ADHS) Hospital Discharge Database and Emergency Department Database, the ADHS S.H.A.R.E 10 (cardiac arrest) and A.S.P.I.R.E. (stroke) databases, and the Arizona Department of Transportation (ADOT) Crash Data. The Arizona EMS Database, in conjunction with the other patient care databases, will assist the Bureau in modifying existing and introducing new treatment protocols and guidelines to promote a regionalized EMS and trauma system that ensures each patient receives the right level of care at the right facility in the right amount of time. The PEAP will also enable the Bureau and individual EMS agencies to evaluate, measure, and improve targeted performance measures via an evidence-based approach. EMS agencies will be able to compare their individual performance against aggregated regional and statewide performance. To facilitate the process, the Bureau will be able to generate standard reports and special reports on request, as well as enable individual EMS agencies to generate their own reports.

Click on the thumbnails below to view a full sized image.

Select the following to view a printable Acrobat (.PDF) version. 

Draft NEMSIS EMS Data Elements v2.2.1 Arizona (.XLS,673.50k)

PREMIER EMS AGENCY-SYSTEM PROGRAM DATA DICTIONARY AND USER’S MANUAL VERSION 4.2A  5/2009 (.PDF,1550.23k)

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