NEMSQA 2025 Report: In trauma care, consistency outperforms heroics

In this episode of EMS One-Stop, Rob Lawrence is joined by his own Medical Director, Dr. Maia Dorsett, to unpack the 2025 NEMSQA Measures Report — a deep dive into trauma-focused quality measures built largely from NEMSIS data. Dr. Dorsett frames the discussion around the central aim of quality improvement: Are we doing a good job? Are we delivering the best possible care? How do we get better? From pediatric vital signs to traumatic brain injury (TBI) fundamentals, she walks listeners through what the report reveals, what it can’t reliably measure yet, and why some of the “sexy” procedures are too rare to serve as useful system-wide metrics. The conversation highlights a recurring theme: fundamentals matter most. Dr. Dorsett explains how measures like complete vital signs and avoiding secondary brain injury in TBI (hypoxia, hypotension, hyperventilation) can drive meaningful outcomes — even during relatively short prehospital intervals. She also points out where current measurement approaches unintentionally create documentation burden for clinicians, arguing that systems should do more of the “figuring out” (like trauma center designation and prenotification capture) without requiring extra clicks. The episode closes with a call to action: anyone can join NEMSQA, contribute to the work, and help shape what EMS quality measurement becomes next. Memorable quotes from Dr. Maia Dorsett “I think the most fundamental question in quality improvement is, are we doing a good job?” “I think part of the value of this report is specifically looking at those things and saying what should we be measuring using NEMSIS data or how should things be integrated into that database so that the answers are there rather than needing to be documented on each individual case?” “If there's one thing that you're going to take away from this trauma report is that, the sexy stuff is important, but it happens rarely. And if you want to improve care in your system, it's about the fundamentals of good care.” Additional resources NEMSQA 2025 Report Release EMS One-Stop: Leading through momentum: Dr. Douglas Kupas on steering NAEMSP Episode timeline 00:31 – Rob welcomes listeners; introduces the 2025 NEMSQA measures discussion and notes prior episode with Dr. Jeff Jarvis 01:10 – Dr. Dorsett joins; holiday surge discussion and flu impact on EDs and admissions 03:08 – Dr. Dorsett explains her role as co-chair of NEMSQA’s Measure Analysis and Research Committee; trauma focus of the 2025 report; pain measures not included due to active research 05:00 – NEMSIS scale and opportunity: extracting meaningful measures from a massive national dataset 05:35 – Dr. Dorsett on what NEMSIS measures well vs. what it shouldn’t force clinicians to document (system should determine trauma center status) 07:46 – “HALO procedures” table: why rare interventions shouldn’t become national quality measures 10:17 – Trauma 08: complete vital signs; pediatric gap (adults ~93% vs pediatrics ~85% in discussion) 14:22 – TBI measures: preventing secondary brain injury; why fundamentals outperform “sexy” fixes; correction rates for hypotension/hypoxia discussed 21:39 – Trauma 04: trauma triage criteria and transport to trauma centers; why national measure looks low; documentation field limitations 24:17 – State collaboration comparison: using state trauma center designation data shifts performance dramatically (often 75–90%+ in examples) 26:55 – Trauma 14: hospital prenotification; importance and measurement challenges (multiple modalities, inconsistent capture) 30:01 – Rob raises operational/policy concerns about trauma alerts and incentives; Dr. Dorsett adds nuance about local criteria variation 33:22 – Closing: Dr. Dorsett’s “fundamentals matter” takeaway; impact at scale 34:44 – Dr. Dorsett plugs joining NEMSQA as an individual/agency; committees are open 35:31 – NAEMSP Tampa preview; Dr. Dorsett: “The people” are why she goes — leaves energized with new ideas Enjoying the show? Email [email protected] to share feedback or suggest guests for a future episode.