1、Designation: F 1268 90 (Reapproved 2008)Standard Guide forEstablishing and Operating a Public Information, Education,and Relations Program for Emergency Medical ServiceSystems1This standard is issued under the fixed designation F 1268; the number immediately following the designation indicates the y
2、ear oforiginal adoption or, in the case of revision, the year of last revision. A number in parentheses indicates the year of last reapproval. Asuperscript epsilon (e) indicates an editorial change since the last revision or reapproval.INTRODUCTIONThe Emergency Medical Service (EMS) system exists fo
3、r only one reasonto serve the public. Ifthe system is to perform its functions, the public must be aware of it and must use it to the fullestextent. Because the public is an essential part of the EMS system, every EMS system must supporta public information, education, and relations (PIER) component
4、. However, because other elementssuch as categorization, critical care protocols, communications, and provider training require as muchtime and energy, plus the fact that most administrators lack orientation to public informationprinciples, there is a tendency to approach the public information, edu
5、cation, and relations componentin a less organized and scientific way. Consequently, PIER may suffer a lower priority and maybecome a random or fragmented activity.The fact is that people do not readily change their attitudes and behavior unless it is specifically andimmediately demonstrated to them
6、 that there is a need to do so. In this day of complex media messagesending, it is often difficult to get the attention of the general public in the first place. To achieve asuccessful PIER program, it should be an organized and systematic effort, including:(1) An assessment of the attitudes, awaren
7、ess and knowledge about ones health and access to thehealth delivery system;(2) A determination of the knowledge needs and identifiable components of the general public;(3) A method for delivery of information that is relevant, accessible, understandable, acceptable,usable, timely, and cost-effectiv
8、e;(4) Ensure that, as much as possible, the information is integrated into attitudes and behaviors ofdaily living; and(5) Evaluate PIER objectives to assess whether or not behavioral changes have occurred, withbeneficial effect upon the individual and ultimately society, and adjusting future PIER ac
9、tivities asindicated.Education about health matters has to be interesting, enjoyable, uncomplicated, relevant, and havesome evidence of immediate concrete benefit to the individuals activities. In EMS, some of theprograms are intrinsically appealing: for example, people might readily participate in
10、CPR training asit represents a dramatic and demonstrable learning process. However, citizens are less enthusiasticabout access information, abuse and misuse messages, or other facts which are to them, less dramaticand apparently less relevant.1This guide is under the jurisdiction of ASTM Committee F
11、30 on EmergencyMedical Services and is the direct responsibility of Subcommittee F30.03 onOrganization/Management.Current edition approved Feb. 1, 2008. Published March 2008 . Originallyapproved in 1990. Last previous edition approved in 2003 as F 1268 90 (2003).1Copyright ASTM International, 100 Ba
12、rr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959, United States.1. Scope1.1 The purpose of this guide is to provide national volun-tary standards and recommendations to effectively provideemergency medical service system information and educationto the public.2. Referenced Documents2.1
13、 ASTM Standards:2F 1086 Guide for Structures and Responsibilities of Emer-gency Medical Services Systems Organizations3. Terminology3.1 Descriptions of Terms:3.1.1 demographicsthe study of the descriptive character-istics of the population. They have long been used to divide orsegment the population
14、.3.1.2 external PIER attributesfor the public or user of theEMS system.3.1.3 internal PIER attributeswithin the EMS system forits participants and providers.3.1.4 public educationan activity that conveys knowledgeor training, or both, in specific skills.3.1.5 public informationan activity that factu
15、ally teacheswhat the EMS system is and how to enter and use it.3.1.6 public information, education and relations (PIER)programthe totality of efforts in all three areas. It is ideallywell integrated, unified, focused, with planning and systematicexecution.3.1.7 public information offcera person who
16、dissemi-nates appropriate and timely facts.3.1.8 public relationsan activity used to foster positivepublic attitudes and enhance trust and credibility about theEMS system and its providers.4. Significance and Use4.1 It is essential to have the publics understanding andsupport for the EMS system to e
17、nsure its proper developmentand utilization.4.2 This guide encompasses those procedures, consider-ations, and resources that are necessary for a successful EMSpublic information, education, and relations program. ComplexEMS systems may integrate or augment, or both, this guide inits entirety. Less c
18、omplex systems may need to collaboratewith other EMS organizations and related agencies. Responsi-bility for this guide will vary by level of authority, that is, state,regional, and local. (See Guide F 1086.)4.3 The PIER tasks involve research, planning, production,distribution, and evaluation. Prod
19、uction requires significantresources and expertise and may be done most appropriately atthe higher level, such as regional, state, and national levels.5. Statement of the Problem5.1 Despite the development and rapid expansion of emer-gency medical services following the passage of the HighwaySafety
20、Act of 1966 and the Emergency Medical ServicesSystem Act of 1973, underutilization and improper utilizationof services still exists in the system. The general public lacksinformation on how to access and use the EMS systemappropriately.5.2 The public needs to learn what EMS is and especiallythat it
21、is a system, the importance of utilizing EMS, how toaccess it, and what to do and not to do until the ambulance andtherefore the EMS system arrives. If the public knowledgeconcerning EMS can be improved, then it is likely thatappropriate utilization of EMS will increase.6. Elements of a PIER Program
22、 for EMS6.1 The essential elements of an effective public informa-tion, education, and relations program include, but are notlimited to:6.1.1 An understanding of EMS system design and opera-tion.6.1.2 Proper access to the system (9-1-1, telephone, callbox).6.1.3 Self help, for example, CPR, First Ai
23、d, Vial of Life,Medic Alert, and other emergency data devices.6.1.4 Provision for the appropriate and timely release ofinformation on EMS related events, issues, and public relations(damage control).6.1.5 Evaluation of EMS.6.1.5.1 Importance of user and provider input.6.1.5.2 How to effectively coll
24、ect and assimilate input.6.1.6 Current health and safety habits as they relate toprevention and reduction of health risks for the public andproviders.6.1.7 Provision for recruitment campaigns for career andvolunteer personnel in EMS.7. Organizational Commitment to and Authority forPIER7.1 There must
25、 be an organizational commitment from theEMS system (See Fig. 1.)7.2 To have an effective PIER program the chief executiveofficer (CEO) must be personally committed to PIER and beable to make definitive decisions concerning committment oforganizational resources. This CEO must assign a PIER2For refe
26、renced ASTM standards, visit the ASTM website, www.astm.org, orcontact ASTM Customer Service at serviceastm.org. For Annual Book of ASTMStandards volume information, refer to the standards Document Summary page onthe ASTM website.NOTE 1In order to provide the elements of the PIER program, thisplanni
27、ng model should be followed.FIG. 1 PIER Planning ModelF 1268 90 (2008)2director who has access to the CEO. This person may in somesmall areas also be the CEO. The CEO must be continuallyapprised of the progress of the PIER program.7.3 The organization must designate a responsible andcommitted public
28、 information and education person withdemonstrated ability, who is accountable for the PIER pro-gram. This person will also provide the mechanism forestablishing standard operating procedures for the occurrenceof unplanned events, and appropriate training for PIOs orothers assuming that role. The PI
29、Os responsibility mayinclude, but not be limited to the news media concerning thenature and extent of an incident and emergency medical care,for planned or unplanned events.8. Identify Resources and Funding8.1 A successful PIER program must have a source offunding exclusively dedicated to PIER. Fund
30、ing sources existat federal, state, and local levels.8.2 Greater expenditures may be required in areas wherehard costs such as media space and time, and morbidity andmortality from medical/trauma emergencies are higher thannational norms.9. Develop System Profile and Identify Major ProblemAreas9.1 I
31、n developing the system profile you should utilizeexisting data included in 9.2.1 to 9.3.1.10. If public perceptiondata is not readily available it may be necessary to collect thedata using a valid research methodology. Development of theprofile will enable PIER personnel to identify broad problemar
32、eas or possible problem areas, and other factors that mayaffect the PIER program in a positive or negative manner.9.2 Astatistically valid comprehensive poll must be taken toestablish a baseline of information on the EMS system opera-tion. The required baseline components of the poll shouldinclude:9
33、.2.1 Demographic VariablesThese include age, race,sex, population characteristics and trends, income levels,predominant languages, education levels, cultural factors, andother socioeconomic factors (religion, employment, and re-lated).9.2.2 System Utilization VariablesThese include numberand type of
34、 EMS personnel (volunteer and paid) and attritionrate, trends in EMS responses (coverage and response time),access type (9-1-1, tele, multi or single, number, radio, and soforth), appropriate use or abuse problems, or both, and out-come costs and other utilization data.9.2.3 Medical FacilitiesThese
35、include number, location(and service area), beds, type, trauma center designation,teaching facility, and the interface/cooperation with the EMSsystem.9.2.4 Current Public Information and EducationProgramsThese include type and scope of existing pro-grams, effectiveness, program costs and funding sou
36、rces, andrelated programs of other organizations and institutions (forexample, AHA, ARC, and so forth).9.2.5 Current Public Perceptions and KnowledgeThisincludes knowledge of existing system structure, capabilities,and quality, access to the system, self help programs (CPR, firstaid, and related pro
37、grams), and current health habits, forexample, diet, smoking, exercise, substance abuse, and soforth, as it is related to prevention and reduction of emergencyhealth risks.9.2.6 Emergency Health DataThis includes morbility/mortality from critical care, subgroups of cardiac, trauma,poison, drugs, bur
38、ns, neonate, CNS, behavioral, and otheremergency health data that may affect the EMS system. Thisincludes prehospital, hospital, and rehabilitation data.9.2.7 Risk Variables (Possible Public Health Hazards andPossible Dangers in Particular Area or System)These in-clude insufficient medical facilitie
39、s, cultural, occupational,criminal, recreational, transportation, system maturity (ALSversus BLS capabilities), weather, sanitation, disease, andgeographic considerations (rivers, mountains).9.2.8 Media ResourcesThese include type (radio, TV,print, public, private), availability, cost, public relati
40、ons andmarketing firms, and contacts.9.2.9 Contributory VariablesThese include adjoiningsystems/resources, political and financial considerations, typeand effectiveness of EMS management at all levels, andapplicable regulatory factors.9.3 Methods to Accomplish System Profile and BaselineStudy:9.3.1
41、Compile data already in existence from:9.3.1.1 Census,9.3.1.2 Vital statistics (health, government, and planningagencies, phone companies, realtors, and so forth),9.3.1.3 Commercial sources,9.3.1.4 Voluntary organizations (AHA, ARC, ATS),9.3.1.5 National and state agencies,9.3.1.6 Current EMS system
42、 data,9.3.1.7 College/universities,9.3.1.8 Chambers of commerce,9.3.1.9 Cultural/civic organizations, and9.3.1.10 Medical facilities registries.9.3.2 Collect data not currently in existence using validresearch methodologies. Identify appropriate technical exper-tise who can assist with the research
43、methodology.10. Develop Goals and Objectives10.1 This guide requires the development of tangible PIERgoals and objectives. Goals must be realistic and should beconsistent with program needs. PIER objectives whether longor short term, must be concise, consistent, attainable, measur-able, written, fle
44、xible, revised periodically, reliable, and ac-countable. Since objectives are, by definition, measurable, theirimpact can be estimated.10.1.1 Measurement criteria and evaluation mechanismsshould be identified in advance and minimal standards forperformance should be set. Baseline data will also help
45、 todetermine priorities of the goals and objectives identified.Goals and broad objectives should be analyzed according to thepublic as a whole, and specific objectives may be addressed toa distinct public segment.NOTE 1By way of example, baseline data can be gathered fromsystem analysis to determine
46、 the false alarm rate, and from survey todetermine the percentage of adult population who know 9-1-1. One goalmight then be to “increase the appropriate use of 9-1-1.” Objectives mightF 1268 90 (2008)3be (1) to ensure that 80 % of the adult population knows to dial 9-1-1 formedical emergencies, and
47、(2) to decrease false alarms to less than 2 % ofthe total calls by _ (date).10.2 The final product of the goal setting process is a workplan that should include explicit goals and objectives.11. Writing the PIER Plan11.1 The work plan should include goals, objectives, imple-mentation steps, required
48、 resources, and time lines. Manage-ment roles, functions, and activities should be identified.Identify specific problems anticipated in accomplishment of agoal: develop alternative solutions that are more realistic ifnecessary.11.2 This guide requires the written preparation of a PIERplan and then t
49、he implementation of that plan, as well as theevaluation of the effectiveness of the PIER plan and propermodification to meet changing needs on an ongoing basis.11.3 There must be a process for the identification of publicinformation needs for the PIER plan and several methods andrequirements are noted within this guide.11.4 The development of a PIER plan must include thefollowing information to ensure the PIER plan is realistic andthat it has tangible goals and measurable objective and is animprovement over past performance data (see 9.2).12. Assemble R
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