1、Designation: F 1268 90 (Reapproved 2003)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.1. Scope1.1 The purpose of this guide is to provide natio
11、nal volun-tary standards and recommendations to effectively provideemergency medical service system information and educationto the public.1This guide is under the jurisdiction of ASTM Committee F30 on EmergencyMedical Services and is the direct responsibility of Subcommittee F30.03 onOrganization/M
12、anagement.Current edition approved Sept. 10, 2003. Published October 2003. Originallyapproved in 1990. Last previous edition approved in 1998 as F 1268 90 (1998).1Copyright ASTM International, 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959, United States.2. Referenced Documents
13、2.1 ASTM Standards:F 1086 Guide for Structures and Responsibilities of Emer-gency Medical Services Systems Organizations23. 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 populat
14、ion.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 fa
15、ctually 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 w
16、ho 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 t
17、o ensure 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. Les
18、s complex 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. P
19、roduction 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 HighwaySafe
20、ty 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
21、it 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 Prog
22、ram 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
23、 Aid, 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 c
24、ollect 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 m
25、ust 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 PIERdirect
26、or 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 information and education person withdemonstrated ability, who is accountabl
27、e for the PIER pro-gram. This person will also provide the mechanism forestablishing standard operating procedures for the occurrence2Annual Book of ASTM Standards, Vol 13.02.NOTE 1In order to provide the elements of the PIER program, thisplanning model should be followed.FIG. 1 PIER Planning ModelF
28、 1268 90 (2003)2of unplanned events, and appropriate training for PIOs orothers assuming that role. The PIOs 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
29、 and Funding8.1 A successful PIER program must have a source offunding exclusively dedicated to PIER. Funding 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/traum
30、a emergencies are higher thannational norms.9. Develop System Profile and Identify Major ProblemAreas9.1 In 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 va
31、lid research methodology. Development of theprofile will enable PIER personnel to identify broad problemareas or possible problem areas, and other factors that mayaffect the PIER program in a positive or negative manner.9.2 A statistically valid comprehensive poll must be taken toestablish a baselin
32、e of information on the EMS system opera-tion. The required baseline components of the poll shouldinclude:9.2.1 Demographic VariablesThese include age, race,sex, population characteristics and trends, income levels,predominant languages, education levels, cultural factors, andother socioeconomic fac
33、tors (religion, employment, and re-lated).9.2.2 System Utilization VariablesThese include numberand type of 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 u
34、se or abuse problems, or both, and out-come costs and other utilization data.9.2.3 Medical FacilitiesThese 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 Educat
35、ionProgramsThese include type and scope of existing pro-grams, effectiveness, program costs and funding sources, 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 st
36、ructure, capabilities,and quality, access to the system, self help programs (CPR, firstaid, and related programs), 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 Healt
37、h DataThis includes morbility/mortality from critical care, subgroups of cardiac, trauma,poison, drugs, burns, 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 He
38、alth Hazards andPossible Dangers in Particular Area or System)These in-clude insufficient medical facilities, cultural, occupational,criminal, recreational, transportation, system maturity (ALSversus BLS capabilities), weather, sanitation, disease, andgeographic considerations (rivers, mountains).9.
39、2.8 Media ResourcesThese include type (radio, TV,print, public, private), availability, cost, public relations andmarketing firms, and contacts.9.2.9 Contributory VariablesThese include adjoiningsystems/resources, political and financial considerations, typeand effectiveness of EMS management at all
40、 levels, andapplicable regulatory factors.9.3 Methods to Accomplish System Profile and BaselineStudy:9.3.1 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
41、.1.4 Voluntary organizations (AHA, ARC, ATS),9.3.1.5 National and state agencies,9.3.1.6 Current EMS system 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 usi
42、ng validresearch methodologies. Identify appropriate technical exper-tise who can assist with the research 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. PI
43、ER objectives whether longor short term, must be concise, consistent, attainable, measur-able, written, flexible, revised periodically, reliable, and ac-countable. Since objectives are, by definition, measurable, theirimpact can be estimated.10.1.1 Measurement criteria and evaluation mechanismsshoul
44、d be identified in advance and minimal standards forperformance should be set. Baseline data will also help 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 dist
45、inct public segment.NOTE 1By way of example, baseline data can be gathered fromsystem analysis to determine 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 mightbe (1) to
46、 ensure that 80 % of the adult population knows to dial 9-1-1 formedical emergencies, and (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.F 1268 90 (2003)311
47、. Writing the PIER Plan11.1 The work plan should include goals, objectives, imple-mentation steps, required resources, and time lines. Manage-ment roles, functions, and activities should be identified.Identify specific problems anticipated in accomplishment of agoal: develop alternative solutions th
48、at are more realistic ifnecessary.11.2 This guide requires the written preparation of a PIERplan and then the 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
49、 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 Resources12.1 There are four types of resources that can be as-sembled: human, information, financial, and materials/equipment. Select from these resources as necessary to imple-ment the plan.12.2
