The most obvious deficiency in the current evaluation of disaster response is the lack of objective, quantifiable measures of performance. This frequently leads to assessments that are highly subjective depending on the evaluator, does not provide those who are planning with targets to achieve, and does not allow for measures that they have improved their preparedness. The goal of this research project is to offer recommendations for government agencies at the federal, regional, and local levels, public health departments, and health care institutions to aid in the development of pediatric emergency management performance measures.

The goal was achieved through the application of traditional quality principles to the assessment of emergency management efforts and to the use of innovative analytic methodologies to develop comprehensive approaches to performance measurement in emergency management.

When one discusses performance measures, it is important to remember that these are metrics we use to improve the quality of care. With regard to emergency management, performance measures are used to increase capacity and efficiency. A classic approach to health care performance measures is to discuss them with regard to the domains of structure, process, and outcome. Recently, in addition to these domains, volume has also become an important predictor of clinical outcomes. Although we believe that these domains can be applied to emergency management functions and the development of performance measures for disasters, there are some fundamental differences when compared with their use in development and categorization of traditional health care metrics which have been built in to our modification of these domains to emergency preparedness. This approach, quantitative methodology and consensus development process, when applied, will significantly advance pediatric preparedness. Ultimately, these pediatric specific measures must exist and be used to assess current levels of performance and guide resource allocation and targeted improvement efforts.