2010 PSOW Conference - Quality Management Program

EMS Quality Management Program Michael D. Curtis, MD, FACEP EMS Medical Director

Medical Direction Triad Quality Management Training Protocols

Five Major Components
QA
CQI
After Action Reviews
RSI
Cardiac Arrest
(Other?)

Quality Management Policies
All documents are confidential and include language on them about confidentiality
We do not discuss specific contents of confidential quality management activities in public meetings or with our oversight boards and committees
Participants in quality management activities are required to maintain confidentiality

Quality Assurance
Retrospective review of a single case
Used in problem cases
To monitor new protocols or procedures (e.g., Ketamine use)
Used in educational case reviews
Access to records
Standard Form

QA Form

CQI
Using descriptive statistics to assess performance on 19 quality indicators over three patient scenarios
Scenarios:
Cardiac Chest Pain
Respiratory Distress
ALOC
In development: Major Trauma

Eight Services Involved
Portage County – SPFD
Portage County – AFD
United Ambulance Service
Wisconsin Rapids Fire Department
Merrill Fire Department
Schofield Fire Department
Weston Fire Department
Rothschild Fire Department

CQI Quality Indicators
Vitals Signs – Complete
Vital Signs < 15 minutes
Vital Signs – Repeat
Oxygen
Lung Sounds
Cardiac Monitor
IV Attempted
IV Success Rate
IV SOFA
IV Established
ALS Intercept
Glucose Check (ALOC)
Nebulizer (RD)
CPAP (RD)
Aspirin (CCP)
12-Lead EKG (CCP)
STEMI Scene Time <20min (CCP)

Example of Score Card

Major Incidents
Multiple Patients
Multiple Agencies Responding

Meeting place
People included
Confidentiality
Recording

After Action Review Form

The Challenge
Once you identify your problems or flaws, what can you do to fix them and prevent them from occurring repeatedly?
Focus on individual performance?
Focus on department-wide education?
Focus on standardizing work processes?
How can we learn from each other at the leadership level to better manage quality improvement?

Questions?

2010 PSOW Conference - Quality Management Program

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