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2010 PSOW Conference - Quality Management Program


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2010 PSOW Conference - Quality Management Program

  1. 1. EMS Quality Management Program Michael D. Curtis, MD, FACEP EMS Medical Director
  2. 2. Medical Direction Triad Quality Management Training Protocols
  3. 3. Five Major Components <ul><li>QA </li></ul><ul><li>CQI </li></ul><ul><li>After Action Reviews </li></ul><ul><li>RSI </li></ul><ul><li>Cardiac Arrest </li></ul><ul><li>(Other?) </li></ul>
  4. 4. Quality Management Policies <ul><li>All documents are confidential and include language on them about confidentiality </li></ul><ul><li>We do not discuss specific contents of confidential quality management activities in public meetings or with our oversight boards and committees </li></ul><ul><li>Participants in quality management activities are required to maintain confidentiality </li></ul>
  5. 5. Quality Assurance <ul><li>Retrospective review of a single case </li></ul><ul><li>Used in problem cases </li></ul><ul><li>To monitor new protocols or procedures (e.g., Ketamine use) </li></ul><ul><li>Used in educational case reviews </li></ul><ul><ul><li>Access to records </li></ul></ul><ul><li>Standard Form </li></ul>
  6. 6. QA Form
  7. 7. CQI <ul><li>Using descriptive statistics to assess performance on 19 quality indicators over three patient scenarios </li></ul><ul><li>Scenarios: </li></ul><ul><ul><li>Cardiac Chest Pain </li></ul></ul><ul><ul><li>Respiratory Distress </li></ul></ul><ul><ul><li>ALOC </li></ul></ul><ul><li>In development: Major Trauma </li></ul>
  8. 8. Eight Services Involved <ul><li>Portage County – SPFD </li></ul><ul><li>Portage County – AFD </li></ul><ul><li>United Ambulance Service </li></ul><ul><li>Wisconsin Rapids Fire Department </li></ul><ul><li>Merrill Fire Department </li></ul><ul><li>Schofield Fire Department </li></ul><ul><li>Weston Fire Department </li></ul><ul><li>Rothschild Fire Department </li></ul>
  9. 9. CQI Quality Indicators <ul><li>Vitals Signs – Complete </li></ul><ul><li>Vital Signs < 15 minutes </li></ul><ul><li>Vital Signs – Repeat </li></ul><ul><li>Oxygen </li></ul><ul><li>Lung Sounds </li></ul><ul><li>Cardiac Monitor </li></ul><ul><li>IV Attempted </li></ul><ul><li>IV Success Rate </li></ul><ul><li>IV SOFA </li></ul><ul><li>IV Established </li></ul><ul><li>ALS Intercept </li></ul><ul><li>Glucose Check (ALOC) </li></ul><ul><li>Nebulizer (RD) </li></ul><ul><li>CPAP (RD) </li></ul><ul><li>Aspirin (CCP) </li></ul><ul><li>12-Lead EKG (CCP) </li></ul><ul><li>STEMI Scene Time <20min (CCP) </li></ul>
  10. 10. Example of Score Card
  11. 11. After Action Reviews <ul><li>Major Incidents </li></ul><ul><li>Multiple Patients </li></ul><ul><li>Multiple Agencies Responding </li></ul>
  12. 12. After Action Reviews <ul><li>Meeting place </li></ul><ul><li>People included </li></ul><ul><li>Confidentiality </li></ul><ul><li>Recording </li></ul>
  13. 13. After Action Review Form
  14. 14. The Challenge <ul><li>Once you identify your problems or flaws, what can you do to fix them and prevent them from occurring repeatedly? </li></ul><ul><ul><li>Focus on individual performance? </li></ul></ul><ul><ul><li>Focus on department-wide education? </li></ul></ul><ul><ul><li>Focus on standardizing work processes? </li></ul></ul><ul><li>How can we learn from each other at the leadership level to better manage quality improvement? </li></ul>
  15. 15. Questions?