Amy Gutman MD Tobey Emergency Associates EMS Medical Director
[email protected]
Slide 2
Review concepts & reasoning behind CQI & chart review
Discuss benchmarks Key Performance Indicators Review common
trip-ups in chart reviews Consider differences between not done
& not charted Show you how to implement a basic CQI Process in
your Agency EMS Quality Improvement Plan (EQuIPt)
Slide 3
Slide 4
Theory-based, data-driven management system that looks at
processes & outcomes to improve X Tools to quantify what we do
Search for common causes of variation Shared success / failures
Long-term approach Process & culture change
Slide 5
Flexibility to meet need changes & refine service delivery
processes Enhances information management, data tracking &
documentation Determine & track program integrity &
effectiveness Promotes data-driven & innovative solutions
Slide 6
Accountability Input from all stakeholders Continuous progress
review Adaptability
Slide 7
Guide quality operations Ensure safe environment & high
quality of services Meet external standards & regulations
Assist agency to meet goals & objectives Benchmarking
success
Slide 8
Comprehensive quality improvement process include
retrospective, concurrent & prospective Retrospective Review of
PCRs after the fact Concurrent Real-time evaluation of pt care
Prospective Anything to improve pt care quality prior to call being
dispatched
Slide 9
After (retro) & look or see (spective) PCR reviews most
commonly performed aspect of QI Reviewing PCRs is tedious but
necessary to gauge patient care Indirect benefit to a medical
retrospective review is the opportunity to assess documentation for
legal & billing purposes
Slide 10
Goals Where Agency aims to be Objectives Specific plans on how
to achieve goals Key Performance Indicators (KPIs) Quantifiably
measure success of an objective that measure if goal was
accomplished
Slide 11
Leadership: Administration leads by example integrating QI into
strategic planning process & entire organization. Strategic
Quality Planning: Developing long & short-term objectives for
structural, performance & outcome quality standards,
identifying ways to achieve objectives, & measuring system
effectiveness Human Resource Development and Management: Developing
full potential of the EMS workforce guided by principle that
providers are motivated to achieve high levels of service &
value EMS Process Management: Creation & maintenance of high
quality services via improvement of work activities & flow
across functional or department boundaries EMS System Results:
Assessing quality results achieved ;examining Agencys success at
quality improvement Stakeholder Satisfaction: Ensuring satisfaction
by those internal & external to EMS system with services
provided Information & Analysis: Managing & utilizing QI
information & data analysis
Slide 12
Plan: Identify problem Do: Identify possible solution Study:
Determine if solution improves or worsens problem Act: Implement
possible solution(s)
Slide 13
Elapsed Times Scene Time by Incident Peripheral Access Advanced
Airway Critical Trauma Unconscious / Unresponsive Cardiopulmonary
Arrest Suspected ACS Suspected Stroke Unstable hemodynamics
including GCS
SSX c/w ischemia plus >1mm ST elevation in 2 contiguous
leads or new LBBB ASA unless c/i or ingestion w/i 90 mins ECG
w/appropriate, training-based interpretation by EMT-P &
transmission to an EM MD / cardiologist Direct transport to a PCI
center with protocol to activate cath lab team prior to EMS arrival
Elapsed time from ECG acquisition to balloon inflation