A Quality Assurance Initiative for Emergency Medical Services

Ohio Revised Code 4765.12 mandates the implementation of ongoing peer review and quality assurance (QA) programs for all emergency medical service (EMS) organizations in the State of Ohio. The purpose of implementing QA programs for EMS is to ensure delivery of quality care to the public. Public health core strategies are to assess systems and assure the implementation of policies and processes that improve community health. Involving public health in the development of a QA program provides technical assistance in developing valid methods that can be used to measure the performance of an EMS system. This study will use a protocol instruction and feedback from QA audits to improve documentation quality of prehospital care. Documentation quality is a basic indicator for ensuring the delivery of quality care. The research uses a repeated measure quasi-experimental design of EMT-B and EMTParamedics in a suburban city of the United States that utilizes a modified Greater Miami Valley EMS Quality Assurance Audit tool to collect data. The proposed hypothesis for this study was EMS documentation will improve following the introduction of a QA feedback loop. McNemar’s test was applied to 2X2 contingency table to test for significant differences in the pre and post feedback scores. The test result for this study was 149.0154 > 3.84, df=1, p=0.05. The test statistic was greater than the table value, the pre and post scores are significantly different at the p=0.05 level. Documentation compliance increased from 4.1% to 47.8%. EMS organizations are reaching out to partner agencies to implement sustainable QA/QI programs that assure policies and procedures are in place to deliver quality care to the community. QA is the foundation of a solid QI initiative. Public health can assist these organizations in QI initiatives to reduce the burden of death and disability from accidental injury and improve access to care. QUALITY ASSURANCE INITIATIVE 3 TABLE OF CONTENTS ABSTRACT .................................................................................................................................... 2 TABLE OF CONTENTS ................................................................................................................ 3 REVIEW OF LITERATURE ......................................................................................................... 8 METHODOLOGY ....................................................................................................................... 12 ANALYSIS OF DATA................................................................................................................. 19 DISCUSSION ............................................................................................................................... 24 CONCLUSION ............................................................................................................................. 27 REFERENCES ............................................................................................................................. 29 FIGURES ...................................................................................................................................... 33 APPENDIX A ............................................................................................................................... 34 APPENDIX B ............................................................................................................................... 35 APPENDIX C ............................................................................................................................... 37 APPENDIX D ............................................................................................................................... 38 APPENDIX E ............................................................................................................................... 64 QUALITY ASSURANCE INITIATIVE 4