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A computer-assisted quality assurance audit in a multiprovider EMS system.
1Department of Emergency Medicine, William Beaumont Hospital, Royal Oak, MI 48072.
Annals of Emergency Medicine
|March 1, 1990
Summary
A hospital quality assurance audit improved emergency medical services (EMS) performance. Paramedic adherence to county protocols increased, with fewer deficiencies noted in run sheets after the audit.
Area of Science:
- Emergency Medicine
- Healthcare Quality Improvement
- Paramedic Education
Background:
- Prehospital care involves multiple agencies and paramedics.
- Assessing the impact of quality assurance on performance is crucial.
Purpose of the Study:
- To evaluate the effect of a hospital's quality assurance audit on paramedic and agency performance.
- To identify areas for improvement in emergency medical services (EMS) protocols and execution.
Main Methods:
- Developed performance criteria based on county EMS protocols with a multidisciplinary committee.
- Reviewed paramedic run sheets for accuracy, categorizing deviations.
- Provided regular feedback to agency supervisors and paramedics.
Main Results:
- Average deficiencies per run decreased significantly for all paramedics (0.47 to 0.34, P < .006).
- One agency showed a non-significant decline in deficiencies (1.98 to 1.06, P = .068).
- Identified individual paramedic performance variations, with some exceeding two standard deviations from the mean.
Conclusions:
- The hospital's EMS quality assurance audit effectively documented performance issues.
- The audit improved compliance with county protocols for patients treated by EMS agencies delivering to the institution.