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Efficacy of an EMS quality improvement program in improving documentation and performance
S M Joyce1, K L Dutkowski, T Hynes
1Division of Emergency Medicine, University of Utah Medical Center, Salt Lake City 84132, USA. steve.joyce@m.cc.utah.edu
Prehospital Emergency Care
|July 1, 1997
Summary
Implementing a quality improvement (QI) program in emergency medical services (EMS) led to significant and sustained enhancements in documentation and provider performance. This study confirms QI
Area of Science:
- Emergency Medical Services (EMS)
- Healthcare Quality Improvement
- Public Health Systems
Background:
- Many emergency medical services (EMS) systems have transitioned from traditional quality assurance (QA) to quality improvement (QI) methodologies.
- The effectiveness of QI in the EMS setting has been a subject of ongoing evaluation.
Purpose of the Study:
- To determine the effectiveness of a quality improvement (QI) program implemented in an EMS system.
- To assess the impact of QI on provider performance and patient care documentation.
Main Methods:
- A comprehensive QI program was implemented, including prospective, concurrent, and retrospective components.
- Monthly audits of approximately 6% of patient care reports (PCRs) were conducted to evaluate documentation, treatment, and outcomes.
- Feedback was provided to providers, and continuing medical education sessions were tailored based on identified issues.
Main Results:
- Over 90% of cases met acceptable response, scene, and transport times both before and after QI implementation.
- Statistically significant improvements were observed in patient assessment documentation, protocol compliance, patient disposition, and overall performance.
- Improvements were also noted in non-transport cases regarding release decisions and signature acquisition.
Conclusions:
- The implemented quality improvement program resulted in significant and sustained improvements in 13 out of 19 evaluated parameters.
- Goals were met for 14 parameters, demonstrating the program's success over a two-year period.
- Quality improvement programs are effective in achieving substantial and lasting enhancements in EMS documentation and performance.