Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-17T14:33:40.504Z Has data issue: false hasContentIssue false
  • English
  • Français

A Paramedic Peer-Review Quality Assurance Audit

Published online by Cambridge University Press:  28 June 2012

Robert A. Swor ,
Joseph J. Bocka  and
Ronald F. Maio
Robert A. Swor*
Affiliation:
Division of Emergency Medicine, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
Joseph J. Bocka
Affiliation:
Department of Emergency Medicine, William Beaumont Hospital, Royal Oak, Michigan, USA
Ronald F. Maio
Affiliation:
Division of Emergency Medicine, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
*
Department of Emergency Medicine, William Beaumont Hospital, 3601 W. 13 Mile Rd, Royal Oak, MI 48072
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

A daily EMS audit was performed to assess whether a paramedic peer review audit would improve the quality of documentation and radio communications in cases transported to a single receiving facility.

Methods:

Prehospital EMS run sheets and run tapes were reviewed for adherence to standards developed for the county EMS system. Items evaluated were run sheet documentation of care and paramedic radio presentation. Checklists were used and multiple parameters evaluated for each case. Two periods, 1987–88 and 1989 were compared to evaluate the effectiveness of this system. Care rendered by a total of 106 paramedics was evaluated. Confidence intervals of 0.95 were calculated on the differences between groups. Practicing paramedics audited 63% of the days in 1987–88 and 80% in 1989. Data from each case were tabulated and a profile, average deficiencies per run calculated for each paramedic.

Results:

A total of 4175 run sheets and tapes were audited for the period 1987–88 with an average of deficiencies/run of 0.27, and for 1989 a total of 1872 run sheets and tapes were reviewed with a deficiency/run rate of 0.21, indicating a statistically significant improvement (0.95 CI= 0.02, 0.08). Twelve paramedics were not auditors in 1987–88, but audited in 1989. Their deficiencies/run decreased from 0.13 to 0.08

Conclusion:

A peer review audit in this system appears to be effective in improving documentation and radio performance. Performance also improved when paramedics served as auditors.

Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 6 , Issue 3 , September 1991 , pp. 321 - 326
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the 6th Annual Conference of the National Association of Emergency Medical Service Physicians, Houston, Texas, June 1990

References

1. Holroyd, B, Knopp, R, Kallsen, G: Medical control, quality assurance in prehospital care. JAMA 1985;256:1027–31.CrossRefGoogle Scholar
2. Stout, JL: Organizing quality control In EMS. JEMS 1988;13:67–74.Google Scholar
3. Stewart, RD: Medical direction in emergency medical services: The role of the physician. Emerg Med Clinics N A 1987;5:119–132.Google Scholar
4. Johnson, JC. Quality assurance in EMS, in Rousch WR, Principles of EMS Systems: A Comprehensive Text For Physicians, Dallas: American College of Emergency Physicians, 1989.Google Scholar
5. Swor, RA, Hoelzer, MH: A computer-assisted quality assurance audit in a multi-provider EMS system. Ann Emerg Med 1990;19:286–290.CrossRefGoogle Scholar
6. Pepe, PE, Stewart, RD: Role of the physician in the prehospital setting. Ann Emerg Med 1986;15:1480–83.Google Scholar
7. Kresky, B, Cohen, A: Considerations for evaluation of patient care in emergency departments. QRB 1980;6:8–5.Google Scholar
8. Murphy, JG, Jacobson, S: Assessing the quality of emergency care: The medical record vs patient outcome. Ann Emerg Med, 1984;13:158–165.Google Scholar
9. Stewart, R, et al. : A computer assisted quality assurance system for an emergency medical service. Ann Emerg Med 1985;14:25–29.Google Scholar