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The Utilization of Quality Assurance Methods in Emergency Medical Services

Published online by Cambridge University Press:  28 June 2012

Eric A. Davis  and
Anthony J. Billitier IV
Eric A. Davis*
Affiliation:
Allegheny General Hospital, Pittsburgh, Pa.
Anthony J. Billitier IV
Affiliation:
This work was performed at the Medical College of Pennsylvania, Allegheny Campus, Division of Emergency Medicine, Pittsburgh, Pa.
*
1644 Farmington Ct., Pittsburgh, PA 15237USA
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Abstract

Objective:

The concept of the necessity of a good quality assurance (QA) plan for emergency medical services (EMS) is well-accepted; guidelines as how best to achieve this and how current systems operate have not been defined. The purpose of this study was to survey EMS systems to discover current methods used to perform medical control and QA and to examine whether the existence of an emergency medicine residency affected these components.

Methods:

A survey was mailed in 1989 to the major teaching hospitals associated with all of the emergency medicine residency programs (n = 79) and all other hospitals with greater than 350 beds within the 50 largest United States metropolitan areas (n = 172). If no response was received, a second request was sent in 1990. The survey consisted of questions concerning four general EMS-QA categories: 1) general information; 2) prospective; 3) immediate; and 4) retrospective medical control.

Results:

Completed surveys were received from 78.5% of residency and 50% of non-residency programs. The majority had an emergency medicine physician as medical director (80.1% vs 61.5%, p = .03). While both residency and non-residency hospitals participated in initial public and prehospital personnel education, academic programs were more likely to be involved in continuing medical education (98.2% vs 82.3%, p = .009). On-line (direct) supervision was more likely to be provided by residency institutions (96.4% vs 81.0%, p = .017) which was provided by a physician in 88.3%. Trip sheet review was utilized by 62.0% of non-residency and 75.5% of residency programs responding, and utilized the paramedic coordinator (44.5% vs 46.1%) or medical director (35.7% vs 34.5 %) primarily.

Conclusion:

This survey characterizes some of the current methods utilized nationwide in EMS-QA programs. Further research is needed to determine the effectiveness of these various methods, and to develop a model program.

Keywords

educationemergency medical servicesemergency medicinemedical controlmedical directionparamedic coordinationquality assurancequality improvementresidencytrip sheets
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 8 , Issue 2 , June 1993 , pp. 127 - 132
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1993

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Footnotes

*

Presented as a Poster at the 6th Annual NAEMSP Conference and Scientific Assembly, Houston, Tex., June 1990.

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