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QA...QI...CQI…PI...Call it what you will…..

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  1. QA...QI...CQI…PI...Call it what you will….. Philip J. Froman, MD, FACEP EMSMDC, INC.

  2. Let’s keep our butts out of court The real story

  3. Why does QI matter? • Improves patient care EMS:QA

  4. Why does QI matter? • Improves patient care • Protects patient EMS:QA

  5. Why does QI matter? • Improves patient care • Protects patient • Protects EMS EMS:QA

  6. Why does QI matter? • Improves patient care • Protects patient • Protects EMS • Teaching tool EMS:QA

  7. Why does QI matter? • Improves patient care • Protects patient • Protects EMS • Teaching tool • Improves Charting EMS:QA

  8. When do we do QI? • On every call EMS:QA

  9. When do we do QI? • On every call • Every departmental EMS meeting EMS:QA

  10. When do we do QI? • On every call • Every departmental EMS meeting • Case reviews EMS:QA

  11. When do we do QI? • On every call • Every departmental EMS meeting • Case reviews • Doc in the Park EMS:QA

  12. When do we do QI? • On every call • Every departmental EMS meeting • Case reviews • Doc in the mountains • State and National Conferences EMS:QA

  13. What is QI? • Reviews actual patient care EMS:QA

  14. What is QI? • Reviews actual patient care • Reviews documentation EMS:QA

  15. What is QI? • Reviews actual patient care • Reviews documentation • Creates mode of departmental teaching EMS:QA

  16. What is QI? • Reviews actual patient care • Reviews documentation • Creates mode of departmental teaching • Satisfies national standards EMS:QA

  17. What is QI? • Reviews actual patient care • Reviews documentation • Creates mode of departmental teaching • Satisfies national standards • Gives mode of constant feedback EMS:QA

  18. What is QI? • Reviews actual patient care • Reviews documentation • Creates mode of departmental teaching • Satisfies national standards • Gives mode of constant feedback • Gives individual strengths and weaknesses EMS:QA

  19. How do we do it? • Chart at the time of the call EMS:QA

  20. How do we do it? • Chart at the time of the call • Review your chart after writing it EMS:QA

  21. How do we do it? • Chart at the time of the call • Review your chart after writing it • Review by departmental QI personnel EMS:QA

  22. How do we do it? • Chart at the time of the call • Review your chart after writing it • Review by departmental QI personnel • County QI personnel EMS:QA

  23. How do we do it? • Chart at the time of the call • Review your chart after writing it • Review by departmental QI personnel • County QI personnel • Review by medical director EMS:QA

  24. How do we do it? • Chart at the time of the call • Review your chart after writing it • Review by departmental QI personnel • County QI personnel • Review by medical director • Close the loop with case reviews EMS:QA

  25. Date/Time Sequential run number Face sheet information Vital signs Oxygen saturation C.H.A.R.T. Pertinent negatives Medication/Allergies PMH/PMD Nontransport documentation Signatures What to include... EMS:QA

  26. Legibility Sequential run numbers Address abnormal vital signs Pertinent positive and negative Nontransport documentation Medicines/allergies PMH/PMD No head to toe Transport/transfer notes Describe, do not diagnose Poor picture painted Tunnel Vision Common errors EMS:QA

  27. Case Discussions • Head injury/Altered mental status EMS:QA

  28. Case Discussions • Head injury/Altered mental status • Abdominal pain EMS:QA

  29. Case Discussions • Head injury/Altered mental status • Abdominal pain • Chest pain EMS:QA

  30. Case Discussions • Head injury/Altered mental status • Abdominal pain • Chest pain • Overdose EMS:QA

  31. Case Discussions • Head injury/Altered mental status • Abdominal pain • Chest pain • Overdose • Febrile seizures EMS:QA

  32. Case Discussions • Head injury/Altered mental status • Abdominal pain • Chest pain • Overdose • Febrile seizures • Wounds EMS:QA

  33. Complete the cycle • Feedback to individual EMS:QA

  34. Complete the cycle • Feedback to individual • Feedback to department EMS:QA

  35. Complete the cycle • Feedback to individual • Feedback to department • Feedback to County EMS:QA

  36. What’s next? • Templates EMS:QA

  37. What’s next? • Templates • Computer charting EMS:QA

  38. QUESTIONS?