LTS REGIONAL CQI PROGRAM
Please note that the LTS Regional CQI Committee meets
concurrently with the LTS EMS Advisory Board.
2024 Meeting Dates:
7:00 PM
January 25, 2024 (DPS)
March 21, 2024 (DPS)
June 19, 2024 (DPS)
October 24, 2024 (DPS)
LTS REGIONAL EMS COUNCIL
CONTINUING QUALITY IMPROVEMENT PROGRAM
GOAL:
To review and collectively evaluate structure, process and outcome of clinical and operational protocols or aspect of care in Lycoming, Tioga and Sullivan Counties as promulgated by Act 45 and the Pennsylvania Department of Health Division of EMS Systems as related to Quality Assurance.
STRUCTURE:
Each EMS service will secure representation on a county CQI committee for Lycoming, Tioga, and Sullivan Counties. The Regional CQI Committee will be comprised collectively of the county CQI committees in cooperation with Regional EMS Council staff.
Each county CQI committee and the regional CQI committee will be guided by a chairman to address pertinent issues within the EMS community.
Each county committee and the Regional CQI Committee will meet on a quarterly basis.
QUARTERS shall be defined as:
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BEGINNING
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ENDING
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FORM/REPORTS DUE
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JANUARY 1
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MARCH 31
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APRIL 15
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APRIL 1
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JUNE 30
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JULY 15
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JULY 1
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SEPTEMBER 30
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OCTOBER 15
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OCTOBER 1
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DECEMBER 31
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JANUARY 15
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Each EMS service CQI representative will be responsible to submit a written report outlining ONE result of their service evaluation. Effective Q3- starting July 1, 2024 - the Council will be submitting CQI for ALL BLS Volunteer Agencies for all AOC's, on top of your submitted report. Reports will be submitted on preprinted forms distributed by the regional council and will include the following data:
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- GOALS AND OBJECTIVES OF THE PROTOCOLS
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- NAME OF BLS PROTOCOL YOU ARE EVALUATING
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- PLAN OF CORRECTIVE ACTION (IF NECESSARY)
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- QUARTER START AND END DATES
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- SERVICE EVALUATION OF THE ACTION TAKEN
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- NUMBER OF TRIPSHEETS REVIEWED
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- NUMBER OF TRIPSHEETS IN COMPLIANCE WITH THE PROTOCOLS
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Upon receipt of quarterly service reports, the LTS Regional EMS Council will compile data received and report back to CQI committees with data findings. Reports will not identify individual service names and data.
Examples of Important Tripsheet Review Criteria
- Prompt and safe response to correct address when dispatched.
- Equipment working properly and unit completely restocked.
- Proper initial patient assessment performed.
- Quarterly, the Regional CQI committee will advise EMS Agencies of their recommendations for topics to be evaluated. In addition, the regional field coordinator will provide the evaluation criteria at the beginning of each quarter. If no calls during the quarter fall under the recommended topics, Agencies may elect to choose an alternate review criteria based on the PA EMS Protocols: Links below:
BLS Protocols: Department of Health 2023 Protocols - BLS
AEMT Protocols: Department of Health 2023 Protocols - AEMT
ALS Protocols: Department of Health 2023 Protocols - ALS
Critical Care Protocols: Department of Health 2019 Protocols - Critical Care
5. Communications with medical commanders available and used when indicated.
6. Assessment and treatment is performed in expedient manner consistent with urgency of situation.
7. Medical commanders follow approved treatment protocols or regional aspects of care.
8. Receiving physician is given adequate and timely information on pre-hospital assessment/treatment.
9. Management of high-risk situations (DOA, CPR, and multiple traumas) is routinely reviewed for efficiency of care.
10. Patients are assessed en route and changed in patient’s condition are communicated and/or documented appropriately.
11. Complete and accurate documentation and patient data is recorded on Trip sheet for each call.
Click HERE to download the CQI Quarterly Reporting Form.
Currently, the 2024 Aspects of Care recommended for evaluation are:
ALS Cardiac Arrest
BLS Cardiac Arrest
Patient Refusals
Patient Assisted Medications
Spinal Immobilization
CQI IS REQUIRED FOR EPI-PEN ADMINISTRATION (FOR SERVICES THAT ARE RECOGNIZED EPI-PEN SERVICES)
Other Aspects of Care to be Considered:
AED Usage
Patient Assisted Medications
Patient Refusals
Spinal Immobilization
Seizures
Altered Level of Consciousness
Breathing Difficulty
Non-Traumatic Chest Pain
CPAP
Glucago
SVN Nebulizer
ALS ONLY:
Etomidate Usage (100% Chart Review)
SAI
Open Fracture
Ketamine
RETURN TO LTS EMS COUNCIL HOMEPAGE
| For more information contact: |
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| Name: |
Amber Snyder |
| Title: |
Regional EMS Field Coordinator |
| Office: |
LTS EMS COUNCIL |
| Email: |
asnyder@lyco.org |
| Voice: |
570-433-4461 |
| Fax: |
570-433-4435 |