Number: 5.1
Replaces: 4-25
Date Issued: January 01, 1998
Revised: September 28, 2000
Date Effective: January 23, 2001
Subject: Emergency Medical Dispatching Quality Assurance and Improvement Process
The E-911 Authority Board will provide the Advanced Quality Assurance software (AQUA) and the National Academy of Emergency Medical Dispatch (NAEMD) quality assurance training so that each PSAP will have a minimum of one AQUA software licensed position and 2 certified EMDs to perform in-house or agency quality assurance (QA). These individuals will be identified as the primary Public Safety Answering Point Emergency Medical Dispatch Quality Assurance person (PSAP EMD-Q) and the alternate PSAP EMD-Q. This EMD-Q training and certification is subject to approval by the Authority Board.
It is the responsibility of the PSAP to meet or exceed the EMD standards or policies as set forth by the E-911 Authority Board, the Advanced Medical Priority Dispatch System (AMPDS), and the NAEMD. Seeking NAEMD Accreditation is recommended and supported by the E-911 Authority Board, but is left to the discretion of the individual PSAPs.
The quality assurance and improvement process within the PSAPs shall follow a standardized procedure utilizing the NAEMD EMD-Q guidelines, with the support and direction of the Authority Board EMD-Q. If it is evident that a PSAP is not utilizing the AMPDS protocol to provide the recommended QA process, the E 9-1-1 Authority Board will no longer be obligated to continue to provide equipment or training support to the PSAP or the EMDs employed by that agency.
A sampling of medical calls processed within a PSAP shall be reviewed monthly by the PSAP EMD-Qs, in accordance with NAEMD standards. The PSAP EMD-Q is responsible for ensuring direct performance feedback to the EMD. The process in which this is done will be included in the individual PSAP’s EMD standard operating procedure (SOP) manual.
The PSAP EMD-Q will provide a sampling of 10 reviewed calls to the Authority Board EMD-Q. Call selection is made following a process established by the Medical Dispatch Review Committee (MDRC). The Authority Board EMD-Q will review those calls and provide feedback to the PSAP EMD-Q.
In the event that the Authority Board EMD-Q and PSAP EMD-Q disagree on the proper procedure for handling a specific call, and if a resolution cannot be achieved locally, the call or incident will be forwarded to the Medical Priority Dispatch System (MPDS) or the NAEMD for final review.
The Authority Board EMD-Q will serve as a resource for the PSAP EMD-Q, assisting with the PSAP QA activities by consulting on QA issues and providing medical education. The Authority Board EMD-Q will review the PSAP EMD-Q’s performance and offer feedback to the PSAP EMD-Q regarding his or her review of specific calls. The Authority Board EMD-Q will not audit cases that have not been previously scored by the PSAP EMD-Q. The Authority Board EMD-Q will also provide medical education to the individual EMD or PSAP supervisors when the need for such education is indicated during call review or upon request.
Policies involving individual non-compliance and remediation are issues that should be outlined in the EMD SOP of the individual PSAP. Remediation plans may be developed with the assistance of the Authority Board EMD-Q.
Any occurrence of gross deviation from the protocol or patient negligence shall immediately be reported to the Authority Board EMD-Q or the System Manager so that the Authority Board members, medical director, and legal advisor can be notified.
The PSAP manager shall report any individual found to have a pattern of non-compliance to the protocol, whose compliance averages fall below compliance standards for more than 60 days to the Authority Board EMD-Q or System Manager.
Agencies not compliant to the QA process for longer than 60 days must notify the Authority Board EMD-Q or System Manager.
In the event the PSAP EMD-Q is found to have a pattern of non-compliance or sub-standard performance within the quality assurance process, the Authority Board EMD-Q will notify that PSAP EMD-Q's supervisor and the Authority Board’s Medical Director / Physician Advisor.