DFRS

POLICES & PROCEDURES
Department Of Fire & Rescue Services
Montgomery County, MD


BLS Quality Assurance


 
 
No. 1301
Feb. 10, 1995

PURPOSE
1.0 To provide a Basic Life Support Quality Assurance Program for all Department of Fire and Rescue Service EMT-A's.

APPLICABILITY
2.0 All DFRS Emergency Medical Technicians-Ambulance.
2.1
This policy was developed in cooperation with the International Association of Fire Fighters, Local 1664.

BACKGROUND
3.0 On April 9, 1992, Fire and Rescue Commission Regulation No. 73-91 went into effect. This regulation requires that the Department of Fire and Rescue Services establish a Basic Life Support Quality Assurance Program consisting of four specific areas. This Regulation requires DFRS to monitor:

  1. the response and management of BLS care inquiries;
  2. quality of the BLS skills provided by EMT-A's;
  3. the quality of incident reports;
  4. the quality of care administered by DFRS EMT-A's.

DEFINITIONS
4.0 Inquiry - A question or complaint regarding the quality of patient care practices.
4.1 BLS Quality Assurance Coordinator (BLS QAC) - The DFRS individual serving as the Quality Assurance Officer.
4.2 BLS - An acronym for Basic Life Support.
4.3 Incident Referral Report - The form to be completed by the Quality Assurance Coordinator when an inquiry is initiated.
4.4 EMT-A Assessor - An individual who has been selected by their shift officer to conduct and evaluate EMT-A drills.
4.5 EMT-A Preceptor - An individual assigned to evaluate and assist a new EMT-A recruit during their internship period.
4.6 Internship - The time period that a new EMT-A recruit is assigned to an ambulance in order to achieve their Montgomery County EMT-A Charge Status.
4.7 BLS Quality Assurance Committee - A committee appointed by the Director to oversee recommendations to the Director on the BLS Quality Assurance Program.
4.8 P.T.I. - An acronym for Previously Trained Individual.

POLICY
5.0 All EMT-A's must meet Department standards for serving as charge EMT-A's. These standards include maintaining high quality patient care skills.
5.1 All BLS patient care inquiries will be handled in a timely, confidential and thorough manner.
5.2 Incident reports will be reviewed regularly to ensure provision of appropriate medical care and adequate documentation.
5.3 The BLS Quality Assurance Coordinator, or designee will review ten percent of all stations' EMS 100 reports to determine future training needs.
5.4 The station officer will ensure that their personnel complete the EMS 100 reports accurately.
5.5 New EMT-A Recruits will serve an internship on an ambulance. The length of the internship will be determined by the Director.

RESPONSIBILITY
6.0 Employees are responsible for:

  1. Advising the BLS Quality Assurance Coordinator via the immediate supervisor of any incident in which patient care may have been compromised by the actions or inactions of a DFRS employee;

  2. cooperating with personnel assigned to investigate BLS care inquiries.
6.1 The BLS Quality Assurance Coordinator is responsible for:

  1. initiating review of BLS inquiries involving DFRS employees;

  2. acknowledging to the initiator receipt of the complaint or inquiry within seven working days;

  3. initiating an Incident Referral Report and conducting an investigation;

  4. generating a written report to the EMS Captain with the findings of the investigation and making any recommendations needed;

  5. overseeing the Recruit Internship Program and collecting and reviewing all recruit EMT-A evaluation forms to ensure that the individual meets Department standards;

  6. making recommendations to grant Montgomery County EMT-A charge status, or extend the EMT-A Internship Program;

  7. establishing a Skills Review Program to be incorporated into the Quarterly Drill Manual for all Department EMT-As from the rank of Firefighter I to Lieutenant;

  8. developing an EMT-A quarterly skills review program.

  9. referring BLS inquiries involving volunteer personnel to the appropriate Corporation authorities.

6.2 EMT-A Preceptors are responsible for:

  1. completing the EMT-A Evaluation Forms on the new EMT-A recruit;

  2. sending the EMT-A Evaluation Forms to the BLS Quality Assurance Coordinator for review.

6.3 The EMS Captain is responsible for:

  1. reviewing investigations and recommending actions to be taken to the Director.

  2. responding to the initiator of an inquiry within thirty days.

  3. submitting investigations to the BLS Quality Assurance Committee for review.
6.4 The BLS Quality Assurance Committee is responsible for reviewing investigations submitted by the EMS Captain to establish any trends.
6.5 EMT-A Assessors are responsible for conducting and overseeing the EMS skills review program as part of the Quarterly Drill Process.

PROCEDURE
7.0 The BLS Quality Assurance Coordinator will be notified of all BLS Patient Care Inquiries.
7.1 The BLS Quality Assurance Coordinator will respond to the inquirer within seven working days of receipt of the inquiry.
7.2 The BLS Quality Assurance Coordinator will conduct an investigation with all parties involved in an inquiry.
7.3 The BLS Quality Assurance Coordinator will forward the findings of an investigation to the EMS Captain.
7.4 The EMS Captain will recommend the appropriate action to take pertaining to the investigation. All disciplinary action will be in accordance with DFRS Policy and Procedure No. 503.
7.5 The EMS Captain will respond to the inquiring party or give them an interim report within thirty days from the receipt of the inquiry.
7.6 Internship Program

The BLS Quality Assurance Coordinator will ensure that training sessions are provided on the following topics:

  1. completing incident reports

  2. medic unit orientation

  3. loads, lifts and carries
7.7 New EMT-A recruits will be issued ten EMT-A Evaluation Forms to be completed by their EMT-A preceptors during the internship period. These forms are to be used to evaluate patient care. If the recruit does not provide patient care, an evaluation form will not be filled out.
7.8 The EMT-A Preceptor will forward completed evaluation forms and copies of corresponding call sheets to the BLS Quality Assurance Coordinator. The package will be forwarded to the BLS QAC at the completion of the recruit's internship.
7.9 The BLS Quality Assurance Coordinator in cooperation with the EMT-A Preceptor will make a recommendation to grant Montgomery County Charge EMT-A Status to the Emergency Services Bureau Chief via the EMS Division Chief.
7.10 If ten evaluation forms are not completed during the recruit's internship, it will be the responsibility of the senior DFRS EMT-A assigned to the ambulance to complete the evaluation forms as the recruit runs the calls. The remaining EMT-A Evaluation Forms are to be completed as soon as possible and forwarded with a copy of the corresponding call sheets to the BLS Quality Assurance Coordinator.
7.11 Previously trained individuals will be issued 10 EMT-A Evaluation Forms prior to entering the field.
7.12 P.T.I.'s will be counted as minimum staffing.
7.13 P.T.I.'s will be evaluated by the senior DFRS EMT-A assigned to the ambulance. The forms are to be used when the P.T.I. provides patient care. The P.T.I.'s Preceptor will ensure that the EMT-A Evaluation Forms are completed as soon as possible. Preceptors will ensure the completed evaluation forms are forwarded with a copy of the corresponding call sheets to the BLS Quality Assurance Coordinator.
7.14 The BLS Quality Assurance Coordinator will establish a skills review program in coordination with the EMS Training Staff. The program will be incorporated into the Quarterly Drill Manual.
7.15 Incident Report Review.

  1. Station Officers will ensure that their personnel complete EMS 100 Reports accurately.

  2. The BLS Quality Assurance Coordinator will review EMS 100 Reports to identify areas in need of training.

  3. The BLS Quality Assurance Coordinator will provide a report to each Station Commander. The report will identify trends that were noted during the incident report review process.


ATTACHMENTS
8.0 Incident Referral Report
8.1 Evaluation Form