History- The EMSI Regional QI Committee was established through invitation to specific individuals to satisfy the state requirements of representatives from various stakeholders in the region. The committee was named Total Quality Management, referring to the entire PDCA cycle of QI (Plan-Do-Check-Act). QI projects are selected by the committee or as needed by the Bureau of EMS, BOD of EMSI or other stake holders in the region.  A Regional QA/QI network was developed by having all ALS agencies name a QI/Training contact to be the “go to” person to facilitate cooperation and participation in any and all regional QA/QI projects.
 

The Quality Improvement Committee meets at least quarterly and includes all levels of EMS services. The committee includes representatives from first responder providers, BLS ambulance providers, ALS ambulance providers, service medical directors, and medical command physicians. The committee also includes representatives from PSAP/ Emergency Medical Dispatch providers, non-EMS AED providers (e.g. police or industrial AED providers), receiving facility/ hospitals, regional trauma centers, and other appropriate organizations.  The first meeting was held on November 1, 2006.

Note: Projects will count as regional QI Initiatives for all participating EMS agencies.

Title 28 § 1001.65. Cooperation.
Each individual and entity licensed, certified, recognized, accredited or otherwise authorized by the Department to participate in the Statewide EMS system shall cooperate in the Statewide and regional EMS quality improvement programs. These individuals and entities shall provide information, data, reports and access to records as requested by the Department and regional EMS councils to monitor the delivery of EMS.

EMSI has distributed Carbon Monoxide detectors to all EMS agencies in the region.  The Regional Medical Director Committee, the Board of Directors at EMSI along with the Pennsylvania Bureau of EMS would like EMSI to track all activations of the CO detectors distributed by our operations team. 

We have developed a Carbon Monoxide Activation reporting system using a web based program called Survey Monkey.  I have included a link to the form to be filled out every time you have an activation.  The form consists of 14 questions, then continues with an additional 6 questions to fill out if there are any patients related to the CO alarm activation.  Simply point your mouse to the link below and it will take you right to the form.

A copy of the patient report will be needed and collected ONLY if there are patients treated and/or transported.  I will contact the EMS agency to make arrangements to obtain a copy of the patient report or download it from the appropriate patient report software.

Here is the link:  https://www.surveymonkey.com/s.aspx?sm=CiYB7a41w4wZsNB23_2f7GRA_3d_3d
(Note: You must complete the survey at one sitting or you will lose your answers and the survey will start from the beginning)

Please keep this link as it will direct you to the reporting form.  Please report ALL activations.

The Total Quality Management Committee representative selected by your EMS agency supervisors or directors should be the one responsible for going online and filling out the CO Activation form.   We will need all CO Monitor activations reported.

You are participating in an exciting project that is relatively new to EMS.  We hope to gain additional knowledge in regards to EMS provider safety as well as Carbon Monoxide exposure to all patients involved.  Data will be available to the region as the project comes to an end which has not yet been determined. 

The TQM Committee is dedicated and is working towards state and regional improvement of EMS through quality improvement and assurance programs such as this.  We will continue to ask for your cooperation and participation in future regional QI initiatives.

If you need your CO detector replaced for whatever reason, it needs to be evaluated by the company.  They will require you to have the serial number and troubleshoot the unit over the phone.  There is a guarantee on the internal battery, but there are circumstances where a complete replacement at no cost may not apply.  You need to call the company.  Here is the contact person.  EMSI has no replacement units.

Click Here for Replacement Information

Joe Martinez
 
Service Technician
Bw Technologies By Honeywell
3279 W. Pioneer Pkwy.
Arlington, TX. 76013
P: 888-749-8878
F: 817-274-8941
e-mail: jose.martinezd2@honeywell.com

EMSI has distributed the Lisle Vacuum Gauge.  This gauge has been distributed to every EMS station in the EMSI region.  We  asked that every ALS and BLS agency do a monthly check on all portable and fixed suction units and report those results to us. 

During EMSI vehicle inspections, we have found numerous problems in the function of patient suction units.  We would like to see if there is a trend in suction unit failures and be able to document those problems.  As you know, suction units need to be in working condition 100% of the time, especially when you need to clear your patients’ airway.  That is why it is very important that we as a region make sure we are doing our part to make sure this vital piece of equipment is in working order.

EMS Agencies documented their monthly tests online.  This eliminated additional paperwork for EMS crews to complete and enabled us to organize the data EMS entered.  There were 7 questions that needed completed for the portable suction units and 7 questions to be completed for the fixed suction units located in the ambulance “action area”.

The testing was very easy.  All EMS had to do is attach the vacuum gauge to the end of the suction tubing, turn the suction unit on. To pass, the suction unit had to reach 300 Hg within 4 seconds.  This is the same test that EMSI does for each ambulance suction unit by our licensure department.  EMS documented the findings.  They also documented the type of suction unit, model number, and what ambulance they were located in.  EMS then needed to access the internet and go to a link to document the data online.  This needed to be done for each ambulance and final reporting was at the end of March and June of 2010.
 

The suction guage reporting system is now closed. https://www.surveymonkey.com/s.aspx?sm=9dPK9KnwLwbhuVoVTX_2bkog_3d_3d

Over 310 suction gauges were given out.  102 EMS Agencies participated in the suction unit QA/QI. Over 1,475 reports were submitted by EMS Agencies.  A majority of agencies now use the suction gauge to check suction machines in their daily ambulance checklists. 
Click Here to access the final report.

After a 2006 survey regarding CPAP, it was determined that the EMSI region only had about 15% of the ALS Ambulance agencies equipped with CPAP.  The Bureau of EMS wanted more CPAP capability in the region.  Using EMSOF funds, EMSI purchased 290 CPAP units for distribution throughout the region.

The TQM Committee (Total Quality Management Committee) reviewed the specifications and funding possibilities of 3 pre-hospital CPAP devices and did a comparison on which unit would be the best to purchase for the EMSI region. These findings were presented to the members of the Regional Medical Direction Committee in March 2007.  The Committee determined that the region would purchase the Emergent Port02Vent CPAP unit to distribute to its services.  The decision was based on a variety of operational and clinical factors.

CPAP units were distributed to EMS agencies that were not equipped with CPAP (85%).  These Advanced Life Support Ambulance Agencies were required to participate in a regional CPAP quality improvement program coordinated by the TQM Committee. This satisfied a state requirement for the regional and service quality improvement project.

Purchasing and distribution started in April 2007 and was completed in October 2007.  A CPAP Data form was developed by the TQM Committee and distributed to all of the TQM representatives at each ALS agency. The ALS agencies were required to fill out a data sheet for each CPAP use and send it to EMSI along with the patient report. Additional data fields were collected and entered on a spreadsheet. Additional data form the receiving hospitals was collected with the cooperation of pre-hospital and medical command facility personnel at each facility.

Data collection began on December 1, 2007 and was completed on May 31, 2008.  425 cases were collected. 
Click Here for statistics and summary of the EMSI CPAP Initiative.