EMS Policy Manual - Contra Costa Health Services

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Contra Costa Emergency Medical Services EMS QUALITY IMPROVEMENT PROGRAM (EQIP) I. PURPOSE POLICY #: 8 PAGE: 1 of 1 EFFECTIVE: 07/01/07 REVIEWED: 08/10/09 To identify primary responsibilities of all participants in the Contra Costa County EMS Quality Improvement Program (EQIP) and to ensure optimal quality of care for all patients who access the EMS system. II. DEFINITION EMS Quality Improvement Program: An integrated, multidisciplinary program that focuses on system improvement. Methods of evaluation are composed of structure, process and outcome measurements. III. REQUIREMENTS A. EQIP includes all Contra Costa County prehospital care providers participating at the level as agreed between the agency and Contra Costa EMS. B. EQIP indicators will be compliant with the California Code of Regulations, Title XXII, Division 9, Chapter 12 and modeled after the State of California Emergency Medical Services Authority (EMSA) Publication: Emergency Medical Services System Quality Improvement Program Model Guidelines. C. The oversight for the EQIP will be the responsibility of the EMS Medical Director with advice from stakeholders participating on the Prehospital Quality Improvement Committee. D. Appropriate QI indicators shall be reviewed at the agency level on a monthly basis and a report of findings shall be made to the Contra Costa EMS Agency at agreed upon intervals. Aggregate data for the EMS System will be maintained by the Contra Costa County EMS Agency. E. Each Prehospital provider agency shall submit an annual report of quality improvement activities to the Contra Costa County EMS Agency. F. The Contra Costa County EMS Agency shall provide an annual report of quality improvement activities to the California EMS Authority. This information may be incorporated as part of the Contra Costa County Emergency Medical Services Agency Annual Report Report. G. All proceedings, documents and discussions of the Prehospital Quality Improvement Committee are confidential pursuant to section 1157.7 of the Evidence Code of the State of California. 1. Each member of the Prehospital Quality Improvement Committee shall sign a confidentially agreement. 2. Each agency shall maintain all records in a confidential manner consistent with current patient privacy laws (HIPPAA).
Contra Costa Emergency Medical Services PATIENT DESTINATION DETERMINATION POLICY #: 9 PAGE: 1 of 4 EFFECTIVE: 07/05/2011 REVIEWED: 07/05/2011 I. PURPOSE To determine the appropriate receiving facility for patients transported by ground ambulance. II. POLICY A. A patient, transported as part of an EMS response, shall be taken to the most appropriate acute care hospital staffed and equipped to provide care appropriate to the needs of the patient. B. County boundaries are not a consideration in determining the appropriate receiving hospital. C. Field transport personnel are responsible for making transport code decisions. III. PROCEDURE Field personnel shall assess a patient to determine if the patient is unstable or stable. Patient stability must be considered along with a number of additional factors in making destination and transport code decisions. Additional factors to be considered include: Patient or family’s choice of receiving hospital and ETA to that facility. Recommendations from a physician familiar with the patient’s current condition. Patient’s regular source of hospitalization or health care. Ability of field personnel to provide field stabilization or emergency intervention. ETA to the closest basic emergency department. Traffic conditions. Hospitals with special resources. Hospital diversion status. A. Unstable Patients 1. An unstable patient is usually transported to the closest appropriate acute care hospital emergency department. 2. If the patient or family requests, or if other factors exist which indicate that another facility be considered, field personnel are to contact the base hospital and present their findings, including ETAs to both facilities. Base personnel will weigh the benefits of each destination and may direct field personnel to a facility other than the closest. 3. Trauma and STEMI patients should be transported in accordance with the appropriate County trauma or STEMI protocols. 4. Unstable patients are usually transported Code 3 unless contraindicated for medical reasons. B. Stable Patients 1. Stable patients are transported to appropriate acute care hospitals within reasonable transport times based on patient’s/family preference. 2. If a patient does not express a preference, the hospital where the patient normally receives health care or the closest ED is to be considered.
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