EMS Services Participating with a PSO can improve quality, safety, & financial performance

January 28, 2015    |   By: Calevir

Written by Lee Varner, BS EMS, EMT-P
Mike Wallace,
EMS Captain, Central Jackson County Fire Protection District

Does this sound like your EMS service….

Your typical runs include calls for chest pain, shortness of breath, seizures, and even cardiac arrest.  You run these calls day in and day out.  You drop patients off at the hospital just in time to clear for another call.

At the end of the day, ask yourself these simple questions:

  • Do you look back at the calls to determine how well your providers performed from the perspective of protocol compliance or customer service?
  • Do you have performance benchmarks  established, for example time to 12 lead or aspirin administration on chest pain patients?
  • Do you know the percentage of survival for cardiac arrest patients in your community?
  • Do you have a mechanism in place that allows for the self-reporting of events as they relate to medication errors, equipment malfunctions, or near misses?

If you answered yes to all of these questions, great job!   However, some of you probably said no to most.

EMS Quality Management activities are critical to the health and success of every EMS organization.  EMS Quality Management looks at performance on multiple levels, but the focus is generally on quality of care, performance indicators, and the analysis of data for improvement.   Quality Management is a double edged sword.   While the motivation to improve is present, many departments fear discoverability and litigation.

It is no secret that hospitals have found opportunities to protect their quality and safety work.   Isn’t it time that EMS learns about protecting their efforts?  

Some states provide protection from discoverability in legal proceedings for Quality Management programs for EMS, yet many do not.  In 2005, the Patient Safety Quality Improvement Act was made law. The Act allows those participating with a federally-designated Patient Safety Organization (PSO) to protect the confidentiality and discoverability of their internal quality management and safety work; a necessity to assure the evaluation and analysis necessary to achieve a greater level of understanding and action to improve care. Participating with a PSO that focuses on EMS safety improvement allows protection of your call critiques, performance measures, data analysis, discussions, and investigations. Working with a PSO also offers a safe way to report and share near misses, unsafe conditions, and adverse events.

Perhaps we can all agree that the last thing we want to share is our errors and mistakes. However, participating with a PSO can solve this problem.

Healthcare is evolving and changing.   Many find these changes exciting as well as a unique opportunity for EMS to fill gaps and niches in healthcare.   Changes in United States healthcare will place a greater emphasis on EMS accountability for quality management and more specifically, quality and safety data.

Think about the last event that occurred and resulted in a patient being injured or seriously harmed.   How many people were affected?  

This is not a trick question, but consider the reality.   The patient and family suffer forever, but what is the impact on your service: its name, its brand?   Let us not forget about our personnel who were involved in the event. They will also live with the consequences of the patient outcome.

Adverse events have a cascading effect on many levels including the human and financial side.   Set aside the fears of litigation or a financial settlement and consider how many hours are spent investigating, discussing, and analyzing the event?

Think of the hours and dollars that could be saved if your EMS service could have prevented the event from occurring in the first place.

Participating with a PSO can improve your organizations quality, safety, and financial performance.   By participating in a PSO, you send a strong message to your community leaders, citizens as well as the media that you make quality and safety a priority in your EMS organization.   We owe this to our patients and to one another.


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The Center for Patient Safety believes that collaboration and sharing are the best ways to drive improvement. We strive to provide the right solutions and resources to improve healthcare safety and quality.