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A Paramedic Peer-Review Quality Assurance Audit

Published online by Cambridge University Press:  28 June 2012

Robert A. Swor ,
Joseph J. Bocka  and
Ronald F. Maio
Robert A. Swor*
Affiliation:
Division of Emergency Medicine, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
Joseph J. Bocka
Affiliation:
Department of Emergency Medicine, William Beaumont Hospital, Royal Oak, Michigan, USA
Ronald F. Maio
Affiliation:
Division of Emergency Medicine, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA
*
Department of Emergency Medicine, William Beaumont Hospital, 3601 W. 13 Mile Rd, Royal Oak, MI 48072
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Abstract

Introduction:

A daily EMS audit was performed to assess whether a paramedic peer review audit would improve the quality of documentation and radio communications in cases transported to a single receiving facility.

Methods:

Prehospital EMS run sheets and run tapes were reviewed for adherence to standards developed for the county EMS system. Items evaluated were run sheet documentation of care and paramedic radio presentation. Checklists were used and multiple parameters evaluated for each case. Two periods, 1987–88 and 1989 were compared to evaluate the effectiveness of this system. Care rendered by a total of 106 paramedics was evaluated. Confidence intervals of 0.95 were calculated on the differences between groups. Practicing paramedics audited 63% of the days in 1987–88 and 80% in 1989. Data from each case were tabulated and a profile, average deficiencies per run calculated for each paramedic.

Results:

A total of 4175 run sheets and tapes were audited for the period 1987–88 with an average of deficiencies/run of 0.27, and for 1989 a total of 1872 run sheets and tapes were reviewed with a deficiency/run rate of 0.21, indicating a statistically significant improvement (0.95 CI= 0.02, 0.08). Twelve paramedics were not auditors in 1987–88, but audited in 1989. Their deficiencies/run decreased from 0.13 to 0.08

Conclusion:

A peer review audit in this system appears to be effective in improving documentation and radio performance. Performance also improved when paramedics served as auditors.

Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 6 , Issue 3 , September 1991 , pp. 321 - 326
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1991

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Footnotes

Presented at the 6th Annual Conference of the National Association of Emergency Medical Service Physicians, Houston, Texas, June 1990

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