EMS AWARDS CONFERENCE	GOLD STARS OF LIFE	STREMAC COMMITTEES	POLICIES & PROTOCOLS	MEETINGS MINUTES	LINKS SITE MAP	ABOUT STREMS
	Southern Tier Regional Emergency Medical Services Council

II. Guidelines for Hospital Emergency Departments and Services

The hospital plays a vital and pivotal role in the EMS system. A hospital-based Area QI Coordinator, drawing on data from a variety of sources, has a bird's eye view of the system and is in a position to effect positive change.

Many elements are required to hold the EMS system together: vehicles, equipment, trained personnel, communications and dispatch, to mention a few. We now know that an additional, essential component must be included: medical direction or "external quality control", which should be completely independent from provider control. The hospital-based Area QI Coordinator should provide this direction, in collaboration with the physician representative to the Area QI Committee.

The hospital should:

1. Identify an Area QI Coordinator.
2. Review all ED deaths and DOAs.
3. Review selected prehospital cases as identified by Service reviewer.
4. Provide for clinical training and continuing education for prehospital providers. (Agreements should be made with local agencies to address this).
5. With Service Reviewer, monitor PCR completeness and compliance with existing protocols.
6. Give and receive feedback with local Service Reviewer regarding PCR completeness, protocol compliance, prehospital diagnosis versus ED diagnosis, patient outcome.
7. Maintain the ED log and include therein the PCR#, ED diagnosis, prehospital service and level of care (ALS or BLS) in addition to the patient identification data. Completion of On-Line Medical Control form (form # 501) must be done and appropriate copies sent to STREMS.
8. Evaluate transfers. (Were provider qualifications and equipment/supplies in transport appropriate for the patient's condition?)
9. Incorporate the PCR into the permanent hospital record.
10. Participate in regional medical control, including audits and protocol revision.
11. Monitor on-line medical control. (Was it in compliance with regional protocols?)