How Good Is
How good is your ambulance service?
WESTPORT, MA – Most of us don’t think much about ambulances and paramedics until we need them.
At those times, usually times of emergency, the average person trusts they’ll receive nothing but the best of care.
Is that a fair assumption?
There are 351 emergency medical service (EMS) providers in Massachusetts and over 80 in Rhode Island. They all start out with similar training and required certification. But how well they maintain a high level of professionalism is almost always tied to the degree of sophistication of the quality improvement (QI) system that monitors their in-the-field performance.
What is QI?
"Quality improvement is a process by which an organization measures and evaluates exactly how well they’re doing and what they need to do to improve," says Paul Girard of Girard & Associates LLC, a Westport-based certified healthcare compliance specialist who serves EMS providers exclusively.
He says the issue of QI is of particular importance for taxpayers in communities where local tax dollars are used to fund emergency ambulance services. "For every individual city and town you want to ensure that tax dollars used for 9-1-1 emergency medical services are being used right and that taxpayers are getting the most value for their dollar in terms of patient care.
"To get to the heart of it," he adds, "you want to make sure that when Mom or Dad or your child gets sick that they’re getting the best possible care consistently, time and time again."
State has no specifics
Girard notes that while the Commonwealth of Massachusetts mandates that all EMS providers have a QI system in place, the regulation does not specify what that means or what an organization needs to do to establish an effective QI system.
The result?
According to Girard, "The case today is that many agencies are left wondering how to put together a good QI system."
Others, he says, have no QI system at all, meaning "that there’s probably not a lot of consistency in service and that if there are any errors or problems in the care being provided, the chances of their being found and corrected are slim to none."
A critical choice
He also calls attempts by local agencies to create a QI system of their own unwise.
"First, if they try that, it’s not independent and objective," he observes. "In order to uncover issues within your system you need an objective and independent review of what’s going on. Second, they can’t rule out biases, which can occur.
"But most important, most EMS agencies have not been trained in QI processes, so they don’t know how to develop methods for maintaining high levels of patient care."
An answer, he notes, is for local EMS providers to seek outside help from specialists in EMS quality improvement.
An objective eye
Girard says the ideal process for establishing an effective QI system involves compiling data on an organization, then measuring that data against established standards of EMS performance. The system Girard uses produces a numeric score which measures the overall level of care being provided by an organization.
"This shows them precisely what they need to know," he adds, "where they’re doing well and where they need improvement, and makes it very easy for them to understand."
An effective quality improvement program helps a community ensure that individuals and families will always receive the finest in emergency medical care.
Paul Girard of Girard & Associates LLC is a certified healthcare compliance specialist serving EMS providers exclusively. For more information call (toll free) 877-374-6811
