Girard & Associates Delivers Unbiased, Expert EMS Run Report Reviews That Protect Patients, Providers—and Reputations!
Could your patient care report withstand the scrutiny of a nationally televised murder trial—or protect you from charges if a critical mistake leads to tragedy? For EMS professionals, a single documentation error can carry life-or-death consequences not only for patients, but also for providers’ careers, licensure, and legal liability.
Two landmark legal cases highlight this stark reality. In DeTarquino v. Jersey City EMS, a crew failed to document that a head-injured patient had vomited—a potential sign of serious brain trauma. The patient was initially discharged from the hospital, only to later seize, lapse into a coma, and die from an intracranial bleed. The court ruled that negligent documentation is distinct from negligent care and denied the EMS providers qualified immunity.
In Henslee v. Provena Hospitals, the failure to document several unsuccessful intubation attempts was deemed gross negligence—even though the care itself may have otherwise followed protocol. These rulings underscore a sobering truth: documentation can create liability, even in the absence of clinical error.
“These cases show why meticulous EMS documentation isn’t just a paperwork exercise—it’s a critical safeguard for patients and providers,” said Paul Girard, Founder, President, and CEO of Girard & Associates, Inc. (G&A). “At Girard & Associates, we help EMS agencies nationwide build the systems and skills needed to prevent these life-altering mistakes.”
What Is The G&A Way?
Founded in 2005 and based in Westport, Massachusetts, Girard & Associates is a national EMS Continuous Quality Improvement (CQI) consulting firm that has conducted over half a million EMS run report reviews and one-on-one “coach-up” sessions. Their proprietary quality improvement model, known as The G&A Way, is built on three pillars: unbiased expertise, objectivity, and accountability.
Unlike traditional in-house quality assurance processes—often limited by internal politics, staffing pressures, or superficial flagging systems—G&A’s process is third-party, deeply clinical, and ruthlessly consistent.
It Starts with the Elite: EMS 1%’ers
Every ePCR review begins with one of G&A’s elite EMS 1%’ers—a term reserved for its rigorously trained documentation risk assessors. These individuals are not simply compliance auditors; they are experienced EMS professionals with deep expertise in clinical care, documentation integrity, and legal risk. They are trained to identify what most overlook: omissions, contradictions, or documentation gaps that could be clinically or legally significant.
Each review is conducted independently, without influence from internal agency dynamics. The result is a fair, unbiased assessment that reflects a national best-practice standard—not a subjective local norm.
Turning Documentation into Data—and Data into Action
Once reviewed, findings are entered into The G&A Way Database, a proprietary engine that calculates a severity-weighted risk score based on the clinical and legal implications of documentation lapses. This scoring system doesn’t simply count errors—it measures how serious those errors could be in terms of patient safety, liability, or compliance.
These risk scores are tracked over time to identify trends across individual providers, shifts, or agency-wide patterns. High-risk calls and their associated risk indices are forwarded directly to the EMS agency’s Medical Director, who provides clinical feedback and guidance on next steps.
From Feedback to Frontline Impact
That medical feedback is then passed to a G&A EMS CQI Coordinator—an experienced coach trained in the firm’s proprietary leadership framework, the 4C’s of Successful EMS CQI Leaders:
- Command Presence
- Competitiveness
- Coachable
- Compassion
Higher risk clinical issues, identified by the medical director through the G&A process, are discuss immediately with the provider to determine if a clinical issue is present after input from the provider.
The coordinator also conducts one-on-one coaching sessions with each provider on a trimester basis to review lessor critical clinical issues and to review that providers documentation for opportunities for improvement.
These are private, supportive, and focused on building competence, not issuing punishment. Each coaching session helps providers understand their personal risk profile, reinforce best practices, and learn how to document more clearly, accurately, and defensibly.
“This isn’t about nitpicking charts,” said Girard. “It’s about developing confident, accountable clinicians who understand that documentation is just as important as clinical care—because, in the courtroom, the chart is the care.”
Unbiased. Unmatched. Uncompromising.
In an era where EMS is increasingly under public, financial, legal, and regulatory scrutiny, The G&A Way offers agencies a scalable, evidence-based solution to a complex and costly problem. The firm’s independent reviews, data-driven scoring, and expert coaching model ensure EMS providers are not only compliant—but clinically sharp, well-documented, and defensible.
Paul Girard, who began his EMS journey in 1979 and became a paramedic in 1986, launched G&A after graduating Magna Cum Laude from Bryant University in 2004. His combined experience in clinical care, finance, and EMS leadership allowed him to build a model that bridges legal risk, medical excellence, and human development.
“Every EMS provider wants to do the right thing,” Girard said. “Our job is to help them document it—clearly, completely, and correctly—so they’re protected, the patient is protected, and the agency can stand behind their care with confidence.”
By Kevin Kelley and Paul Girard
About Girard & Associates
Girard & Associates, Inc. is a privately held national EMS CQI firm based in Westport, MA, with over 40 staff across the country. The firm offers documentation auditing, CQI program development, compliance risk reduction, and EMS provider coaching. Paul Girard is the co-host of The G&A Way EMS CQI Podcast and a nationally recognized expert on EMS quality improvement.
For more information, visit www.girardassoc.com or contact Paul Girard at 1-877-374-6811 or paul.girard@girardassoc.com.
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