How to Start a CQI Program?

[Jon]

OK..... hypothetically speaking, of course... a long-time EMT recently ran a trauma call s/p MVC (belive motorcycle involved). Pt. presents with extreme pain, obvious road rash throughout.

Non-Medical Emergency personel have already observed a defomity of some variety in the pt's leg, and report this to the EMT. EMT states nothing wrong with pt. except road rash, fails to do a full physical exam and leaves pt. for 2nd BLS crew. ALS onscene is told "just roadrash" and works with initial BLS crew on another pt. (being flown to a trauma center).

2nd crew finds patient, does a full exam, including clothes removal, and finds an open tib/fib fx, and a femur Fx. Tries to BLS to closest ED, gets told "no" and to fly pt.... calls for 2nd bird, medic comes running and is REALLY pissed that he got caught by another's poor patient care....

It seems that, hypothetically, the EMT would be at fault, possibly negligent, in failing to notice the fractures on an initial trauma exam.


Problem is.....

hypothetically, the EMT is a long-term member of your orginization, and has been doing this since Johnny and Roy. Riding on the ambulance is a social thing for them, as well as a chance to earn some extra money.

There is no CQI program in place. Once you are a primary, you are one forever.

Now what???

 

[TTLWHKR]

In that case, Never mind.

 

[Jon]

My main concern isn't to go after any EMT who might, hypothetically, have screwed up, but to make sure it dosen't happen again.

I failed to finish the post, and I appoligize...

I'm looking for some help implementing a BLS level CQI program.

Thanks,

Jon

P.... Any EMT who, hypothetically messed up in such a fashion will eventually get what is coming to them, and I'm more concerned with having something in place for the next time something like this hypathetcally happens.

 

[TTLWHKR]

I'll give it a thought or two...

Maybe later, I went through the development of my volunteer dept. from a 1960's model 'best equipped and best trained is best' ambulance service into a modern 'step into the future'.

I set up a Quality Assurance program that involved patient and crew input, records of materials used, records of apparatus responses, and put it all into a database using a microsoft program and EMS software from the Commonwealth office of EMS.

I'm going away for a while, I'm picking up a hearse that I purchased... Prolly be away for about a week or more. It's already snowing up there they tell me, so it will be an interesting trip. Waiting for a fax w/ directions at the moment.

 

[Jon]

Good luck, Alex...

And thanks, in advance.


Jon