Delaware Administrative Code
Title 1 - Authorities, Boards and Commissions
700 - Delaware State Fire Prevention Commission
710 - Ambulance Service Regulations
Section 710-13.0 - Statewide Basic Life Support Quality Assurance/Quality Improvement
Universal Citation: 1 DE Admin Code 710-13.0
Current through Register Vol. 28, No. 3, September 1, 2024
13.1 The Commission hereby establishes a Statewide Basic Life Support (BLS) Quality Assurance and Quality Improvement working group.
13.2 Purpose. The Quality Assurance/Quality Improvement working group (QA/QI), under direction of the State Medical Director or the designee is responsible for assuring and improving the quality of Basic Life Support within the EMSS that are served by the State of Delaware.
13.3 Definitions
13.3.1 "Quality assurance" or "QA" means the
retrospective review or inspection of services or processes that is intended to
identify problems.
13.3.2 "Quality
improvement" or "QI" means the continuous study and improvement of a process,
system, or organization.
13.4 Objectives
13.4.1 Conduct medical incident reviews
(QA)
13.4.2 Collect patient care
statistics to evaluate EMS effectiveness and identify trends (QI)
13.4.3 Provide constructive feedback on
quality improvement to all EMS Providers within the State of Delaware
13.4.4 To coordinate the findings of quality
assurance activities with the content of EMS Provider continuing education
programs
13.4.5 To provide
assistance to EMS providers with local agency QA/QI programs.
13.5 Emergency Medical Services Provider Agencies Quality Assurance and Improvement Requirements:
13.5.1 EMS provider agencies must appoint a
Quality Assurance Manager
13.5.2
The Quality Assurance Manager is charged with the responsibility of assuring
that reasonable standards of care and professionalism are met within their
respective EMS provider agency.
13.5.3 The Quality Assurance Manager should
attend a quality management training program.
13.5.4 The Quality Assurance Manager shall
implement a Quality Assurance and Improvement Program within their agency or
department.
13.5.5 The Quality
Assurance Manager shall perform monthly reviews of their data collection and
conduct formal reviews with their personnel.
13.5.6 The Quality Assurance Manager will
work closely with the Statewide QA/QI working group on emergency medical
services policies, guidelines, protocols and system performance.
13.5.7 The Quality Assurance manager will
consult with their county and State EMS Medical Director.
13.5.8 The Quality Assurance manager will
consult with the Delaware State Fire School Director or its designee.
13.6 Statewide QA/QI Improvement Working Group
13.6.1 The goal of this working
group is to make sure BLS is meeting all State standards and is providing the
best patient care to the citizens and visitors of Delaware.
13.6.2 The statewide BLS QA/QI working group
shall be comprised of:
13.6.2.1 2 BLS
representatives, Delaware EMT certified, from each county;
13.6.2.1.1 1 selected from names submitted by
the County Firefighter's Association; and
13.6.2.1.2 1 selected from names submitted by
the County EMS or Chief's Association;
13.6.2.2 The BLS Medical Director or the
designated agent;
13.6.2.3 1
representative from the State Fire Prevention Commission, who shall chair the
working group;
13.6.2.4 1
representative from the Delaware State Fire School;
13.6.2.5 1 representative from the Office of
Emergency Medical Services; and
13.6.2.6 1 representative from the Delaware
Volunteer Firefighter's Association.
13.7 Working Group Responsibilities
13.7.1 Responsible to assure reasonable
standards of care and professionalism are met within the State's BLS
system.
13.7.2 Participate in
patient care report review audits, data collection, and evaluation of system
performance.
13.7.3 Maintain strict
confidentiality of patient information, personnel and Q/A topics.
13.7.4 Each working group member MUST sign a
confidentiality statement to be provided by the Office of Emergency Medical
Services.
13.7.5 Make sure
information disseminated is protected from discovery of protected healthcare
information.
13.7.6 Make
recommendations for changes to policies, guidelines and protocols.
13.7.7 Attend a quarterly meeting to discuss
QA/QI issues.
13.7.8 Design and
implement QI projects that are practical and able to collect patient care
statistics to evaluate system effectiveness and identify trends in patient
care.
13.7.9 Establish clinical
benchmarks to measure the State's BLS system.
13.8 Medical Incident Review and Analysis
13.8.1 The QA/QI process evaluates all
aspects of patient care and emergency medical services performance in the BLS
system. QA/QI process shall evaluate the Key Performance Indicators (KPI) of
the EMS system as defined by the SFPC.
13.8.2 Quarterly reports will be developed
through the State's patient care reporting system. A percentage of the patient
care reports will be reviewed using a designated and approved auditing tool as
developed by the QA/QI working group and approved by the Commission.
13.8.3 The QA/QI working group shall review
these reports during the quarterly meeting.
13.8.4 The primary goal is to identify and
address any problem or improvement areas and recommend potential solutions:
13.8.4.1 Knowledge or skill issues
13.8.4.2 Documentation issue
13.8.4.3 Resource issue
13.8.4.4 Protocol issue
13.8.4.5 Communication issue
13.8.4.6 Statewide system issue
13.8.4.7 Conduct issue
13.8.5 The QA/QI working group shall provide
constructive feedback and recommendations to improve the State's BLS system.
13.8.5.1 Recommend changes to policy,
procedures, or protocols
13.8.5.2
Recommend changes in operational procedures or equipment
13.8.5.3 Recommend training
13.8.6 All working group
recommendations will be forwarded to the appropriate EMS provider agency or
agencies and to the Commission.
Disclaimer: These regulations may not be the most recent version. Delaware may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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