Continuous Quality Improvement

Continuous Quality Improvement, or CQI, is a peer-based process that conducts a clinical review of selected cases each month. Based on strict confidentiality and a shared commitment to excellent prehospital care, CQI reveals potential areas for improvement of the EMS System, suggests training opportunities, highlights outstanding clinical performance, audits compliance with treatment protocols, and reviews specific illnesses or injuries along with their associated treatments. These efforts contribute to the continued success of our emergency medical services through a systematic process of review, analysis and improvement.

CQI committee meetings are open to all field providers. For a schedule of monthly meetings, click here.

To view CQI Learning Points click here.

CQI Focus Studies

El Dorado County EMS is committed to the scientific analysis of prehospital care data for the purpose of improving patient care. Three focus studies have been conducted by our CQI Committee. A fourth study on "Cardiac Arrest Survival" after inclusion of new American Heart Association guidelines in local treatment protocols is currently underway.

IV Access Study
Beginning in March 2007 our CQI Committee is collecting all cases of transported patients who arrive at hospital with no IV despite multiple attempts. These PCRs should be given to each provider agency's CQI rep to bring to CQIC. Dr. Housel and Dr. Ensign will review these cases to determine patient characteristics, and if care was affected. The results of this study will give us information on the need for adult IO as well as the IV start success rate in the county on ALS patients.

Advanced Airway Study
This study evaluated every attempted advanced airway placement performed by El Dorado County paramedics from October 2004 to May 2005. There were a total 63 cases reported with 57 patients receiving an advanced airway for an overall success rate of 90%. 43 patients received endotracheal intubation, 10 received nasotracheal intubation, and 4 received a Combitube. There were no unrecognized esophageal intubations reported in this study. To view a presentation on this study, please click here.

Chest Pain Study
This two-part study reviewed the assessment and treatment by paramedics of nearly 300 patients presenting in the field with chest pain presumed to be cardiac in origin. Final study results and recommendations were presented to CQIC and the Medical Advisory Committee in August 2004. This two-phase study enabled us to identify and measure systemwide improvement in the recognition and treatment of potential myocardial infarction. For more information on this study, contact the EMS Agency.

Monophasic vs. Biphasic Defibrillation Study
This retrospective study compared survival rates in El Dorado County for biphasic defibrillation versus monophasic defibrillation. The results showed a significantly higher rate of survival for biphasic defibrillation, which is consistent with other field studies. For more information on this study, contact the EMS Agency.