A Computer-assisted Quality Assurance System for an Emergency Medical Service

A busy urban emergency medical service answering more than 50,000 calls each year developed a plan for quality assurance using a computer-assisted model designed to employ a full-time quality assurance officer whose work was supplemented with computer evaluation of EMS field reports. The development of standardized reporting formats, protocols and computer programs enabled a significant improvement in detection of errors of documentation and patient care. Investigated cases rose dramatically in the month following implementation of the system, from five patient care errors per month to 35 (P less than .05), and from 50 documentation errors to 265 per month (P less than .05). Our experience indicates that computer-assisted evaluation of field performance, as judged by prehospital records, is a useful tool to ensure standards in patient care and EMS recordkeeping.