Quality Improvement and Assurance

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I can assure you that I have made more

mistakes than you and I am no where near perfect nor am I an

expert.

I don’t know everything, I’m

learning everyday, for myself and because my

fellow EMS family deserves my best.

I’m the woman in the arena.

—Theodore Roosevelt

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Quality Assurance

• Reactive

• Retrospective

• Focuses on the Individual

• Answers “Are we meeting the

standard of care?”

• Led by Management

• Answers “Are we following

previously established protocols

and policies?”

• Sporadic or intermittent

occurences

Quality Improvement

• Proactive

• Usually Prospective

• Focuses on System Processes

• Works on Necessary Culture

Shift

• Ideally led by Staff &

Management

• Answers “How can we exceed

our current standard?”

• Continuous (CQI)

Why?

“Please come to my office, I’d like to review a run report with you.”

We’ve built strong, alpha,

independent thinkers who can

take control of chaotic

emergent situations- now you

expect them to do what-

because you say so?? They are

all adults, crisis forged- they’re

not going to do anything they

don’t believe in-- they need to

know and understand the

“why”.

The Psychology of Changehttp://www.ihi.org/Topics/Psychology-of-Change/Pages/

https://hbr.org/2012/09/ten-ways-to-get-people-to-chan

https://www.mckinsey.com/business-functions/organization/our-insights/the-psychology-of-

change-management

Punishment is so 1980’s! Just Culture and Patient Safety taught us that you teach people to fear and they will hide accidents and errors.

SOAPBOX WARNING

Education, education, education!

In-person is best, not cost-effective, agency bandwith?

https://www.sepsis.org/trainingmodule/sepsis-first-response/

https://24-7.hsi.com/course-catalog?hsCtaTracking=ed58e8fd-f95b-4f61-8f3d-487e51e748be%7C7fcf0a4b-2067-41f0-b5b8-396d7d68356d

https://americancme.com

https://www.train.org/mi

https://www.ems1academy.com/

https://www.strykeremergencycare.com/learn-and-train/videos/

https://www.targetsolutions.com/company-blog/free-ems-training-webinar/

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November 14, 2017

www.24-7ems.comwww.action-training.comwww.americancme.comwww.onlineaha.orgwww.ems-ce.com

www.centrelearn.comwww.easyic.netwww.arrivealivedonoharm.comwww.medic-ce.comwww.mediced.com

www.medmergesolutions.comwww.miemseducation.com

Praetorian Digital- EMS 1 www.ems1academy.com (formerly Kaplan)Praetorian Digital-Fire Rescue www.firerescue1academy.com (EMS related courses only)Recert https://www.recert.com

www.targetsolutions.com

http://www.surgery.med.umich.edu/pediatric/trauma/protocols/

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Supervisors,

PSRO, and

peers are more

susceptible to

Hindsight Bias.

http://www.ihi.org/resources/Pages/Tools/default.aspx

http://Lexipol.com/resources/

https://www.hhs.gov/

https://www.ahrq.gov/talkingquality/measures/six-domains.html

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https://hbr.org/2012/09/ten-ways-to-get-people-to-change

Credit to Aaron Reinhart-SafeTech Solutions for showing me this resource at Leadership

Academy

http://www.ihi.org/resources/Pages/Tools/Quality-Improvement-

Essentials-Toolkit.aspx

Credit to Krisy Kuhl- MDHHS-BETP Community Integrated

Paramedicine Coordinator for sharing this resource years ago

Web Resources

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FEATURED TOOLS• Patient Safety Essentials Toolkit• Download these nine essential tools to guide your organization in improving patient safety and delivering safe,

reliable care. Tools include FMEA, SBAR, root cause analysis, daily huddles, and more.• Quality Improvement Essentials Toolkit• Download these ten essential quality improvement tools to help you with your improvement projects,

continuous improvement, and quality management, whether you use the Model for Improvement, Lean, or Six Sigma.

• IHI Global Trigger Tool for Measuring Adverse Events• The use of "triggers," or clues, to identify adverse events (AEs) is an effective method for measuring the overall

level of harm in a health care organization.• SBAR Tool: Situation-Background-Assessment-Recommendation• The SBAR (Situation-Background-Assessment-Recommendation) technique provides a framework for

communication between members of the health care team and can be used as a tool to foster a culture of patient safety.

IMPROVEMENT TOOLS• Quality Improvement Team Member Matrix Worksheet• QI Team Member Work Styles Inventory Worksheet• Quality Improvement Project Measures Worksheet• Quality Improvement Project Change Concepts Worksheet• Sustainability Planning Worksheet

https://pubmed.ncbi.nlm.nih.gov/

https://edhub.ama-assn.org/steps-

forward/module/2702507#resource

https://www.ahrq.gov/talkingquality/measures/six-

domains.html

Web Resources

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Agency for Healthcare

Research & Quality

✓ Burnout or Compassion Fatigue?

✓ Bias

✓ Fundamental Attribution Error

✓ Confirmation bias

✓ Self-serving bias

✓ Hindsight bias

✓ Optimism/Pessimism bias

✓ Sunk lost cost

✓ Negativity bias

✓ Decline bias

✓ Backfire Effect

✓ In-Group bias

✓ The Forer Effect

✓ Implicit Bias

✓ Stereotyping

✓ Racial

✓ Gender

✓ Ethnic

✓ Creates Health Disparities

What is your agencies & MCA PSRO’s duties according to the

MDHHS-BETP System Protocols?

Questions? Ask the Expert- not me! ☺

Emily Bergquist, EMT-P I/C, MSAMedical Control Authority CoordinatorDivision of EMS and TraumaBureau of EMS, Trauma and PreparednessMichigan Department of Health & Human Services1001 Terminal Rd.PO Box 30207Lansing, MI 48906Office: 517-335-0067Cell: 517-449-9225Fax: 517-335-9434Website: www.michigan.gov/ems

• Fierce Conversations- Susan Scott

• Fierce Leadership- Susan Scott https://fierceinc.com/

• Daring Greatly –Brene’ Brown

• Dare to Lead- Brene’ Brown https://daretolead.brenebrown.com/

• The 5 Dysfunctions of a Team-Patrick Lencioni

• Mistakes Were Made, But Not by Me- Carol Tavris, Elliot Aronson

• Verbal Judo- George Thompson https://verbaljudo.com/

• The 4 Essentials of Effective Communication- Bento Leal

• The Coaching Habit, Say Less, Ask More & Change the Way you Lead- Michael Bungay Stanier

• How to Win Friends and Influence People-Dale Carnegie

• Thinking Fast and Slow- Daniel Kahneman

• 360* Leader- John Maxwell

• Emotional Intelligence 2.0- Travis Bradberry, Jean Greaves

• It’s Not About You- Tom Rath

• Crucial Conversations- Kerry Patterson

• The Four Tendencies- Gretchen Rubin https://quiz.gretchenrubin.com/

• Trauma Stewardship- Travis Bradberry

• 13 Things Mentally Strong People Don’t Do- Amy Morin

• Start with Why- Simonek

https://nasemso.org/projects/ems-compass/https://ems.govhttps://www.ems1.com/quality-improvement-program/articles/naemsp-2020-quick-take-bringing-ems-quality-improvement-front-and-center-3f5Unmhwv35I9bQR/http://www.nhtsa.dot.gov/people/injury/ems/leaderguide/https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment

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You must complete the quiz and evaluation to receive CE credit.

• You have two weeks to complete the quiz & eval

• You must acquire a passing score of 80% or better to receive your CE

• CE web-link: https://msu.co1.qualtrics.com/jfe/form/SV_3Q8CttPW8P

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Copy and paste the address into your web browser or you must be in presenter mode to click the link.

• This link can also be found in the informational email

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