Quality Improvement for Institutions

NCDR eReports EMS

EMS and Systems of Care Webinars Series


Making the Leap to Improvement Science

  • A historical overview of quality management in healthcare and EMS, the EMS Compass project and its evolution into the National EMS Quality Alliance
  • An examination of how the typical EMS or hospital quality program's improvement projects can benefit from a more rigorous approach that directly applies the principles and tools of the scientific method - commonly referred to as improvement science
  • Learn the difference between quality assurance and improvement - and why both are needed for quality strategy
  • See an example of a resuscitation systems of care that illustrates the calculation of quality, cost and value
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Structuring Your Organization for Quality

Overview: This webinar introduces strategies to dramatically expand an EMS agency’s capacity to do quality improvement projects.

Often in EMS agencies the responsibility of quality improvement lies with the quality manager. One person is responsible for gathering, cleaning, analyzing, and reporting the data; as well as, resolving clinical incidents and complaints and providing education. This leaves little time for actual quality improvement projects. Join this webinar to learn some strategies to increase capacity to do quality improvement projects.

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Structuring Your System for Quality

Overview: Watch Mic Gunderson, with moderators Tom Bouthillet and Tim Phalen, as they discuss strategies to improve capacity and maximize quality in your system of care. The entire EMS System, including 9-1-1 centers, non-transport medical first response agencies, ambulance services and hospitals, must modify its strategies and tactics in order to improve quality of care.

This webinar:

  • Highlights some needs differences between individual organizations and systems
  • Shows ways that systems can adopt different structures and tactics to their infrastructure and capabilities to improve quality and efficiency
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Clinical Specialty Teams: Expanding Your Clinical Quality Program Capacity

Overview: Clinical Specialty Teams are small groups of staff members who share a passion for care in a clinical area, such as, cardiac arrest, STEMI, trauma, stroke, pediatrics, or airway management.

These teams are empowered by the medical director and senior management team to take responsibility for a specific clinical area by:

  • Measuring quality.
  • Proposing improvement and research project ideas.
  • Recommending protocol, policy and equipment changes.
  • Serving as subject matter experts in development of training and continuing education content.

This Webinar gives details of how to put these teams together in your EMS organization or hospital to help them thrive!

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EMS Clinical Specialist

Overview: Watch Mic Gunderson, with moderators Tom Bouthillet and Tim Phalan, in the final installment of the series on the Team-Based Quality Model. It is envisioned that EMS Clinical Specialist are educated in very specific clinical areas, similar to the way clinical nurse specialists and physician fellows are educated.  The clinical education in their specialty goes far beyond standard paramedic curricula and is complemented by intensive education in management, adult education, research, and quality methods. This is all done in preparation for their roles in leadership of EMS clinical specialty teams (described in a prior webinars) and potentially opens a much larger set of career options for them.

Watch this webinar to learn:

  • The role and responsibilities of an EMS clinical specialist
  • The didactic training and experiential learning used for training EMS Clinical Specialists
  • How communities can work collaboratively to establish EMS Clinical Specialist training programs
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Clinical Performance Requirements

Overview: Please join Mic Gunderson with guest panelists Jeff Jarvis MD, Tom Wieczorek and Glenn Leland along with moderator Tom Bouthillet as we explore the issues and implementation of clinical performance requirements for public, private and volunteer EMS providers.

Through research, we know that clinical interventions by EMS make a difference in outcomes. However, most EMS agencies are assessed primarily on their response time by local municipalities and regulatory agencies, even though this is just one element of EMS response.

EMS should be about more than response times. But what other measures of clinical performance should apply in performance-based contracts with private ambulance services and through performance standards in publicly operated services?

We'll answer this question and more in our next webinar on Clinical Performance Requirements in EMS.

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Project Teams, Charters and Senior Management

Overview: Watch Mic Gunderson, with moderators Tom Bouthillet and Tim Phalan, in the latest installment of the free "EMS and Systems of Care Webinar Series." In this webinar they continue to drill down in the details of the team-based clinical quality model.

This webinar goes further into the details of the team-based clinical quality model with:

  • Ad hoc improvement project teams
  • The project charter document that defines work and deliverables
  • The crucial role played by the senior management team
  • The relationship between ad hoc project improvement teams and the clinical specialty teams that recommend their formation

After completing this module, attendees have the information needed to write their own project charters, secure senior management team feedback and support, and make ad hoc improvement project teams an integral part of their quality programs.

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Implementing Time Sensitive Care Coalitions

Overview: Delivering effective and efficient care for time sensitive emergencies, such as, STEMI, stroke, cardiac arrest, trauma and sepsis, require systems of care that coordinate efforts between 911 communications centers, non-transport medical first response agencies, ambulance services and hospitals. Opportunities for cross-disciplinary learning and improvement are missed when systems of care groups remain siloed.

This webinar:

  • Explores the multi-condition time-sensitive care coalition model,
  • Describes the problems with siloed efforts,
  • Explains the challenges of organizing systems of care coalitions,
  • Presents ideas and resources that can be used to implement and operate multi-condition time sensitive care coalitions.
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Improving Accuracy of EMS STEMI Alerts

Overview: Two hallmarks of well-managed STEMI system of care include an accurate field diagnosis for STEMI, followed by formally declaring a STEMI Alert to the hospital well in advance of arrival.

This webinar presents ways to:

  • Measure the accuracy of EMS STEMI alerts
  • Improve the overall accuracy of these alerts
  • Balance overcalls and undercalls on STEMI Alerts

Join Mic Gunderson, Tim Phalen and Tom Bouthillet for this timely presentation and discussion.

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Systems-Level Measurement & Improvement


Get insights into how measuring and improving performance at a systems-level is a tricky but very worthwhile process.

The Challenge:Measure how well a system of care for a time sensitive emergency is working.
The Process: Aggregate data across multiple hospitals and EMS agencies to measure how much change in a system occurred after a process improvement change.
Potential Complications: This may require organizations that are in direct competition to collaborate, which can introduce numerous political challenges on top of the technical ones.

This webinar:

  • Identifies several of the more common challenges of systems-level measurement and improvement
  • Offers insights and suggestions on how to overcome them
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Advanced Performance Measure Development: Process Capability Indexes


See how and why process performance measurement differs in processes that only need one performance specification versus processes that need two specifications.

On this webinar, learn how to:

  • Interpret and utilize process capability indexes to measure process performance with two specifications.
  • Process capability indexes contrast the reality of process performance against process specifications.
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Composite Measures: Use and Development

Overview: Combining multiple measures into one composite measure can help summarize performance for reporting. This webinar presents several options to consider when combining measures and the pitfalls you should avoid.
Join Mic Gunderson, Tim Phalan, Tom Bouthillet for this informational webinar.

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Costly Errors in the Misdiagnosis of Data Variations

Overview: When monitoring the performance of a clinical or non-clinical process, it is easy to misinterpret the variations that can occur. Sometimes variations are expected and some are from 'special causes' that need to be recognized and addressed. Unfortunately, misinterpreting normal for 'special cause' variation or vice versa can have consequences, often severe. As an example, counter-productive corrective actions can occur if a normal variation in the EMS STEMI Alert accuracy rates is mistaken to be an actual performance problem – leading to a loss of time, resources, money and clinical quality.

This webinar explores:

  • The differential diagnosis of normal and special cause data variation
  • The potential consequences from misdiagnosis of data variations
  • Tools that can dramatically improve the accuracy of your data variation diagnoses
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Data Aggregation: Looking Across Cases, Organizations and Regions


Aggregate data provide the critical information needed to improve clinical, operational and financial outcomes across entire organization, regions, states and more. This webinar explores proper techniques and common pitfalls when aggregating data; such as, using normalization for comparisons.

Join Mic Gunderson and moderators Tim Phalen and Tom Bouthillet for this webinar to help take your EMS and time sensitive systems of care quality efforts to the next level.

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