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<br />internal medical quality controls - continued <br /> <br />Concurrent - The concurrent phase of the quality process encornpassesthe delivery of service and <br />patient care. It focuses on performance monitoring and application of procedures. The Operations Managers <br />are the primary resource for this evaluation. The Care Ambulance Operations Managers actively engage <br />field employees, public safety personnel, and facility staff. During this interaction, the Operations Managers <br />are observing patient care and crew interpersonal skills with other members of the patient care team. The <br />concurrent evaluation provides the environment for almost immediate feedback on job performance. The <br />concurrent evaluation is where many exceptional performances are recognized. <br /> <br />The real time aspect of concurrent evaluation allows issues or concerns to be identified and addressed <br />immediately. Quality improvement is ongoing and does not need to wait for the end of month report <br />Operational changes to improve system performance can be implemented quickly when organizations are <br />committed to quality. Care Ambulance through a variety of mechanisms has the ability to notify employees <br />of changes that are put into practice. These changes are approved by appropriate company officials prior to <br />implementation. <br /> <br />Retrospective - All phases of the quality process are important. The retrospective phase is the after-event <br />evaluation of system performance. To ensure positive findings retrospectively, it is important to invest heavily <br />in quality control that is prospective (hiring, training etc.) and concurrent (evaluation of the service / care at <br />the time of delivery). Retrospective quality control is looking back on service or care that has already been <br />delivered. Examples of areas of retrospective review are: <br />Patient Care Reports <br />Use of an Automated External Defibrillator <br />Documentation of the need for patient restraints <br />Emergency Vehicle Operations reports <br />Unexpected clinical events <br /> <br />The results of the retrospective review provide data to facilitate changes in operating procedures to improve <br />performance. This data also allows the organization to identify trends. Data is wonderful, but improvement <br />only occurs when the data is acted on. The QA/QI Manager works closely with the Training Department to <br />identify areas for additional training or the need for a change in training curriculum. There may be times when <br />the quality process identifies an individual or individual(s); who require refresher training. These situations <br />are referred to the Training Department where the necessary training is provided. Upon completion of the <br />training, the Training Manager will advise the QAlQI Manager that the required training has been completed. <br />The individual(s) will be monitored to ensure compliance. This action of "closing the loop" is one of the <br />fundamental concepts of continuous quality improvement. <br /> <br />Many organizations say that they are driven by the CQI process, yet only invest in the retrospective <br />component of the process. Care Ambulance truly embraces CQI and has the systems in place to facilitate <br />continual improvement: Prospective, Concurrent, and Retrospective. It is with great pride that Care <br />Ambulance employees provide exceptional service to each and every customer because of our commitment <br />to quality. 14 <br />