EMD Quality Assurance and Improvement 3 — Questions and Answers
Question 1: In a PDCA (Plan-Do-Check-Act) quality improvement cycle, what occurs during the 'Act' phase?
- Data is collected and analyzed for emerging trends
- A new procedure is piloted with a small dispatcher group
- Changes are standardized or the cycle restarts based on evaluated outcomes (Correct answer)
- Dispatchers are informed of new monthly performance goals
Correct answer: Changes are standardized or the cycle restarts based on evaluated outcomes
The Act phase institutionalizes successful changes or returns to the Plan phase if the intervention did not achieve the desired result.
Question 2: In EMD protocol compliance, 'zero tolerance' elements are best described as steps that:
- Require optional adherence based on the dispatcher's discretion
- Must never be omitted regardless of call circumstances (Correct answer)
- Are enforced only during peak call volume periods
- Apply exclusively to cardiac arrest calls
Correct answer: Must never be omitted regardless of call circumstances
Zero tolerance steps — such as obtaining a callback number or sending pre-arrival instructions — are mandatory on every applicable call.
Question 3: Which feedback method is considered most effective for improving individual dispatcher performance in an EMD center?
- Anonymous written critiques distributed at the end of each month
- Timely, specific, one-on-one coaching sessions using recordings of actual calls (Correct answer)
- Group presentations of aggregated error rates by shift
- Posted monthly rankings showing each dispatcher's compliance score
Correct answer: Timely, specific, one-on-one coaching sessions using recordings of actual calls
Immediate, specific coaching tied to a real call provides actionable context that generic group feedback cannot replicate.
Question 4: In EMD QA, a dispatcher's 'compliance score' primarily measures:
- How quickly the dispatcher completes post-call documentation
- The degree to which the dispatcher followed each required step of the approved protocol (Correct answer)
- The accuracy of patient demographic information entered into the CAD
- Whether EMS units acknowledged dispatch within 30 seconds
Correct answer: The degree to which the dispatcher followed each required step of the approved protocol
Compliance scoring evaluates adherence to every required protocol element — key questions, instructions, and code selection.
Question 5: Why is tracking 'call processing time' a key metric in EMD quality assurance?
- It determines the dispatcher's annual performance bonus
- It measures operational efficiency and identifies delays that may adversely affect patient outcomes (Correct answer)
- It is required only for motor vehicle accident calls
- It calculates the total number of available EMS units per shift
Correct answer: It measures operational efficiency and identifies delays that may adversely affect patient outcomes
Shorter call processing times — especially in life-threatening calls — directly correlate with faster EMS response and better patient survival rates.
Question 6: When a QA reviewer identifies a pattern of the same protocol error across multiple calls by one dispatcher, the most appropriate next step is to:
- File a formal complaint with the state EMS licensing board
- Initiate targeted coaching and a structured performance improvement plan (Correct answer)
- Remove the dispatcher from call-taking duties immediately
- Document the pattern without taking further action unless a complaint is filed
Correct answer: Initiate targeted coaching and a structured performance improvement plan
A pattern indicates a knowledge or skill gap that coaching and a formal improvement plan can address systematically.
Question 7: In cardiac arrest call QA, which dispatcher time interval is considered the most critical performance indicator?
- Time from unit dispatch to hospital notification
- Time from call receipt to delivery of the first CPR instruction (Correct answer)
- Time from patient contact to medication administration by paramedics
- Time from scene arrival to hospital departure
Correct answer: Time from call receipt to delivery of the first CPR instruction
Rapid delivery of CPR instructions by the dispatcher dramatically increases survival rates by initiating bystander resuscitation before EMS arrives.
EMD Quality Assurance and Improvement 3
In a PDCA (Plan-Do-Check-Act) quality improvement cycle, what occurs during the 'Act' phase?