LAC 48:I.6053. Quality Assurance [Formerly §6043]

A. The ambulance service shall have an on-going comprehensive, integrated, self-assessment quality improvement process that provides assurance that patient care is provided at all times in compliance with accepted standards of professional practice. B. The ambulance service shall have written plans, policies, and procedures addressing quality assurance. C. The ambulance service shall follow a written plan for continually assessing and improving all aspects of operations which include: 1. goals and objectives; 2. the identity of the person responsible for the program; 3. a system to ensure systematic, objective regular reports are prepared and distributed to the ambulance service/ provider’s governing body and any other committees as directed by the governing body; 4. the method for evaluating the quality and the appropriateness of care; 5. a method for resolving identified problems; and 6. a method for implementing practices to improve the quality of patient care. 7. a method to document EMS Practitioner skills competencies including a process for demonstrating proper pediatric care based on the agency or local protocols/guidelines. D. The plan shall be reviewed at least annually and revised as appropriate by the ambulance service’s medical director and director of operations. E. Quality assessment and improvement activities shall be based on the systematic collection, review, and evaluation of data which, at a minimum, includes: 1. services provided by professional and volunteer staff; 2. audits of patient charts; 3. reports from staff, volunteers and patients/clients about services; 4. concerns or suggestions for improvement in services; 5. organizational review of the ambulance service program; 6. patient/family evaluations of care; and 7. high-risk, high volume and problem-prone activities. 8. In the event of an ambulance crash resulting in a catastrophic injury, the Louisiana Bureau of EMS shall have the right to request crash data from the Louisiana Department of Motor Vehicles for the purpose of collecting data on ambulance crashes to identify trends for patient care and quality improvement associated with the operation of ambulances. Any information collected under this section shall be de-identified as to all individual and entities contained in the data and aggregated at the statewide level. Further, as part of the data collection associated with the data collection set forth in this section, the Louisiana Bureau of EMS may contact an individual ambulance provider only by telephone or in person to obtain Provider information about such ambulance crashes involving catastrophic injuries. The Louisiana Bureau of EMS shall direct all correspondence under this section to the registered license holder for the ambulance provider. a. In instances in which immediate medical treatment in an emergency department of a hospital is required by an ambulance provider of an employee prior to them being able to return to work, reporting shall not be required under this section. b. Ambulance provider information shall include and be specifically limited to the following questions: i. At any time during the ambulance crash, did the stretcher become dislodged from its locking mechanism? ii. At any time during the ambulance crash, did the stretcher locking mechanism separate from the vehicle? iii. Did any equipment over ten pounds become airborne? iv. Did any compartment or cabinets open? c. No ambulance provider, whether private or a unit of government, including municipalities and political subdivisions of the state, shall be required to provide any information associated with any ambulance crash and/or the ambulance provider information, regardless of whether the ambulance crash had any catastrophic injuries, that may be subject to or be made part of any litigation or an administrative hearing or proceeding, regardless of whether the litigation, hearing or proceeding is civil or criminal in nature. If the ambulance provider has a reasonable expectation that the ambulance crash will result in litigation or an administrative hearing or proceeding, the ambulance provider shall not be required to disclose any ambulance provider information, or any other information, to the Bureau of EMS until such time as the litigation or administrative hearing or proceeding has concluded and all appeals have been exhausted. d. Should the ambulance provider be unable to provide requested information due to pending litigation, administrative hearing or proceeding or suspected pending litigation, administrative hearing or proceeding, the ambulance provider shall provide information requested by the Bureau of EMS at such time as the pending or suspected litigation or administrative hearing or proceeding has concluded and all appeals have been exhausted. e. Any and all information associated with any ambulance crash collected by the Bureau of EMS is solely for data collection and patient care quality improvement purposes associated with the operation of ambulances. No source data collected by the Louisiana Bureau of EMS or compiled by the ambulance provider shall be subject to any public records disclosure as the raw data collected shall be protected under the provision of La. R.S. 13:3715.3(A)(1) because the data collected in accordance with this Rule is specifically designated as data, studies, and analysis of a healthcare licensing agency of the Louisiana Department of Health. F. When problems are identified in the provision of ambulance care, there shall be: 1. evidence of corrective actions, including ongoing monitoring; 2. revisions of policies and procedures, as appropriate; and 3. educational intervention and changes in the provision of services. G. The effectiveness of actions taken to improve services or correct identified problems shall be evaluated.