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Performance Improvement EMS Provider

1.Quarter Reporting
2.Name of Entity:
3.Person Completing Report:
4.Number of Trauma Patients sedated in the field? 
5.Performance Improvement Criteria / Indicators
Number of times scene time > 20 minutes for an injury-related call this quarter.
6.Performance Improvement Criteria / Indicators
Number of times >30 minutes from dispatch time to scene time for an injury-related call this quarter.
7.Number of trauma related pediatric resuscitations.
8.Number of patients that met the RAC-D definition of “Major Trauma” that were transported to hospitals outside of RAC-D this quarter.
9.For each patient above who was transferred out of TSA-D what was the determining diagnosis or factor that led to transfer out of TSA-D?
10.Number of trauma-related patients pronounced dead on scene this quarter.
11.Number of non-preventable trauma deaths this quarter.
12.Number of potentially preventable trauma deaths this quarter.
13.Number of preventable trauma deaths this quarter.
14.Number of times Air Medical Services requested but unable to respond this quarter.
15.Specific Occurrence Report
Age:
16.Gender:
17.Chart Identification #:
18.Mechanism of Injury:
19.Identified injuries and pertinent information:

20.Patient Outcome:
21.Provider Discussion:

22.Contributing Factors