As you may know, the Standards of Practice set out the minimum standards in paramedic services. Each regulated member is required to understand and comply with these Standards, but how does this translate in the day-to-day work of EMRs, PCPs and ACPs?
In an effort to help regulated members understand and apply the Standards to real life situations, we will be sharing scenarios that give context to the Standards and ideas on how to implement this into practice.
The following scenario will attempt to address quality assurance and improvement.
4.4 Quality Assurance and Improvement
The purpose of quality assurance and improvement is to ensure the regulated member has the opportunity to evolve their practice to a standard excellence. Through evaluation and analysis of the performance of restricted activities, the regulated member will be able to identify strengths and weakness within their practice and tailor continuing competence activities accordingly.
Regardless of practice setting, the participation in a quality assurance and improvement system plays a key role in ensuring the regulated member’s ability to perform all aspects of patient care, including restricted activities.
Wherever available, regulated members must participate in their employer’s quality assurance and improvement programs.
Regulated members must actively contribute to the College’s system of quality assurance and improvement by ensuring the practice of restricted activities occurs only as authorized in regulation and according to these Standards of Practice.
Scenario:
Jordan, a Primary Care Paramedic, works full time on a rural ambulance in southern Alberta and occasionally picks up shifts with an industrial EMS provider. In both practice settings, Jordan performs restricted activities such as medication administration, airway management and patient assessment under established medical control and organizational policies.
Jordan’s employer participates in a formal Quality Assurance and Improvement (QAI) program that includes regular patient care record (PCR) audits, medication variance reviews, clinical performance feedback and mandatory continuing education linked to identified practice trends.
Following a recent shift, Jordan receives a notification that one of his PCRs has been selected for routine QA review. The case involved a middle-aged patient with chest pain who received aspirin and nitroglycerin before transport. As part of the review process, Jordan is asked to reflect on:
- His assessment and decision-making
- Adherence to treatment protocols for cardiac chest pain
- Accuracy and completeness of documentation
- Appropriate authorization and performance of restricted activities
During the feedback meeting, the QA reviewer identifies that while Jordan’s clinical care was appropriate and timely, his documentation of the contraindication screening for nitroglycerin was brief and could have been clearer. The reviewer also notes a recent trend across several providers where documentation of medication checks prior to administration could be more explicit to support transparency and patient safety.
Jordan reflects on this feedback and recognizes it as an opportunity for improvement rather than discipline. He:
- Reviews the relevant Standards of Practice and medication administration guidelines
- Completes an online continuing competence module focused on high-risk medication documentation
- Adjusts his documentation habits to clearly record assessments supporting restricted activity decisions
- Incorporates the feedback into his personal learning plan for the year
In addition, Jordan ensures his practice aligns with College expectations by:
- Performing restricted activities only when authorized by the regulation
- Participating fully in employer-led QAI initiatives
- Responding to feedback in a professional and reflective manner
- Supporting a culture of continuous quality improvement within his team/practice
By actively engaging in both employer-based and College-led quality assurance and improvement processes, Jordan demonstrates his commitment to evolving his practice, maintaining excellence and ensuring safe, high-quality patient care across all practice settings.
This scenario demonstrates a regulated member’s responsibilities under Standard 4.4 Quality Assurance and Improvement, emphasizing reflective practice, participation in QA systems and continuous improvement in the performance of restricted activities.