Quality Management and Best Practices
Stratford EMS takes quality seriously. Our Continuous Quality Improvement (CQI) program is a systematic, ongoing review of the care we provide, the people who provide it and the outcomes our patients experience. The program covers the whole system, from the 9-1-1 call through hospital outcome and billing. It is transparent and reproducible, and it is designed to standardize performance, reduce risk and ensure that every patient receives high-quality care.
Quality Starts With Our People
Quality improvement begins long before a call is reviewed. It starts with careful selection and hiring, strong human resource management and continuous training. Every member completes ongoing continuing education and recertification to maintain current knowledge and clinical skills, and lessons learned through CQI are built back into our training.
What We Review
Every patient care report is linked with its dispatch data, crew data and hospital follow-up, so each call can be evaluated from the 9-1-1 call through the patient’s outcome. Calls are selected for detailed clinical review by random selection, by call type (including all high-acuity and time-sensitive calls such as STEMI, cardiac arrest, stroke and childbirth) and by referral from a member, supervisor, hospital partner or patient. Our review includes:
- Emergency Medical Dispatch case review: accuracy and compliance of call-taking and pre-arrival instructions
- Response time review: time from 9-1-1 call to arrival on scene
- Patient care report review: clinical care, protocol compliance and documentation
- Hospital follow-up: outcome data for our patients after we deliver them to the hospital
- Billing and documentation review: accurate, complete and compliant records
- Patient experience: independent survey results and direct patient comments
How We Use What We Learn
- Individual feedback: Review findings are shared with each member directly and privately. That includes recognition of excellent care as well as areas for growth.
- Department results: Cumulative department performance data is shared with all staff every month.
- System improvement: Leadership and our Medical Directors use the data to identify trends, set improvement priorities and change protocols, training, equipment or processes where needed. We then measure again to confirm that the change worked.
Patient and Responder Safety
Stratford EMS follows a Just Culture approach to safety. Members are expected and encouraged to report errors, near misses and safety concerns without fear of unfair blame. Each report is reviewed, tracked and resolved, and the focus is on fixing the systems and processes that allowed the event to happen. Stratford EMS also supports the national EMS Voluntary Event Notification Tool (E.V.E.N.T.), which lets EMS professionals anonymously report patient safety events, near misses and violence against responders so the entire profession can learn from them.
Patient Experience Surveys
Stratford EMS surveys the patients we serve about their experience with our care. Surveys are conducted by EMS Survey Team, an independent third-party firm. This keeps responses anonymous, protects patient privacy and ensures the integrity of the results. It also lets us benchmark our performance against EMS agencies across the country.
Patient feedback helps us improve the quality of care, operations and customer service. Above all, we use it to help our members improve their interactions with patients. Direct comments from patients, the most important voice in our system, are shared with our staff because they provide the most genuine feedback we receive.
Cardiac Arrest Registry to Enhance Survival (CARES)
Since 2020, Stratford EMS has participated in the Cardiac Arrest Registry to Enhance Survival (CARES), a national registry established by the Centers for Disease Control and Prevention (CDC) and Emory University. Using standard Utstein-style reporting, CARES links 9-1-1, EMS and hospital data to track cardiac arrest survival in communities across Connecticut and the United States. The Connecticut Office of Emergency Medical Services provides CARES access to Connecticut EMS agencies at no cost. We use this data to measure each link in the chain of survival and to work with local first responders and bystanders to improve cardiac arrest survival in Stratford.
American Heart Association Mission: Lifeline EMS Recognition
Stratford EMS has participated in the American Heart Association’s Mission: Lifeline EMS recognition program since it launched in 2014, and has been recognized at the Gold Plus level. Mission: Lifeline EMS recognizes EMS agencies nationwide for excellence in prehospital heart attack (STEMI) care. EMS is often the first point of care for these patients, and the speed and quality of that care can set the course for the patient’s outcome. The program also recognizes the teamwork between EMS agencies and the destination hospitals that care for these patients.
Medical Oversight
Our clinical care and CQI program operate under the medical oversight of the Emergency Department physicians and EMS Coordinators of the Sponsor Hospital Council of Greater Bridgeport (SHCGB), which includes Bridgeport Hospital (Yale New Haven Health) and St. Vincent’s Medical Center (Hartford HealthCare). Our Medical Directors set clinical protocols, authorize our paramedics and EMTs to practice, provide education and review clinical care to ensure it meets the highest standards.