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EMS QA/QI - Performing a QA/QI Review

Purpose Statement

The EMS QA/QI Review Process enables supervisors and quality assurance reviewers to systematically evaluate patient care reports for accuracy, completeness, and compliance with organizational standards. This structured workflow facilitates communication between reviewers and report authors, ensures documentation quality, maintains regulatory compliance, and provides meaningful feedback that improves EMS documentation and patient care across the organization.By standardizing the review process, departments can identify documentation trends, address training needs, and maintain consistent, high-quality EMS reporting standards.

Background Information

Quality Assurance and Quality Improvement (QA/QI) are foundational components of modern EMS operations. The First Due EMS QA/QI process creates a structured review lifecycle that begins when an EMS provider selects Request Supervisory Review during report completion.
How Reports Enter the QA/QI Workflow
  • Reports automatically enter the QA/QI list when a provider selects Request Supervisory Review
  • This action triggers a workflow that routes the completed ePCR into the QA/QI queue for assignment and review
QA/QI Status Definitions
An incident displayed in the QA/QI list will have one of five statuses:
  • Not Started – Report submitted for QA/QI; no reviewer comments exist
  • Review In Progress – Reviewer comments added; author review not yet requested
  • Waiting – Reviewer is waiting for the report author to make corrections
  • Pending – Report author has resubmitted updates for reviewer approval
  • Review Complete / Approved – QA/QI review process is finalized

Required Permissions

ePCR QA/QI Permissions
Users must have one or more of the following permissions:
  • List My QA/QI EMS Incidents – View assigned or unassigned records
  • List All QA/QI EMS Incidents – View all QA/QI records
  • Assign EMS Reports to QA/QI Reviewers – Assign reviewers
  • List View Management – Filter, sort, and customize QA/QI views

Video

Step-by-Step Guide

Initial Review Process

 
1. Access EMS QA/QI
  • Navigate to Incident Documentation
  • Click EMS QA/QI
 

 
 
 
 
2. Assign Reports
  • Select one or more reports
  • Click Assign To
 

 
 
 
 
3. Confirm Reviewer Assignment
  • Ensure each PCR is assigned to at least one reviewer
  • Reviews cannot begin until assignment is complete
 
PCRs need to be assigned to one or more reviewers before a review can begin.
 
 
 
 
4. Filter and Organize the QA/QI List
  • Use filters at the top of the list to refine incidents
  • Configure columns and filters as needed
  • Save custom views for future use
 

 
 
 
 
5. Begin the Review
  • If assigned as a reviewer, the Review button appears in the Actions column
  • Click Review to open the report in review mode
 

 
 
 
 
6. Add Field-Level Comments
  • Hover over any field
  • Click the Comment icon to leave feedback
 
Hover over any field, and click on the comment icon to leave a comment for the selected field.
 
 
 
 
7. Select Comment Type and Enter Feedback
  • Choose a comment type:
    • Red (Error) – Critical issues requiring correction
    • Yellow (Warning) – Recommended improvements
    • Green (Well Done) – Positive reinforcement
  • Enter comments in the text box
  • Info:
    • Green comments do not require approval or resolution
 
Choose between an error (red), warning (yellow) or well done (green) message, and type a comment in the text box.
 
 
 
 
8. Save Comments
  • Click Send Comment to save and continue reviewing
 

 
 
 
 
9. Review All Comments
  • Click Comments to view a consolidated list of all feedback
 

 
 
 
 
10. Request Author Review
  • Click Request Review to notify the report author
  • Info:
    • The author receives an email notification with a link to the ePCR
    • The QA/QI status changes to Waiting
 
Click on Request Review to complete your initial review and notify the crew member that that their review is needed.
 

Approve / Deny Process

11. Review Author Updates
  • When the author resubmits the report, the status changes to Pending
  • Click Review to evaluate updates
 

 
 
 
 
12. Approve or Reject Individual Changes
  • Approve or reject changes on a field-by-field basis
  • Info:
    • Rejecting changes returns the report to Waiting status
    • The author is notified of additional required updates
 
Approve or Reject individual field changes from the crew member.
 
 
 
 
13. Review Changes in Bulk (Optional)
  • Use the Comments panel to review and approve all changes collectively
 

 
 
 
 
14. Final Approval
  • Click Approve to complete the QA/QI process
  • The report status updates to Review Complete / Approved
 

Best Practices

For QA/QI Reviewers and Supervisors
Standards & Consistency
  • Establish documented QA/QI standards
  • Apply criteria consistently across all reviews
  • Use standardized checklists
Timeliness
  • Complete initial reviews within 24–48 hours
  • Set aside dedicated QA/QI review time
Providing Effective Feedback
  • Be clear, specific, and educational
  • Use red comments only for critical compliance issues
  • Balance corrections with green positive feedback
  • Explain the why behind corrections
  • Provide examples of proper documentation
Workflow Management
  • Use saved views to prioritize reviews
  • Batch similar reports for efficiency
  • Avoid letting reports remain in Waiting status
  • Focus on meaningful issues rather than stylistic preferences
Educational Approach
  • Treat QA/QI as a learning opportunity
  • Identify recurring issues indicating training needs
  • Share de-identified examples of excellent documentation
  • Recognize providers who demonstrate improvement
For Report Authors Receiving QA/QI Feedback
Responding to Review Requests
  • Monitor email for QA/QI notifications
  • Respond promptly to avoid workflow delays
  • Review all comments before making changes
  • Ask clarifying questions when needed
Making Corrections
  • Address every comment
  • Fully resolve issues—not just minimal fixes
  • Document clinical reasoning if disagreeing
  • Double-check accuracy before resubmitting
Learning & Professional Growth
  • View QA/QI feedback as professional development
  • Track recurring feedback themes
  • Apply lessons learned to future reports
  • Seek additional training when patterns emerge

Troubleshooting & FAQs

Access & Permission Issues
I can’t see EMS QA/QI in the menu
  • Verify QA/QI permissions
  • Confirm List My QA/QI EMS Incidents access
  • Log out and back in
  • Contact your administrator if needed
No Review button appears
  • Confirm the report is assigned to you
  • Check the Assigned To column
  • Refresh or log out/in
Assignment & Workflow Issues
Can reports be assigned to multiple reviewers?
  • Yes, multiple reviewers can be assigned
  • Coordinate feedback to avoid duplication
What if I request review too early?
  • The report moves to Waiting
  • You must wait for resubmission to add more comments
Author hasn’t responded
  • Verify email delivery
  • Follow up directly
  • Use department escalation policies
Comment & Review Issues
Can comments be edited or deleted?
  • No, to preserve audit history
  • Submit follow-up comments if clarification is needed
Difference between red and yellow comments?
  • Red: Mandatory corrections (compliance/safety)
  • Yellow: Recommended improvements
Should green comments be used?
  • Yes—positive reinforcement improves engagement and morale
Status & Approval Issues
Status didn’t change to Approved
  • Confirm all comments are approved
  • Click the final Approve button
  • Refresh or log out/in if needed
Can I partially approve a report?
  • No final partial approvals
  • Reject unresolved items and approve resolved ones individually