Office of Quality Assurance & Improvement Development

The Anne Arundel County Fire Department Office of Quality Assurance and Improvement continued its commitment to excellence in the delivery of pre-hospital care in 2023. As custodians of quality, we are dedicated to upholding the highest standards of care, operational efficiency, and continuous improvement. Through a strategic focus on quality assurance, continuous improvement initiatives, and dedication to the highest standards, the division achieved significant milestones in enhancing the overall performance of our delivery of Emergency Medical Services (EMS) while improving patient outcomes for the residents and visitors to Anne Arundel County. 

Resources and Utilization:

1. The Department utilizes over 1000 clinicians, both career and volunteer, consisting of Emergency Medical Technicians (EMT) and Advanced Life Support (ALS) Paramedics to deliver emergency medical services to anyone in need. 

2. This year the Department upgraded Cape St. Claire’s (Station 19) Basic Life Support (BLS) Ambulance to Advanced Life Support (ALS). This upgrade brings the Department’s EMS infrastructure to 29 ALS ambulances, 14 BLS ambulances, 9 ALS-equipped Engines, and three 24-hour EMS Supervisors.  

3. In 2023, our clinicians were called for service 65,003 times, which resulted in over 51,197 transports to local emergency departments or specialty centers focusing on comprehensive cardiac, stroke, trauma, and pediatric care utilizing ground (ambulance) or air medical transport via the Maryland State Police Aviation Command or U.S. Park Police. 

Key Achievements:

1. Performance Metrics Improvement: 

○      Following the successful implementation of targeted interventions to enhance key performance metrics, our Department was awarded the Mission: Lifeline® EMS Gold - Target: Heart Attack Honor Roll award from the American Heart Association. This award signifies our commitment and success in implementing higher standards of care by ensuring that every STEMI (a type of heart attack) patient receives treatment according to nationally accepted evidence-based guideline recommendations and standards.

2. Training and Skill Enhancement:

○      The Department has over sixty (60) ALS Paramedics credentialed to perform Rapid Sequence Induction and Intubation (RSI). This optional supplemental program approved through the Maryland Institute for Emergency Medical Services Systems (MIEMSS) allows these advanced clinicians to perform aggressive airway stabilization for the critically ill and injured. Due to the advanced nature of this skill, these clinicians are required to complete quarterly training and annual clearance to maintain their credentials. 

○      The Department supports the Anne Arundel County Police Department’s Quick Response Team (QRT) by providing on-call paramedics trained in Tactical Emergency Medical Care twenty-four hours a day three-hundred-sixty-five days a year. These tactical paramedics integrate with QRT’s quarterly training and operate under an expanded scope of practice to ensure their mission of ensuring all of the QRT members remain operationally ready during deployments. 

○      The Office of QA/QI also works directly with the Training and Research Division to develop and implement department-wide or clinician-focused training and/or improvement plans that directly support our commitment to meet and exceed identified benchmarks. 

○      The QA/QI staff supports the following county committees, the Pediatric Fatality Review Board, the Fatality Opioid Review Board, and the Opioid Task Force in conjunction with our Health Department.

3. Technological Improvements and Integration: 

○      Following the Department's purchase of new Quality Assurance and Improvement Systems, namely “First Watch” and “First Pass,” this division successfully integrated these state-of-the-art technologies into our daily operations. 

○      Notable advancements from this integration include reducing turnaround times for ambulances at hospitals and optimizing resource allocation to meet the growing demands of our community.

4. Quality Assurance Audits and Review: 

○      Rigorous internal audits and reviews were conducted to assess and improve the overall quality of care provided by our Clinicians. 

○      Findings from these audits were utilized to implement targeted improvements in accordance with nationally recognized benchmarks, address identified challenges with achieving the standards, and uphold the highest quality of patient care. 

5. Office of Quality Assurance and Improvement Development:

○      With the support of departmental leadership, the Office was able to add two members to its staff:

                                           i.         EMS Logistics Specialist: The mission of the EMS Logistics Specialist is to directly support the EMS Supervisor and field clinician by obtaining hospital-specific supplies and distributing them to the field. The relief provided by this specialist to the EMS Supervisor increases their ability and availability to handle in-person quality assurance and improvement tasks. Providing this equipment to all clinicians allows for standardized treatment for all patients across the county.

                                         ii.         Quality Assurance Specialist: The mission of the Quality Assurance Specialist is to oversee the daily operations and implementation of the county’s Quality Assurance software, “First Pass.” In addition, this specialist conducts reviews of advanced airway procedures, completed via video laryngoscopy, with field clinicians under the guidance of the Medical Director and as required by MIEMSS. 

The Office of Quality Assurance and Improvement’s annual report for 2023 reflects a year of significant accomplishments and continued commitment to ensuring our clinicians provide exceptional emergency medical care. By addressing challenges head-on and embracing innovative solutions, our division is poised to build upon these achievements in the coming years, further solidifying our role as leaders in pre-hospital care, quality, and system-wide improvement.