QA/QI Reviews

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Jesse Jamieson, a physician assistant in University Hospital’s Emergency Department (ED), reviews cases brought in by EMS providers. He explains how the QA review process works.


In the past year, many of you may have received a QA follow-up on cases. We thought it may be helpful to give everyone an overview of how our QA review process works.


Providing case outcomes started with the intention of bridging the gap between what was seen in the field and the ultimate diagnosis, treatment and disposition. Cases are selected at random, based upon the ESI (Emergency Severity Index) triage provided by University Hospital nursing staff. The goal is to screen for higher acuity/complex patients. As you all know, patients may end up being sicker (or not) than the initial assessment, but we feel this was a good way to screen for more complicated patients. Feedback for patients who were triaged for a lower ESI number is usually triggered by an admission or at random.


While the EMS reports and care provided is evaluated, a priority is placed on the hospital chart review to provide meaningful information. My goal is to try and find aspects of each case that might translate back into patient care. Hopefully, being able to know the outcome of a patient’s case will close the loop on patient interactions and aid in future diagnosis and treatments made in the field. As we all know, even while in the hospital, patient presentations can be muddled and become increasingly difficult to ascertain especially in remote/austere environments.


Rather than providing specific critiques on care, the goal has been to provide general information. With the formation of a QA committee, our next step will be to evaluate specific high-level cases and turn those lessons into educational or training opportunities.


At this time, reviews are only being provided for cases that end up at University Hospital. If you would like feedback on a specific case, please submit a form through uwhealth.org/emsfeedback, and Christine Randall, our EMS Outreach Coordinator will follow up.