Building a Patient Safety Organization “Field of Dreams” for Emergency Medical Services

For emergency medical service (EMS) providers in the state of Missouri, patient safety organizations are a “field of dreams”—a field of legal protection, learning, collaborating, and most of all, improving pre-hospital care. While many hospitals and other providers are still struggling to fully appreciate the breadth of federal legal protections and other benefits available from working with patient safety organizations (PSO), the Missouri Ambulance Association (MAA) recognized the value months before the final rule was even published. In Missouri, EMS providers—the paramedics, EMTs, and others who respond to 911 calls—have no peer review protection for their quality improvement and patient safety work. Their principal fear was that any well-intentioned efforts at patient safety and quality health care improvement had the potential to be subpoenaed and used against them in legal proceedings. When representatives from the MAA began hearing about the Missouri Center for Patient Safety (MOCPS) and PSOs in general, they paid attention.

It was not for lack of trying that Missouri’s EMS providers had no peer review protections. Since 1996, the MAA had lobbied for nearly 20 different bills, only one of which came close to passing. Ultimately, according to Jason White, consultant for the MAA, the bills were mired in other political agendas, and the pieces related to peer review protection for EMS were always removed. In 2006, Becky Miller, executive director of the MOCPS, was making a series of presentations to various groups around the state to introduce the Center and to provide early education on PSOs. Miller presented to the EMS State Advisory Council in 2006, and got the attention of the late Dr. Bill Jermyn, then EMS medical director for the Missouri Department of Health and Senior Services (DHSS). After hearing Miller speak, Jermyn informed White that working with the PSO might very well be the solution to peer review protection. At the time, the MAA dismissed the idea. They still hoped they would  succeed in getting a bill passed, but came to realize 2 years later they needed to search elsewhere for a solution. 


For the complete column please visit Patient Safety & Quality Healthcare website.