Regional Base Hospital

RBH Professional Standards & Compliance

The purpose of the Professional Standards and Compliance Program is to initiate and gather information in order to perform case reviews either directly or on behalf of other programs within the Sunnybrook Centre for Prehospital Medicine. Not all case reviews are due to possible medical directive variances performed by paramedics.

The program has many important functions that are performed on a daily basis, including tracking system trends, identifying possible continuing medical education topics, assisting stakeholders with reviews, and reviewing overall call performance where an official investigation must take place (i.e. accidental death at work or coroners’ inquests).

Investigation Report

A statistical report outlines all case review activities performed by Sunnybrook Centre for Prehospital Medicine for a one year period.

Case Review Totals

Case review totals include case reviews that have been opened, closed, the average number of days a case remains open and how many were reviewed by Base Hospital Medical Directors (BHMDs). Even though the BHMDs are involved in most case reviews at some point, “reviewed by BHMD” represents those where the BHMD retained the files and managed the case from start to close.

Type of Case Review

Case reviews include those where variances occurred as well as reviews mandated even if all attending paramedics acted appropriately (i.e. accidental death at work or coroners’ inquests). Patches are often reviewed for documentation or lack of documentation and is considered a patch review, not a documentation review. The review is often a comparison of orders given by the physician and the information received and documented by the paramedic.

Audit Filter Type

The audit filter type table is used to capture the most common types of audit filters identifying cases to be reviewed.

Medication Variance Type

The medication variance section includes dosage errors, medications administered when not indicated and medications not administered when indicated (omissions).

Result of Case Review

Information from the paramedic is required in a case review. Feedback forms are issued by the medical directors or program managers and, in the majority of cases, require a written response from the paramedic. Remediation regarding a variance can be accomplished in a number of ways, ranging from a telephone conversation with the medical director or program manager to the completion of an assignment by the paramedic. The majority of cases resulting in remediation are self-reported cases where reporting the incident is considered self-remediation and no further follow-up is required.