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3. Off-line Medical Control will be established by policies, protocols, and procedures. <br />On-line Medical Control will be coordinated with the on-duty Emergency Department <br />physician at Paris Regional Medical Center Hospital. <br />B. Provide Continuous Quality Improvement <br />1. PHYSICIAN shall direct, approve, and oversee all Quality Improvement activities. <br />Methods of Continuous Quality Improvement will include chart audits, EMS training <br />officer observations, exception reports, ED Physician feedback, educational <br />programs, protocol testing, skills testing, random surveys, and organized research <br />activities. <br />2. PHYSICIAN will develop immediate action plans for sentinel events which are <br />defined as resuscitation cases, no transports, patient or family complaints, high risk <br />procedures such as cricothyrotomy, chest decompression, intraosseous placement, <br />rapid sequence induction, narcotic administration, adverse outcomes, and <br />communication failures. <br />3. In addition, PHYSICIAN will see that 10% of each EMS certificant's patient charts <br />are audited bi-monthly. PHYSICIAN will arrange for assistance in Continuous <br />Quality Improvement gathering if calls run more than 75 days behind processing. <br />This assistance will be provided at no extra cost to PHYSICIAN. <br />4. PHYSICIAN will also oversee the operation of an ad hoc peer review committee <br />made up of three CITY paramedics, two first responders, and one ED Nurse. <br />C. Approve Continuing Education Programs <br />1. PHYSICIAN shall approve continuing education based on Continuous Quality <br />Improvement parameters and individual improvement programs. PHYSICIAN will <br />develop specialized programs and implement them as needed through the office of the <br />City of Paris EMS Training Coordinator. <br />D. Representation <br />1. PHYSICIAN will be required to attend the Ad Hoc Peer Review meetings when <br />scheduled. Periodic and special requested attendance will be required for Medical <br />Staff meetings at Paris Regional Medical Center, Emergency Department <br />Committees, and CITY Council meetings as well as any other matters requiring the <br />involvement of the Medical Director. PHYSICIAN will provide information on <br />Continuous Quality Improvement for local concern and customization of policies, <br />protocols, and procedures. <br />Page 2 of 7 <br />