iv
Table of Contents
Hire/Employee
............................................................................................................................................... 23
Independent Contractor
...................................................................................................................................... 23
Memorandum of Understanding and Memorandum of Agreements
............................................................................... 23
Performance Expectations
.......................................................................................................................... 24
Compensation and Benefits
........................................................................................................................ 25
Workers’ Compensation
..................................................................................................................................... 25
Continuing Education
....................................................................................................................................... 25
IRS Requirements
............................................................................................................................................. 25
Dissolution
..................................................................................................................................................... 26
Liability Coverage
....................................................................................................................................... 26
Medical Malpractice Coverage
............................................................................................................................. 26
Errors and Omission Coverage
............................................................................................................................. 27
General Liability Coverage
................................................................................................................................. 27
Directors’ and Officers’ Coverage
.......................................................................................................................... 27
Indemnification
............................................................................................................................................... 27
Areas of Caution for Medical Directors
...................................................................................................... 27
Hiring and Promotional Decisions
....................................................................................................................... 28
Provider Disciplinary Actions
.............................................................................................................................. 28
Budget and Procurement Regulations..................................................................................................................... 28
Conflict of Interest Considerations
............................................................................................................. 28
Agency Oversight .............................................................................................................. 31
Workforce Oversight and Supervision ........................................................................................................ 31
Provisions of Patient Care
........................................................................................................................... 32
Protocols
........................................................................................................................................................ 32
Standing Orders
............................................................................................................................................... 32
Online Medical Direction
................................................................................................................................... 33
Offline Medical Direction
.................................................................................................................................. 33
Medical Director in the Field......................................................................................................................33
Incident Command System
................................................................................................................................ 34
EMS Scope of Practice
................................................................................................................................ 35
Education Standards
................................................................................................................................... 36
National EMS Educational Standards
.................................................................................................................... 36
EMS Provider Continuing Education Program Development
....................................................................................... 37
Provider Competency Verification
......................................................................................................................... 38
Performance-Based Organizations
.............................................................................................................. 38
Quality Improvement
........................................................................................................................................ 38
Types of Quality Improvement
............................................................................................................................ 40
Six Sigma in EMS
............................................................................................................................................ 41
HIPAA and Quality Improvement
........................................................................................................................ 42
Performance Measures
....................................................................................................................................... 42
Benchmarking
................................................................................................................................................. 43
Best Practices
.................................................................................................................................................. 44
Ambulance Service Accreditation
......................................................................................................................... 44
EMS Research
................................................................................................................................................. 44
Health and Safety of Medical Directors and Providers
................................................................................ 45
Patient Safety
.................................................................................................................................................. 46
Agency Dynamics .............................................................................................................47