About (QIF)

West Region Quality Improvement Forum (QIF)

Mission Statement:

Continuously Strive to Optimize EMS/Trauma Patient Care and Outcome


  • Caesar Ursic, MD
  • Vice Chairs: Tony Kuzma, EMT-P, Wendy Rife, RN

Meeting Information

Meetings are held at Olympic Ambulance, 1205 Ruddell Rd SE, Lacey. Trauma Coordinators Meet 11:30 am - 12:00 pm, QIF meets 12:00 pm - 3:00 pm. Meeting Schedule Contact the WREMS office at 360-705-9019 for more information.

West Region Trauma Quality Improvement Forum Information

West Region Quality Improvement Plan

Visit the Dept of Health website to learn more about regional quality assessment and improvement program requirements.

Lessons Learned

Lessons Learned from the Pierce County CQI Committee Case Reviews

March, 2017 CQI

  • Importance of "Closed Loop" communications during EMS care to be certain the message and plan of action is clear.
  • Utilization of vital signs parameters and ALS assessment are important aspects of patient care. Don't treat the monitor only, if in doubt pull the ET tube out and reinsert.


January, 2017, CQI

  • Parents may be adamant about taking their child POV versus EMS transport to the hospital ED, but EMS must clearly emphasize the risks versus the benefits and document everything.
  • The index of suspicion should be high on calls with a concerning mechanism of injury, even if the patient initially appears fine.


September 28, 2016 CQI - Stroke Case Review - Artery of Percheron

  • Posterior strokes present differently.
  • Same as with cardiac event signs-symptoms, women may present with different signs-symptoms of a stroke.


September 28, 2016 CQI - Cardiac Arrest Case Review

  • EMS Providers need to listen to your instincts when it is telling you something life-threatening may be going on.
  • Follow AHA and protocols to provide >40 minutes of high quality CPR for the patient with witnessed collapse who remains in shockable rhythms or has organized electrical rhythms (PEA).
  • Know a back-up plan if your dispatch center has a system failure and radio communication is cut-off


May, 2016 CQI - Case pertained to a young boy who was described as anxious and combative, put in time-out in room by mom.

  • Gather as much information as possible
  • Perform an exam on every patient
  • Broselow Tape can be inaccurate for obese patients
  • Plan for the worst, hope for the best
  • Be a patient advocate


March, 2016 CQI - Case Review of a patient with chronic ear infections and an ongoing unresolved illness despite months of treatments with steroids and antibiotics. Lessons Learned.

  • Keep an open mind when dealing with chronic medical conditions.
  • Watch for common symptoms with uncommon duration and extraordinary amounts of medication.
  • Understand relationship between high doses of steriods and Afib.


March, 2016, CQI - Case review of a 5-week old baby with respiratory issues. Lessons Learned.

  • Activate resources based on current status as well as history given.
  • Need to have language regarding ROR-AMA for pediatric patients in protocols.
  • Any infant with apparent life-threatening event (ALTE) needs to go to ER, preferably by EMS.
  • Pediatric patient with apnea longer than 20 seconds needs to go to ER