The Pennington First Aid Squad in curly text

How to deal with charts flagged for quality assurance

Kirk Schmitt

Charts may be demoted by a PFAS quality assurance (QA) officer or by our medical control officer. Demotion is usually because of problems in the chart, but sometimes it is used to give praise. When a chart is demoted it is "flagged." It is best to avoid flags. It is easy to avoid flags if you proofread your charts in the page format and if every crew member checks the chart. No matter what the reason for a flag, you must respond.

The messages included in QA flags are part of the permanent record of the chart. The charts and flag messages can be read by lawyers using our charts in lawsuits. QA flags and charts must be handled in a timely fashion. The PFAS rule for charts is:

Flags must also be handled within 48 hours.

You will be notified by email that a chart is flagged for QA reasons. This is one of the reasons PFAS insists you have an email account and that it be an account you actively monitor. The message will come from and will specify the PRID (patient report ID) for the flagged chart. The number is in blue. Click on it and it will take you directly to the flagged chart.

email from emscharts for flagged chart

If you have a chart flagged for QA, your "Patient Records" page may look like this. Click on "Home", then "Patient Records" to get this display.

Image of emsCharts display

To correct problems with charts flagged for QA, click on the chart and it will open. At the top of the chart, you will see an option to "View Flags." Click on it.

Image of emsCharts display

A dialog box opens that shows the latest QA message and who it is directed to. The correction may be assigned by name or to any crew member. Click on the line (here it says "summary page").

Image of emsCharts display

If the message is just praise, click one of the three options and say "thanks" or something appropriate in your reply. If the message requires a correction or addition to the chart, you must fix the problems or explain the shortcomings. For example, in the following chart, our medical director demoted the chart because of poor spelling and because there were no vital signs in the narrative.

Image of emsCharts display

For this chart, you would first exit the QA flag by clicking "Back to List" , correct the spelling in the chart and add vitals to the narrative. After you made corrections, you would click through the screens again until you got to the last one above then decide how to reply. You could click on any of the three choices above and fill in the resulting dialog box. For example if you clicked "Handle via Email Discussion,"

Image of emsCharts display

After you click on "Send Email" in this example, the chart in the list of charts flagged for QA will either change to green or disappear from your list. Unless the QA officer flags the chart again, you have completed your handling of the flag.

You can send copies of the email to yourself or other crew members by typing the email addresses on the "To:" line. You will need to separate the email addresses with a semicolon, for example: ;

If you have problems with this process, or other problems with emscharts, contact a quality assurance (QA) officer.