HomeMy WebLinkAboutEMS-01 - Quality Improvement FormFresno County EMS Communications Center
Dispatch Continuous Quality Improvement (DCQI) Report
For Official use Only
FDCQI#:
Page 1 of 2Revised:
Date:Time:Fire Incident #:EMS #:
Location:
INCIDENT INFORMATION
INCIDENT TYPE
Fire Still Alarm Emergency Call Medical Call Rescue
Special DutyAirport EmergencyIn Service Detail Balance of Alarm
Special Call
Other:
ISSUE
Acknowledgment Assignment Dispatch Procedure Equipment Utilization Inappropriate Behavior
Interpersonal Resource Utilization Policy Clarification Radio Etiquette Zoning
Other:
AGENCIES DIRECTLY INVOLVED:
BRIEFLY DESCRIBE ISSUE
ACCOUNT OF INCIDENT
AUTHOR'S PROPOSED RESOLUTION
Author's Name:Agency:Date:
Complete this form by typing the required information into the highlighted boxes. Please propose a suggested resolution.
Fresno County EMS Communications Center
Dispatch Continuous Quality Improvement (DCQI) Report
For Official use Only
FDCQI#:
Page 2 of 2Revised:
ORIGINATING AGENCY'S LIAISON FINDINGS & COMMENTS
RESPONDING AGENCY'S LIAISON FINDINGS & COMMENTS
Liaison's Name:Agency:Date:
Date:Liaison's Name:Agency:
DATE CQI RESOLVED & CLOSED
Date:Liaison's Name:Agency:
FINAL RESOLUTION FORWARDED TO ORIGINATING AGENCY'S LIAISON
To:Agency:
Agency:Date:By: