Audit by Provider Organization; Confidentiality; Rules

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Sec. 26. (a) Each provider organization shall conduct an audit and review at least quarterly to assess, monitor, and evaluate the quality of patient care as follows:

(1) The audit must evaluate patient care and personnel performance.

(2) The results of the audit must be reviewed with the emergency medical service personnel.

(3) Documentation for the audit and review must include the following:

(A) The criteria used to select audited runs.

(B) Problem identification and resolution.

(C) Date of review.

(D) Attendance at the review.

(E) A summary of the discussion at the review.

(4) The audit and review must be conducted under the direction of one (1) of the following:

(A) The provider organization medical director.

(B) An emergency department committee that is supervised by a medical director with a provider organization representative serving as a member of the committee.

(C) A committee established by the provider organization and under the direction of the medical director or medical director's designee. If the medical director selects a designee, the designee must:

(i) be a physician licensed under IC 25-22.5;

(ii) have an active role in the delivery of emergency care; and

(iii) be designated in writing by the medical director as the medical director's designee.

(5) The audit must provide a method for identifying the need for staff development programs, basic training, in-service training, and orientation.

(6) The audit must evaluate all levels of care by emergency medical service personnel.

(b) An audit and review proceeding under this section is confidential, and any communication at the audit and review proceeding is a privileged communication.

(c) This section does not prevent participation by a provider organization in a peer review committee proceeding under IC 34-30-15.

(d) The commission may adopt rules under IC 4-22-2 to implement this section.

As added by P.L.79-2016, SEC.1.


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