The AEMT Instructional Guidelines in this section include all the topics and material at the EMTlevel PLUS the following material: I. Quality ImprovementA. System for Continually Evaluating and Improving CareB. Continuous Quality Improvement (CQI)C. Dynamic ProcessII. Patient SafetyA. Significant - One of The Most Urgent Health Care ChallengesB. Incidence-IOM Report "To Err Is Human" Up to 98,000 Patients Die Due to Medical ErrorsC. High-Risk Activities1. Hand off2. Communication issues3. Medication issues4. Airway issues5. Dropping patients6. Ambulance crashes7. Spinal immobilizationD. How Errors Happen1. Skills based failure2. Rules based failure3. Knowledge based failureE. Preventing Errors1. Environmentala. Clear protocolsb. Lightc. Minimal interruptionsd. Organization and packaging of drugs2. Individuala. Reflection in actionb. Constantly question assumptionsc. Reflection biasd. Use decision aidse. Ask for helpIII. EducationA. Levels of EMS licensureB. National EMS Education Agenda for the Future: A Systems ApproachIV. Authorization to PracticeA. Legislative Decisions on Scope of PracticeB. State EMS Office OversightC. Medical Oversight1. Clinicala. Offline Protocolsb. Online Protocolsc. Standing orders2. Quality improvement3. AdministrativeD. Local CredentialingE. Employer Policies and ProceduresV. Integration With Other Professionals and Continuity of CareA. Medical PersonnelB. Law EnforcementC. Emergency ManagementD. Home Healthcare ProvidersE. Other RespondersVI. Maintenance of Certification and LicensureA. Personal ResponsibilityB. Continuing EducationC. Skill Competency VerificationD. Criminal ImplicationsE. Fee