EmailMeForm
2023 Quality and Safety Course
We are pleased that you are interested in the NAEMSP® Quality and Safety Course. The application submission deadline is August 16, 2023.
Thank you for your interest and application.
Demographics
Full Name (include medical credentials)
*
Street Address
*
City, State Zip
*
Phone
*
Email
*
EMS System/Service/Organization
*
Work experience
Your Role within the service
Medical Director
Quality Director
Other
How long have you been practicing/in this current role?
*
What course work or prior education do you have in quality improvement?
*
What data does your EMS system/service/organization currently analyze?
*
Describe your prior experiences with quality improvement in your agency/system.
*
What do you hope to accomplish in this course?
*
Are any other individuals from your organization applying to participate in the course? If so, please state their name(s)?
*
Required Documentation
Upload CV
Add File
Upload Letter of Support
*
Add File
Personally-written letter from your EMS agency, system or local leadership in support of your capstone project, stating you will get support in your efforts on the capstone project. This letter cannot be authored by the applicant.
Affirmations
In order to ensure that participants have the basic infrastructure to develop a meaningful capstone project we are asking that the following course requirements are met.
I confirm that I have direct access or authority to obtain access to clinical electronic clinical data reporting.
Click here to confirm statement.
I confirm that I have access to medical/operational leaders for project sponsorship/input.
Click here to confirm statement.
I confirm that I will be able to regularly commit blocks of time to participate in monthly 1-2-hour calls, review data and selected literature, interface with a faculty member and execute a capstone project and other assignments.
Click here to confirm statement.
