Category Definitions:

Treatment decision: An issue arising from clinical judgment, such as the choice of interventions, medications, or procedures provided.

Refusal of care/transfer issue: A situation where a patient, family, or facility/agency does not follow recommended care or transfer, creating barriers to optimal treatment and inter-facility transfer.

Variance from regional standards: Process differs from a Board-approved regional guideline where regional standards are defined. 

Lack of regional standard: An issue identified where no regional guideline currently exists, leading to inconsistent care.

Operational logistics: Barriers related to system coordination, resource movement, or workflow operations.

Destination decision making: Concerns over the appropriateness of the patient’s receiving facility based on the patient's preference, acuity or regionally available resources.

Human resource issue: Problems related to personnel availability, performance, or competencies that influence patient care and outcomes. 

Non-human resource/equipment issue: Failures or shortages of equipment, technology, or supplies that impact patient care.

Communication failure: A breakdown in information sharing between EMS, hospitals, or other stakeholders that affects patient care.

Other: An issue that does not fit the above categories but still represents a PI concern.