Who must approve the written QA plan for Tier I transports?

• A. The EMS Medical Director.
• B. The hospital QA committee.
• C. The EMS System and IDPH.
• D. The city public health official.

Answer: (C)

The main concept is system-wide governance of quality assurance for Tier I transports. A written QA plan at this level sets how the entire EMS system will monitor, review, and improve Tier I transports, and it must align with state rules and regulations. Because this kind of plan affects multiple agencies and jurisdictions, it requires both the EMS System and the Illinois Department of Public Health to approve it, ensuring consistency and compliance across the system. The EMS Medical Director handles medical direction and clinical oversight but does not by itself authorize the formal QA plan. Hospital QA committees focus on quality processes within a hospital, not the statewide or system-wide transport QA plan. City public health officials typically do not approve EMS system QA plans.