Although the need for the implementation of a quality management conce
pt for the German emergency medical system (EMS) has been discussed fo
r more than 10 years, such a concept has not been realised on a broad
scale. Standardised national data sheets were developed many years ago
. They are used by many local agencies, but a data-gathering system on
a state or national basis is still lacking. In times of reduced funds
for health care expenditures, quality management could be a reliable
way to ensure that the EMS provides safe services to the patient based
on the current state of medical science in an efficient manner. Based
on clear definitions, structure, process, and outcome quality can be
analysed, and the results provide the basis for continuous quality-imp
rovement strategies. As not all aspects of the system can be analysed
continuously, one has to select areas of special importance. External
and internal quality control are equally important. Quality control wo
rks on the basis that all EMS team members are motivated to perform on
a professional level to ensure that each patient is treated adequatel
y. It evaluates the system to create circumstances that enhance the ac
hievement of this goal. Quality management is not only concerned with
mishaps, because areas with documented good performance also provide i
mportant information.