Consulting · for EMS leadership

A second pair of physician eyes on your PCR QA program.

Independent audits, workflow design, and training recommendations for agencies that want their charts, and their reviewers, to hold up under scrutiny. Built around your PCRs, your reviewers, and your medical director’s standards.

Request an audit See what’s included

Independent & physician-ledDe-identified chart review onlyTypical engagement: 4–8 weeks

Sample scorecard · Riverside EMS Q3

Audit findings

Charts reviewed

120

random sample

Issues flagged

287

across 8 dimensions

Reviewer agreement

71%

κ = 0.42 (fair)

Per-dimension performance

Vitals completeness72% · target 95%

Refusal documentation64% · target 90%

Capacity / decisional assessment41% · target 85%

Time-stamped reassessments88% · target 90%

Medical control contact noted79% · target 85%

Names & numbers are illustrative4 areas to address

What we do

Two services, both focused on PCR QA.

We don’t take medical control. We don’t write your protocols. We help the people who already do that work see their charts more clearly, and build a QA program that catches issues before regulators or attorneys do.

Audit

PCR QA program audits

An independent, structured review of how your agency reads its own charts. We sample real PCRs, score them against a published rubric, and benchmark your reviewers' agreement with each other and with a physician baseline.

Random + targeted chart sampling (refusals, high-acuity, ALS skill)
Rubric-scored against your protocols and state/regional standards
Inter-rater reliability between current QA reviewers
Written report with prioritized findings & remediation plan

You walk away with: Audit report + 60-min readout

Design

QA workflow & SOP design

Most agencies don't have a QA problem; they have a QA workflow problem. We design the operating system: who reviews what, how often, what triggers escalation, and how findings actually make it back to the medic and the training officer.

Sampling rules and reviewer cadence
Tiered review SOP (peer → senior reviewer → physician escalation)
Documented rubric & scoring guide your reviewers will actually use
Closed-loop feedback path to training

You walk away with: SOP package + rubric + workflow diagrams

How it works

A predictable five-step engagement.

No open-ended retainers. Every engagement runs the same shape: scope, sample, calibrate, report, hand off. You know what you’re paying for and what you’ll have when it’s done.

Discovery call

Week 0 · Free

A 30-minute call with leadership, your medical director, and your QA lead. We scope the question, agree on access, and confirm what's in (and out of) the engagement.

Document & sample review

Weeks 1–2

We pull a stratified sample of de-identified PCRs against your existing protocols, QA SOPs, and reviewer rubric. Sample size is set to your call volume, typically 80–150 charts.

Reviewer calibration session

Week 3

We score a shared subset alongside your QA reviewers to measure inter-rater reliability and surface where the rubric is read differently across the team.

Findings & recommendations

Week 4

Written report scoring each documentation dimension, ranked findings, and prioritized training recommendations: what to fix this month, this quarter, this year.

Readout & handoff

Week 5

60-minute readout with leadership and the medical director, then a handoff package your team owns: SOP edits, rubric, sampling rules, and the training recommendation list.

What you receive

Concrete artifacts. No vague slides.

At the end of an engagement you own the documents below. They’re written so your QA lead can pick them up the next morning and use them, not so they need to be re-translated by another consultant.

30–50 pp

Audit report

Executive summary, per-dimension scoring, ranked findings, sample-anonymized excerpts illustrating each issue, and a prioritized remediation plan.

Cohen's κ + heat-map

Reviewer agreement analysis

Where your QA reviewers agree, where they don't, and which rubric items drive the disagreement. Includes recommended rubric clarifications.

Editable .docx

QA SOP package

Sampling rules, review cadence, escalation tree, reviewer onboarding checklist, and a closed-loop path from finding → training officer → medic.

1-page reference

Scoring rubric

A version of the rubric used in the audit, edited to match your protocols and language. Designed to fit on a single laminated card on the QA reviewer's desk.

Ranked & scoped

Training recommendation list

Specific recommendations: which dimensions to drill, suggested formats (case review, scenario practice, protocol refresh), and which providers to prioritize.

Used in the 60-min call

Readout deck

What we found, why it matters, what to do this month vs. this quarter. Yours to circulate to the medical director, board, and training committee.

Who it’s for

Built for the people accountable for the chart.

EMS agency leadership

Chiefs and operations leads who want an outside read on whether their QA program is doing what they think it's doing, before the next audit, RFP renewal, or sentinel event.

Medical directors

Physicians overseeing a service who want a structured review of documentation patterns across their team, without personally pulling and scoring 100 charts on a Saturday.

Fire / EMS chiefs

Combined departments where the same QA officer is reviewing both fire and EMS reports. We focus the audit on PCRs and write findings the chief can act on with the medical director.

QA / QI managers

QA leads who need a credible second opinion to back their existing recommendations, or who inherited a QA program and need to know what they're working with.

Pricing

Fixed-fee engagements. Starting prices below.

Travel, additional reviewer cohorts, and on-site time are quoted separately. Every engagement starts with a free 30-minute scoping call so the price you see in the proposal is the price you pay.

QA program audit

$1,400

$700starting

Early initiation discount — 50% off

One-time, fixed-fee independent review of your PCR QA program.

Up to 120 chart sample, stratified
Inter-rater reliability across current reviewers
Written audit report & ranked findings
60-minute leadership readout
Training recommendation list

Larger agencies (>25k calls/yr) priced on call volume.

Request a scoping call

Most engagements

Audit + workflow design

$2,400

$1,200starting

Early initiation discount — 50% off

Audit plus a redesigned QA workflow your team can run on day one.

Everything in the QA program audit
QA SOP package (sampling, cadence, escalation)
Editable scoring rubric tuned to your protocols
Reviewer onboarding checklist
Two follow-up calls in the 60 days after handoff

Most common engagement for agencies refreshing a stale QA program.

Request a scoping call

Custom scoped

Quoted

For multi-site systems, regional MIH/CP programs, and unusual scopes.

Multi-agency or regional rollups
Mobile integrated health / community paramedicine charts
Pre-litigation chart review (with counsel of record)
Reviewer training cohorts (>6 reviewers)
Quarterly re-audit cadence

Quoted after a discovery call. Typically $20k+.

Tell us about your scope

About us

Built from years in the field.

Kayvon Yazdan, MD

Founder · PCRU · Firefighter

Kayvon Yazdan, MD.
Physician. Firefighter.

Kayvon practices clinically and rides the rig. PCRU grew out of years of reading PCRs both as a hospital-side physician and as a working firefighter, and watching the same documentation gaps cause the same downstream problems on both sides of the bay door.

Consulting engagements are scoped, fixed-fee, and run by Kayvon directly, not handed off to an associate. The work is squarely about the chart: how it’s written, how it’s reviewed, and how reviewers are trained.

Practicing physician

Medical resident

Active firefighter

Career & volunteer experience

EMS educator

Resident & provider teaching

QI background

Hospital + prehospital

Blake Nazario-Casey.
Engineer. Firefighter.

12 years of experience across fire, EMS, and emergency room work. Blake builds the tools he wished existed when he was writing charts between calls — and the infrastructure behind every PCRU engagement.

Blake handles the technical side of every consulting engagement: data pipelines, analysis tooling, and the reporting infrastructure that turns chart review findings into clear, actionable deliverables.

Software engineer

Full-stack & infrastructure

Firefighter / EMT

12 years field experience

ER technician

Emergency department operations

Product & data

QA tooling & analytics

Blake Nazario-Casey

Co-Founder · PCRU · Firefighter

Frequently asked

The most common questions, answered plainly.

No. Consulting engagements are strictly about documentation quality and the QA program around it: chart review, reviewer training, workflow design. Kayvon does not provide medical control, online or offline, and does not direct, second-guess, or override patient-care decisions made by your medical director, providers, or protocols.

No. Findings are aggregated across the sample and tied to documentation dimensions, not to named medics. If your QA program needs to surface individual performance, that is your medical director's role under your existing peer-review structure. We'll show your reviewers how to do it consistently, but we don't sit in that seat.

No. Protocols are the medical director's domain. We read PCRs against the protocols you already have, flag where documentation diverges from them, and recommend training. If a protocol gap shows up in the audit, we'll note it and hand it to your medical director. We don't author the fix.

Charts are reviewed in-place inside your ePCR system whenever possible. If export is required, we work with de-identified PCRs and a documented chain of custody. No patient-identifying information leaves the engagement environment, and the final report uses anonymized excerpts only.

The product is a self-serve training platform for medics: synthetic scenarios with structured feedback. Consulting is a service for agencies: an outside physician audits your real QA program, designs the workflow, and recommends what your team should train on next (which may or may not include the product).

The audit is a quality-improvement document, not a legal opinion. Many agencies share it with accreditors, insurers, and their medical advisory boards as evidence of an active QA program. For pre-litigation chart review you'd retain Kayvon directly through counsel under a separate scope.

Still have a question?

Kayvon reads every inbound personally.

Get in touch

Tell us about your QA program.

A short form: call volume, what’s prompting the look, who would own the engagement on your side. Kayvon reads every inbound personally and replies within two business days with either a scoping call slot or an honest “we’re not the right fit.”

[email protected]

Replies within 2 business days

Scoping calls are free, ~30 minutes