EMS Quality & Performance

Elevating care through data-driven quality systems

Apical EMS Solutions partners with EMS agencies to build quality programs that actually work — combining rigorous chart review, actionable analytics, and independent investigation into a cohesive framework for continuous improvement.

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30+
Years of EMS
clinical experience
350K+
Patient encounters
analyzed
CPHQ
Board certified in
healthcare quality
U.S. Coast Guard
Veteran-Owned
Small Business
What we do

Three integrated service lines

Each engagement is designed to generate value beyond its immediate scope — chart review reveals the data, QI consulting builds the systems, and independent investigations protect the culture.

01

QA as a Service

Ongoing retrospective chart review, clinical scoring, and performance reporting — delivered by U.S.-licensed paramedics with structured methodology.

  • Monthly QA reports with trend analysis
  • Custom clinical scoring rubrics
  • Power BI dashboard integration
  • Protocol compliance tracking
  • Leadership review calls
02

QI Consulting

Program design, analytics infrastructure, and targeted improvement initiatives built around your agency's specific performance gaps and accreditation goals.

  • QI program assessment and design
  • Custom analytics and dashboards
  • Documentation improvement projects
  • Accreditation preparation (CAAS, ACE)
  • NEMSQA benchmarking support
03

Independent Just Culture Investigations

Third-party investigations of adverse events, complaints, and systemic failures — conducted with independence, rigor, and a Just Culture framework.

  • Independent from agency command structure
  • Just Culture methodology
  • Written findings and recommendations
  • Systemic and individual factor analysis
  • Presentation to leadership available
Pricing

Transparent, value-based pricing

Three service lines designed to work independently or together. Engagements are scoped to your agency's size and needs — contact us to discuss the right fit for your system.

Line 01

QA as a Service

Ongoing chart review and clinical performance reporting by U.S.-licensed paramedics. Recurring monthly engagement with defined deliverables.

Starting from
$1,500
per month · 6-month minimum
  • Up to 150 charts/month (Essentials)
  • Up to 300 charts/month (Standard)
  • Up to 500 charts/month (Advanced)
  • Monthly QA report + dashboard
  • Custom scoring rubric included
Download details →
Line 03

Just Culture Investigations

Independent third-party investigations of adverse events and systemic failures. Complete independence from agency command structure.

Starting from
$4,000
per investigation
  • Standard investigation (16–20 hrs)
  • Complex investigation (20–24 hrs)
  • Systemic review available
  • Written findings report
  • Leadership presentation add-on
Download details →
Add-on services
Additional chart reviews$3.50–$5.00 per chart
On-site trainingFrom $2,500/day
Mock audit / accreditation prep$3,500–$7,500
Investigation presentation$1,500–$2,500
Quarterly QI workshopFrom $2,000
Custom Power BI dashboardFrom $2,500
Overview
Company Overview
All three service lines, credentials, pricing summary, and endorsement.
Download PDF →
Line 01
QA as a Service
Full tier breakdown, included deliverables, and value case.
Download PDF →
Line 02
QI Consulting
Engagement types, platform expertise, and project scope detail.
Download PDF →
Line 03
Just Culture Investigations
Investigation types, six-step methodology, and publication note.
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About

Behind Apical: a practitioner who has spent a career studying how EMS learns.

Apical EMS Solutions is led by Daniel Garner, a nationally registered paramedic and U.S. Coast Guard veteran whose work in EMS spans over three decades. His Coast Guard service included assignment as a rescue swimmer. His civilian career has since moved between the operational and quality sides of the profession: front-line paramedic, clinical liaison for large-scale platform rollouts, and quality program leader for multi-state EMS operations. That range is deliberate. Quality work done well requires knowing what the job actually feels like at three in the morning, not just what it looks like in a protocol binder.

He is the author of Institutional Grace: Rethinking Accountability, Growth, and Redemption in Modern Organizations (Apical Press, 2026), with a foreword by Mike Taigman of FirstWatch. The book argues that accountability and grace are not opposites, and that organizations which treat human error as a failure of design rather than a failure of character learn faster, retain better, and deliver safer care. It is the intellectual foundation for how Apical approaches Just Culture investigations.

His peer-reviewed research on vital sign assessment in EMS non-transports, co-authored with colleagues and drawing on the NEMSIS 3.5 dataset, was published in Prehospital Emergency Care. When he recommends a quality metric or an investigative approach, it is grounded in the same evidence base your medical director reads.

  • NRP — National Registry ParamedicEMS career since 1987
  • CPHQ — Certified Professional in Healthcare QualityNAHQ
  • MBAHealthcare management focus
  • Published ResearcherPrehospital Emergency Care · NEMSIS 3.5
  • Author, Institutional GraceForeword by Mike Taigman, FirstWatch
  • NEMSQA EQUiP CollaborativeNational quality standards
  • U.S. Coast Guard VeteranVeteran-Owned Small Business
From Institutional Grace
"Systems that punish every error do not become safer; they become systems where errors are hidden."
Daniel Garner
Author, Institutional Grace (Apical Press, forthcoming)
Foreword by Mike Taigman
Get in touch

Ready to build something that actually works?

Whether you're starting a QA program from scratch, preparing for accreditation, or navigating a critical incident — we can help. Let's start with a conversation about where your agency is and where it needs to go.

Phone (303) 880-9770
Service area Nationwide · Mountain West focus
Endorsed by The Blue Cell, LLC