The TEMS Performance Improvement Committee is responsible for the effective identification, analysis and correction of systemic issues related to protocols and new patient care initiatives for prehospital and inter-hospital transfers within the Tidewater region. The committee links EMS data and hospital data for a comprehensive view focused on process improvement and retrospective systemic analysis in areas of care, such as medication, Personal Protective Equipment (PPE), Sepsis, Mental Health and Rapid Sequence Intubation (RSI), to name a few. This requires an objective review by qualified, appropriate representatives of EMS, transport and hospitals within the TEMS Region, protected by a process which ensures patient confidentiality. The Committee participates collaboratively with other Regional EMS Councils, the Virginia Department of Health’s Office of EMS and the State EMS Advisory Board’s continuous quality improvement initiatives.