Santa Clara County EMS Orientation
Exam Study Guide
How and when should level A variances be reported? Correct Ans-Level A variances shall be
reported immediately to the EMS Duty Chief via County Communications. The reporting party
shall submit the EMS System Variance Report (EMS Form # 903) to the EMS Agency shall be
submitted within 24 hours. In addition to the 903 form, copies of dispatch records patient care
record (PCR) and
statements from those involved in the incident should be turned in as well
What level variance is this?
Any incident that does not result in patient harm,
but is a deviation from EMS Agency policies, procedures, and
protocols. Correct Ans-Level B
Examples of a Level B Variance may include but are not limited to
the following: Correct Ans-a) Potential Clinical Care Variance
b) Potential Policy Variance
c) Poor interagency Coordination
d) General Complaint (Public)
e) Communications System Variance.
f) Equipment failure or malfunction.
, Level B variances should be reported to? Correct Ans-EMS Agency within five
(5) business day using EMS Form # 903 (System Performance
Variance Report). In addition to EMS Form # 903 the following
items at a minimum shall be submitted; copies of dispatch records
patient care record (PCR) and statements from those involved in
the incident.
Level C Variances are Correct Ans-incidents where the responders provided
outstanding care and went above and beyond the normal expectations
of responders.
Level C Variances include but are not limited to the following: Correct Ans-a) Good Patient
Outcome
b) Outstanding Customer Service
c) Positive provider agency/hospital cooperation
d) Field provider went above and beyond normal expectations.
Level C variances should be reported to the Correct Ans-EMS Agency within
seven (7) business day using EMS Form # 903 (System
Performance Variance Report). In addition to EMS Form # 903
the following items at a minimum shall be submitted; copies of
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