Every EMS operational program shall have a written quality assurance plan approved by its medical director. The quality assurance plan shall include provisions for: Reviewing data concerning patient care rendered by EMS providers affiliated with the EMS operational program; Identifying and analyzing trends in EMS care rendered by EMS providers affiliated with the EMS operational program; Annually reporting to MIEMSS on quality assurance issues on a form required by MIEMSS; Providing remedial action to resolve any patient care issues involving EMS providers or the EMS system which should be addressed at the jurisdictional level; Identifying violations of the Maryland Medical Protocols for Emergency Medical Services Providers; Notifying MIEMSS within 30 days of discovery of any incidents, protocol variations, or trends which in the opinion of the medical director: May have resulted in harm to a patient, May require disciplinary action by MIEMSS, or Suggest the need for changes to the Statewide EMS system by MIEMSS; and Reviewing oral or written allegations that: An EMS provider failed to act in accordance with applicable law or protocols, or Prehospital patient care was below the applicable standard of care.