As in any sector, the focus of the health services must be directed towards the patient-client as the centre of the system, with organisation revolving around patient-client needs. Hence, the former must have objective and continuous information on both its clients' needs and their results, with quantitative and qualitative parameters. The application of these measures is complex in the field of pre-hospital emergency systems, since to their intrinsic variability is added geographic dispersion,the difficulty in controlling the direct quality of care and the fact that our care process ends up in different organisations. That is the challenge that was taken up five years ago in SAMUR with the aim of carry out a continuous analysis of the processes and results of the service. This article offers an overall vision of our quality system,which forms a basis of management essentially supported on the following pillars: certifications of quality management, process, performance evaluation, management based on indicators and productivity based on aims.