Background Ambulance services around the world play a pivotal role in the delivery of advanced life support (ALS) in an out of hospital setting. The European Resuscitation Council guidelines highlight the importance of high-quality cardiopulmonary resuscitation (CPR) and early defibrillation for out-of-hospital advanced life support, with the quality of CPR associated with patient outcomes. Despite this importance, research suggests that there is variable quality of ALS in out of hospital settings. Methods A multicentre simulation randomised controlled trial was conducted to measure the effectiveness of introducing a CPR quality officer role in supervising and maintaining the quality of CPR in ALS. The data was collected by a research team that undertook training from the principal researcher. The participants were ALS trained paramedic students who had experience responding to out of hospital cardiac arrests. The participants were randomised into an intervention and control group and asked to undertake two simulated scenarios, one employing the CPR quality officer, the other without. The primary outcome measure was the compression score calculated by Laerdal QCPR® software. The score was represented as an overall percentage, illustrating the quality of performed chest compressions, interruptions, and chest recoil. Results This is a work in progress, with full data collection now completed. The trial pilot results produced reported an increased overall QCPR score, reduced interruptions, improved chest recoil and an improved chest compression fraction. Qualitative data from focus groups identified that participants were supportive of the inclusion of the CPR quality officer and did not feel the role interfered with their ALS efforts. Conclusions The addition of a designated CPR quality officer addresses a fundamental component within the chain of survival. High-quality sustained CPR positively correlates with patient outcomes. Furthermore, assigning a designated CPR officer affords other team members to focus on their tasks. This inclusion is simple, cost-effective and can be utilised in an array of healthcare settings.