Emergency Medical System Development Pilot
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Emergency Medical System Development Pilot Stakeholders Conference. 17 November 2009 Fairview Hotel, Nairobi, Kenya. Today's agenda. Topic. Objective. Welcome & Introductions Opening and Keynote Address Academic role Africa Collaborative for EMS EMS Development Nairobi Pilot Project

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17 november 2009 fairview hotel nairobi kenya

Emergency Medical System Development PilotStakeholders Conference

17 November 2009

Fairview Hotel, Nairobi, Kenya


Today s agenda

Today's agenda

Topic

Objective

Welcome & Introductions

Opening and Keynote Address

Academic role

Africa Collaborative for EMS

EMS Development

Nairobi Pilot Project

Required Elements of

an EMS System

The Call to Action

Identification of Next Steps

Review of: Emergency Medical System a Priority of the Ministry of Medical Systems Reforms Agenda

Review the role of universities and researchers in facilitating this process

Set the foundation for the pilot project

Review lessons learned from India’s EMRI Program

Stakeholders group discussion to align on practical action

Outline immediate next steps


Welcome

Welcome

Asante Sana

Many Thanks

Merci Beaucoup


Setting the foundation for action

Setting the foundation for action

Why are we here?

We Share the Same Dream...

Why are you here?

...You Have the Same Passion...

Healthcare - The Most Basic Commitment of a Society to its Fellow Citizens

Why now?

...A Window of Opportunity

Emergency Healthcare- The Most Vulnerable Stage

The journey

Life-Long for many, a 3 year labor of love for the UCLA Team


Introductions building bonds to overcome challenges

Introductions - Building bonds to overcome challenges

Please share your

Name

Organization

Role


Vision for today

Vision for today

There are risks and costs to a program of action. But they are far less than the long range risks and costs of comfortable inaction

John F. Kennedy

Let us reflect throughout today on how to create a foundation for practical and united action


Today s agenda1

Today's agenda

This section WIP

Topic

Objective

Welcome & Introductions

Opening and Keynote Address

Academic role

Africa Collaborative for EMS

EMS Development

Nairobi Pilot Project

Required Elements of

an EMS System

The Call to Action

Identification of Next Steps

Review of: Emergency Medical System a Priority of the Ministry of Medical Systems Reforms Agenda

Review the role of universities and researchers in facilitating this process

Set the foundation for the pilot project

Review lessons learned from India’s EMRI Program

Stakeholders group discussion to align on practical action

Outline immediate next steps


A new model of health care needs to be developed

A new model of health care needs to be developed

Silo approach to health care has failed us

Care coordination is needed at every level and every transition point

Pre-Hospital (Emergency Care)

Hospital

Rehab

Chronic & Long-Term Care

Current system prevents comprehensive care coordination: This is a global problem

What are alternate approaches?


Sustainable change requires systems thinking and the collaboration of three groups

Sustainable change requires systems thinking and the collaboration of three groups

Working together in a balanced

and collaborative manner is key


Emergency medicine is a consistent challenge globally

Emergency medicine is a consistent challenge globally

Emergency Medical System- A Global Problem

The Continuous Improvement Challenge in Developed Nations

A “Silent Killer” in Developing Nations

Sub Saharan Africa, South America, MENA, U.S. (Underserved)


Role of academia is valuable as a facilitator and developer of insights

Role of academia is valuable as a facilitator and developer of insights

Relative Independence

U.S. Universities: University of California, Stanford University, (Duke, UNC, etc)

Local Universities: TBD

Multi-Level, Multi-Profession Systems Thinking

School of Medicine

School of Management

School of Nursing

School of Education


Review of pilots

Review of pilots

Africa Pilots

Nigeria, South Africa, Kenya,

Why Kenya?

East Africa- Kenya, Tanzania, Nairobi Pilot(s):

Phase I- Initial 2 sites, Consult & Consensus-

FAST (NO WRONG DOOR)


Today s agenda2

Today's agenda

Topic

Objective

Welcome & Introductions

Opening and Keynote Address

Academic role

Africa Collaborative for EMS

EMS Development

Nairobi Pilot Project

Required Elements of

an EMS System

The Call to Action

Identification of Next Steps

Review of: Emergency Medical System a Priority of the Ministry of Medical Systems Reforms Agenda

Review the role of universities and researchers in facilitating this process

Set the foundation for the pilot project

Review lessons learned from India’s EMRI Program

Stakeholders group discussion to align on practical action

Outline immediate next steps


The growing need for ems internationally

THE GROWING NEED FOR EMSINTERNATIONALLY


Emergency medical services ems systems development

Emergency Medical Services (EMS) Systems development


Emergency medical services ems systems

Emergency Medical Services (EMS) Systems


Ems system components and attributes

Ems system components and attributes


Ems system components and attributes1

Ems system components and attributes


Regional description models

Regional Description Models


Prehospital system models the five model types for ems system

Prehospital System ModelsThe five model types for EMS system


Hospital models

Hospital models


Basic framework

Basic framework


Phase approach for ems program cycle

Phase approach for Ems program cycle


Phase i analysis

Phase I Analysis


Phase ii planning

Phase II Planning


Phase iii implementation

Phase III Implementation


Phase iv evaluation

phase iv evaluation


Developing a successful program

Developing a Successful Program


Today s agenda3

Today's agenda

Topic

Objective

Welcome & Introductions

Opening and Keynote Address

Academic role

Africa Collaborative for EMS

EMS Development

Nairobi Pilot Project

Required Elements of

an EMS System

The Call to Action

Identification of Next Steps

Review of: Emergency Medical System a Priority of the Ministry of Medical Systems Reforms Agenda

Review the role of universities and researchers in facilitating this process

Set the foundation for the pilot project

Review lessons learned from India’s EMRI Program

Stakeholders group discussion to align on practical action

Outline immediate next steps


International em a case study

International EM – A Case Study

India – GVK Emergency Management and Research Institute (EMRI) Collaboration with Stanford University, USA.

Dr. S Mahadevan, Stanford Emergency Medicine

Developed a successful Emergency Medical Services System in several states in India

Overview of this system


Gvk emri

GVK EMRI

Started in August 2005

Not-for-profit professional organization operating in the PPP mode

Private entrepreneur funded initial startup costs

Government provided 108 emergency service and legislation

Only professional emergency service provider in India today

Handles medical, police and fire emergencies through the "1-0-8 Emergency service”


Quick facts

Quick Facts

Over 1900 Ambulances and 15 Prime Responder Vehicles across 9 states

Ambulance reaching in 14 minutes in urban areas and 22 minutes in rural areas

100% Virtual handholding by Paramedic and Physician in critical cases

Medical Emergencies (Vehicular Trauma 18%, Maternal Complications 22%, Suicidal attempts 6%, Cardiac 4%, etc)

46,000 + Lives saved

12,000+ Associates – Ambulance (90%), ERC (5%), Support (5%)

Source: http://www.pressreleasepoint.com/node/165826/pdf


Emri ems project

EMRI EMS Project

Emergency Medical Technician (EMT) Training program

Extensive education initially provided by Stanford, trained Indian instructors who now train future EMTs.

Universal toll-free number

Call Center that dispatches ambulance

Provided jobs for community


Emri ems project1

EMRI EMS Project

Improves healthcare

Created public demand

When private funding reduced, public implemented policy for EMS

Now funded by Indian Government and private sources

Expanded to several other Districts


Key points for an ems system

Key Points for an EMS System

Learning from India’s EMRI EMS project, sustainability is the TOP priority in design

Infrastructure

Emergency Number

Call Center

Employees (Nurses, EMT, Doctors)

Hospital Emergency Departments


Key points for an ems system1

Key Points for an EMS System

Education

Community Emergency education

EMT, ER Nurse, Emergency Doctor

Cooperation/Dedication

from Stakeholders


Public health

Public Health

In response to resolution WHA60.22 on emergency-care systems, adopted by the World Health Assembly, May 2007, WHO/Europe actively contributes in the following aspects:

Devising standardized tools and techniques for assessing need for pre-hospital and facility-based capacity in trauma and emergency care

Reviewing legislation

Determining standards of essential trauma and emergency care

Providing guidance for the creation mass-casualty management systems

Encouraging research


International em emerging areas

International EM – Emerging Areas

Will Kenya have the first Comprehensive Emergency System in Sub-Saharan Africa?

A chance to be a leader amongst Sub-Saharan African nations?


Thank you

Thank You

Acknowledgements (to name a few)

UCLA EMPH, Fred Hagigi DrPH, MBA, MPH

Charles Otieno, M.D., MPH, Jonathan Crisp, M.D.

Shubha Kumar, DrPH, Julie Elginer, DrPH MBA

Nanette Ramzan, Edith Omwami PhD

S. Mahadevan, M.D.

Jerome Hoffman M.D., Scott Votey M.D., Seve Rottman M.D., Marshall Morgan M.D.

UCLA Emergency Medicine residency

Luis R. Goldfrank, M.D.


Today s agenda4

Today's agenda

This section WIP

Topic

Objective

Welcome & Introductions

Opening and Keynote Address

Academic role - Africa Collaborative for EMS

EMS Development: Nairobi Pilot Project

Required Elements of an EMS System

The Call to Action

Identification of Next Steps

Set the foundation for today's conference

Review of: Emergency Medical System a Priority of the Ministry of Medical Systems Reforms Agenda

Review the role of universities and researchers in facilitating this process

Set the foundation for the pilot project

Review lessons learned from India’s EMRI Program

Stakeholders group discussion to align on practical action

Outline immediate next steps and preparation for Thursday


Today s agenda5

Today's agenda

This section WIP

Topic

Objective

Welcome & Introductions

Opening and Keynote Address

Academic role - Africa Collaborative for EMS

EMS Development: Nairobi Pilot Project

Required Elements of an EMS System

The Call to Action

Identification of Next Steps

Set the foundation for today's conference

Review of: Emergency Medical System a Priority of the Ministry of Medical Systems Reforms Agenda

Review the role of universities and researchers in facilitating this process

Set the foundation for the pilot project

Review lessons learned from India’s EMRI Program

Stakeholders group discussion to align on practical action

Outline immediate next steps and preparation for Thursday


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