Jumpstarting Your Performance Measure Activities: Part Two Performance Measures #67 and #68 2006 Annual EMSC Grantee Mee

1. Jumpstarting Your Performance Measure Activities: Part TwoPerformance Measures #67 and #682006 Annual EMSC Grantee Meeting June 21, 2006

2. Purpose of Presentation • Review Performance Measures #67 and #68 • Discuss data collection and implementation strategies for Performance Measures #67 and #68

3. Performance Measure #67 • Measure: The adoption of requirements by the State/Territory for pediatric emergency education for the recertification of paramedics. • Goal/Target of Measure: By 2011,the State/Territory will haveadopted requirements forpediatric emergency education forthe recertification of paramedics.

4. Performance Measure #67: Definitions • Adoption: The requirements have been formally put into place in the EMS Rules and Regulations at either the State/Territory or County/Regional level (i.e., at every county/region in the State/Territory) and apply to all paramedics in the State/Territory. • Requirements: Formal written recommendations and guidelines for pediatric emergency care education as part of the recertification of paramedics. • Recertification: Refers to the process of re-registering and fulfilling requirements for certification or licensure to continue practicing as a paramedic in the state.

5. Performance Measure #68 • Measure: The degree to which the State/Territory has established permanence of EMSC in the State/Territory EMS system. • Goal/Target of Measure: There is no requirement for the overarching Performance Measure #68, but there are targets for each of the four sub-measures.

6. Performance Measure #68a • Measure: The establishment of an EMSC Advisory Committee within the State/Territory. • Goal/Target of Measure: By 2006, anEMSC Advisory Committee willhave been established within theState/Territory.

7. Performance Measure #68b • Measure: The incorporation of pediatric representation on the State/Territory EMS Board. • Goal/Target of Measure: By 2007, pediatric representation will have been incorporated on the State/Territory EMS Board.

8. Performance Measure #68b: Definitions • Incorporation: The existence of a formal, designated voting position for a pediatric representative on the EMS Board, which is mandated in the State/Territory EMS Statutes, Rules or Regulations. • EMS Board: Refers to the state/territory governing entity or body that provides oversight for emergency medical services.

9. Performance Measure #68c • Measure: The establishment of a one full time equivalent (FTE) EMSC Manager that is dedicated solely to the EMSC Program. • Goal/Target of Measure: By 2011, a one full time equivalent (FTE) EMSC Manager that is dedicated solely to the EMSC Program is established. • Definition: Solely: 100% of the EMSC Manager’s time is devoted to the EMSC Program.

10. Performance Measure #68d • Measure: The integration of EMSC priorities into existing EMS or hospital/healthcare facility statutes/regulations. • Goal/Target of Measure: By 2011, all six EMSC priorities will have been integrated into existing EMS statutes/regulations.

11. Performance Measure #68d: Definitions • EMSC Priorities: • Pre-hospital provider agencies in the State/Territory have on-line and off-line pediatric medical direction at the scene of an emergency for Basic Life Support (BLS) and Advanced Life Support (ALS) providers. (Performance measure #66a) • Pre-hospital provider agencies in the State/ Territory have the essential pediatric equipment and supplies, as outlined in American Academy of Pediatrics (AAP)/American College of Emergency Physicians (ACEP) Joint Guidelines for BLS and ALS ambulances. (Performance measure #66b)

12. Performance Measure #68d: Definitions • EMSC Priorities (continued): • The existence of a statewide, territorial, or regional standardized system that recognizes hospitals that are able to stabilize and/or manage pediatric emergencies. (Performance measure #66c)

13. Performance Measure #68d: Definitions • EMSC Priorities (continued): • Hospitals in the State/Territory have writtenpediatric inter-facility transfer guidelines thatspecify the following (Performance measure #66d): • Roles and responsibilities of the referring facility and referral center • Process for requesting consultation and patient transfer • Specific sections of the patient’s medical record to be sent to the referral center • Process for obtaining informed consent for transfer by the patient’s parent(s) or legal guardian • Process for selecting the most appropriately staffed transport service to match the patient’s acuity level • Level of care to be provided to the patient during the transfer

14. Performance Measure #68d: Definitions • EMSC Priorities (continued): • Hospitals in the State/Territory have written pediatric inter-facility transfer agreements that specify the following (Performance measure #66e): • Inter-facility communication between physicians at the referring facility and referral center for consultation and to gain referral center consent for the transfer • Transportation of the patient to an appropriate pediatric referral center that matches the level of care needed by the patient • Transfer of patient information (e.g., medical record,copy of signed consent for transport) andpersonal belongings of the patient • Return transfer of the pediatric patient to thereferring facility as appropriate

15. Performance Measure #68d: Definitions • EMSC Priorities (continued): • The adoption of requirements by the State/Territory for pediatric emergency education for the recertification of paramedics. (Performance measure #67)