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EMS Performance Improvement Toolkits

EMS Performance Improvement Toolkits. The EMS Performance Improvement Center www.EMSPIC.org. The EMS Stroke Care Toolkit. The EMS Toolkit Project. Centers for Disease Control and Prevention (CDC) $250,000 for one year. The Duke Endowment Phase I $300,000 annually 2004-2007 Phase II.

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EMS Performance Improvement Toolkits

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  1. EMS Performance Improvement Toolkits The EMS Performance Improvement Center www.EMSPIC.org

  2. The EMS Stroke Care Toolkit The EMS Toolkit Project • Centers for Disease Control and Prevention (CDC) • $250,000 for one year • The Duke Endowment • Phase I • $300,000 annually 2004-2007 • Phase II

  3. What is an EMS Toolkit? • Detailed Report • Evaluates an EMS specific topic • Patient Care • Service Delivery • Personnel Performance • Benchmarking with state and similar systems • Recommendations for improvement • Continuous use

  4. Six Sigma meets Public Health

  5. The Simplicity • Web-Based • NHTSA Version 2.2.1 Dataset • Possibly Additional Data Elements • No Prior Performance Improvement Knowledge Required • “TurboTax” Implementation • Visual Reporting Methodologies • Massive Technical Assistance

  6. Its NOT: Judgmental Negative Degrading Difficult It IS: Easy Useful Helpful Educational Enabling Positive Worthwhile The Perception

  7. What is an Intervention • Customized direction provided within each EMS Toolkit based on an individual EMS System’s results. • Approximately 25 to 30 interventions or recommendations per EMS Toolkit • Each EMS System is encouraged to choose 1 or 2 for implementation within their System • Rinse and Repeat

  8. The Toolkits • Year 1 • Local EMS System Response • State EMS System Design and Performance • Year 2 • Cardiac Arrest Care • Trauma Care • Year 3 • Pediatric Care • Acute Cardiac Care • Stroke Care (CDC funded)

  9. A Match Made in Heaven • Money from Duke Endowment • EMS Toolkits from OEMS • EMS Systems Use EMS Toolkits • Duke Endowment money to EMS Systems to address EMS Toolkit identified issues.

  10. EMS Toolkit Phase II Project • Funded by The Duke Endowment • $1,600,000 to EMS Systems based on the EMS System Response Toolkit • Continued funding to EMSPIC and OEMS • Rinse and repeat (7 to 10 years) • Request for Application to fund South Carolina

  11. EMS System Response TimeToolkit

  12. EMS System Response Toolkit • Data Completion Rate • EMS Response Times • EMS Unit Availability • EMS Transport Time • EMS Total Call Time • EMS Call Center Time • Miscellaneous Factors

  13. Record Selection

  14. EMSResponseTimes

  15. Intervention 10Calls per Day of Week and Time of Day • The purpose of this intervention is to provide instruction on how to evaluate EMS event numbers by analyzing the number of calls by the day of the week and the time of the day. Information obtained from this analysis can be used to create improved EMS System Response plans which can improve EMS System Response Time. • Each EMS Event typically requires an EMS unit to provide service delivery and care. If the number of EMS events outnumber the number of EMS vehicles which are staffed and in service at any point in time, the EMS Systems Response Time will increase. • By receiving this intervention, the EMS System Response Toolkit determined that there were at least 5 times where the number of EMS events (averaged for the day of the week and hour of the day) equaled or exceeded the number of staffed EMS units in service during that same time.

  16. Recommended Plan of Action Implement a plan which will increase the number of EMS units during times when the number of EMS events are likely to be greater than the number of available EMS units. This could be done by one of the following methods: • Bring in additional peak time EMS units during hours where EMS events exceed normal staffing patterns. • Change the EMS unit staffing pattern to place more EMS units in service during high volume times. For example, move an EMS unit which is normally in service during nighttime hours into service during daytime hours. • Consider changing personnel staffing hours from 24 to 12 hour shifts to allow more shifts (and EMS units) to be in service during peak hours.

  17. Community Demographics

  18. Fatal Injury Rates • There is a 21:12 (151%) difference between the top 10 and bottom 10 • There is a 20% increase in the injury fatality rate • The average EMS System Total Response Time for North Carolina is 21:40 (mm:ss).

  19. EMS Response Toolkit Findings • Data Completion and Accuracy Issues • Long Wheels Rolling Times • Unit Availability • Long Transport Distances • Call Center Times • First Responder Coverage • Vehicle Maintenance Plan • Quality Management Program • Demographic Trends

  20. North Carolina EMD Alleghany Northampton Currituck Warren Ashe Surry Stokes Gates Rockingham Caswell Person Camden Vance Hertford Pasquotank Granville Watauga Halifax Wilkes Perquimans Yadkin Chowan Forsyth Orange Avery Franklin Bertie Guilford Mitchell Durham Alamance Nash Caldwell Alexander Davie Edgecombe Yancey Madison Tyrrell Martin Washington Wake Iredell Davidson Burke Dare Randolph Chatham Wilson Mcdowell Catawba Rowan Buncombe Pitt Beaufort Haywood Johnston Greene Swain Lincoln Hyde Lee Rutherford Henderson Harnett Cleveland Cabarrus Wayne Graham Montgomery Gaston Jackson Moore Polk Stanly Lenoir Mecklenburg Transylvania Craven Macon Cherokee Pamlico Clay Cumberland Hoke Jones Richmond Union Anson Sampson Duplin Carteret Scotland Onslow Robeson Bladen COUNTIES WITH EMD PROGRAMS Pender COUNTIES WITHOUT EMD PROGRAMS Columbus New Hanover Brunswick PENDING APPROVAL 68 Counties have approved EMD Centers 2 Counties are pending approval

  21. EMS Acute Trauma CareToolkit

  22. EMS Trauma Care Toolkit • EMS System Characteristics • Data Quality • County Injury Statistics • EMS System Capability • EMS System Performance • EMS Personnel Performance • EMS Patient Outcomes • EMS Injury Prevention

  23. Record Selection Criteria

  24. Injury Statistics

  25. Skills Performed

  26. Measurement Quiz 1 • You are given the following monthly report • Intubation Success Rate • What actions would you take? • Are these equal?

  27. Injury Prevention

  28. EMS Cardiac ArrestToolkit

  29. EMS Cardiac Arrest Toolkit • EMS Cardiac Arrest Overview • Data Quality • County CV Disease/Patient Statistics • EMS System Capability • EMS System Performance • EMS Personnel Performance • EMS Patient Outcomes • EMS Education and Community Outreach

  30. Cardiac Arrest Etiology

  31. Arrest Location Type

  32. Utstein Template

  33. Community Outreach

  34. EMS Acute Cardiac Care(STEMI)Toolkit

  35. EMS Acute Cardiac Care Toolkit • EMS Acute Cardiac Care Overview • Data Quality • County CV Disease/Patient Statistics • EMS System Capability • EMS System Performance • EMS Personnel Performance • EMS Patient Outcomes • EMS Education and Community Outreach

  36. Overview

  37. Patient Selection

  38. County Statistics

  39. System Capabilities

  40. System Performance

  41. Personnel Performance

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