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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

EMS Performance Improvement Toolkits

The EMS Performance Improvement Center

www.EMSPIC.org

the ems stroke care toolkit
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
what is an ems toolkit
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
the simplicity
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
the perception
Its NOT:

Judgmental

Negative

Degrading

Difficult

It IS:

Easy

Useful

Helpful

Educational

Enabling

Positive

Worthwhile

The Perception
what is an intervention
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
the toolkits
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)
a match made in heaven
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.
ems toolkit phase ii project
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
ems system response toolkit
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
intervention 10 calls per day of week and time of day
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.
recommended plan of action
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.
fatal injury rates
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).
ems response toolkit findings
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
north carolina emd
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

ems trauma care toolkit
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
measurement quiz 1
Measurement Quiz 1
  • You are given the following monthly report
    • Intubation Success Rate
    • What actions would you take?
    • Are these equal?
ems cardiac arrest toolkit1
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
ems acute cardiac care toolkit
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
outcomes
Outcomes
  • Number needed to Treat = 15
ems acute stroke care toolkit1
EMS Acute Stroke 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
outcomes1
Outcomes

Number needed to Treat = 12

pediatric hot issues
Pediatric Hot Issues
  • Airway Management
  • Circulatory Support
  • Pain Management
  • Special Needs
  • Education and Prevention
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