Upload
chinara
View
62
Download
0
Embed Size (px)
DESCRIPTION
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. - PowerPoint PPT Presentation
Citation preview
EMS Performance Improvement Toolkits
The EMS Performance Improvement Centerwww.EMSPIC.org
2
Access 911
First Responder
EMS Response
Dispatch
Emergency Department
Specialty Care Transport
Specialty Center
Rehabilitation
Prevention/ Education
Event/Recognition
The EMS Stroke Care ToolkitCenters for Disease Control and Prevention (CDC)$250,000 for one year
The EMS Toolkit ProjectThe Duke EndowmentPhase I
$300,000 annually 2004-2007
Phase II
What is an EMS Toolkit?Detailed ReportEvaluates an EMS specific topic
Patient CareService DeliveryPersonnel Performance
Benchmarking with state and similar systemsRecommendations for improvementContinuous use
Six Sigma meets Public Health
EMSSystem
ResponseToolkitReports
IdentifyIntervention
ImplementIntervention
AnalyzedAnd
TrendResults
The SimplicityWeb-BasedNHTSA Version 2.2.1 DatasetPossibly Additional Data ElementsNo Prior Performance Improvement Knowledge Required“TurboTax” ImplementationVisual Reporting MethodologiesMassive Technical Assistance
The PerceptionIts NOT:
JudgmentalNegativeDegradingDifficult
It IS:EasyUsefulHelpfulEducationalEnablingPositiveWorthwhile
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 ToolkitEach EMS System is encouraged to choose 1 or 2 for implementation within their SystemRinse and Repeat
The Toolkits
Year 1Local EMS System ResponseState EMS System Design and Performance
Year 2Cardiac Arrest CareTrauma Care
Year 3 Pediatric CareAcute Cardiac CareStroke Care (CDC funded)
A Match Made in Heaven
Money from Duke EndowmentEMS Toolkits from OEMSEMS Systems Use EMS ToolkitsDuke Endowment money to EMS Systems to address EMS Toolkit identified issues.
13
EMS Toolkit Phase II Project
Funded by The Duke Endowment$1,600,000 to EMS Systems based on the EMS System Response ToolkitContinued funding to EMSPIC and OEMSRinse and repeat (7 to 10 years)
Request for Application to fund South Carolina
14
EMS System Response Time
Toolkit
EMS System Response Toolkit
Data Completion RateEMS Response TimesEMS Unit AvailabilityEMS Transport TimeEMS Total Call TimeEMS Call Center TimeMiscellaneous Factors
16
Record Selection
EMSResponse
Times
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
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.
23
Community Demographics
24
Fatal Injury Rates
EMS Systems by 90% Fractal Total EMS Response Time
EMS System Total 90% Fractal EMS Response Time(mm:ss)
Injury Fatality Rate(deaths/100,000 Pop)
Top 10 Average 14:00 62.4
Bottom 10 Average 35:12 75.0
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
FindingsData Completion and Accuracy IssuesLong Wheels Rolling Times Unit AvailabilityLong Transport DistancesCall Center TimesFirst Responder CoverageVehicle Maintenance PlanQuality Management ProgramDemographic Trends
North Carolina EMD
AlamanceAlexander
Alleghany
Anson
Ashe
Avery
Beaufort
Bertie
Bladen
Brunswick
Buncombe
Burke
Cabarrus
Caldwell
Camden
Carteret
Caswell
CatawbaChatham
Cherokee
Chowan
Clay
Cleveland
Columbus
Craven
Cumberland
Currituck
DareDavidson
Davie
Duplin
Durham
Edgecombe
Forsyth Franklin
Gaston
Gates
Graham
Granville
Greene
Guilford
Halifax
Harnett
Haywood
Henderson
Hertford
Hoke
Hyde
Iredell
Jackson
Johnston
Jones
Lee
Lenoir
Lincoln
Mcdowell
Macon
MadisonMartin
Mecklenburg
Mitchell
Montgomery Moore
Nash
New Hanover
Northampton
Onslow
Orange
Pamlico
Pasquotank
Pender
Perquimans
Person
Pitt
Polk
Randolph
Richmond
Robeson
Rockingham
Rowan
Rutherford
Sampson
Scotland
Stanly
StokesSurry
Swain
Transylvania
Tyrrell
Union
VanceWarren
Washington
Watauga
Wayne
Wilkes
Wilson
Yadkin
YanceyWake
COUNTIES WITH EMD PROGRAMS
68 Counties have approved EMD Centers 2 Counties are pending approval
COUNTIES WITHOUT EMD PROGRAMS
PENDING APPROVAL
27
EMS Acute Trauma Care
Toolkit
EMS Trauma Care ToolkitEMS System CharacteristicsData QualityCounty Injury StatisticsEMS System CapabilityEMS System PerformanceEMS Personnel PerformanceEMS Patient OutcomesEMS Injury Prevention
29
Record Selection Criteria
Injury Statistics
Skills Performed
Measurement Quiz 1
Medic # Success Rate
001 50%002 50%
Attempts
10
2
Injury Prevention
36
EMS Cardiac Arrest
Toolkit
EMS Cardiac Arrest ToolkitEMS Cardiac Arrest OverviewData QualityCounty CV Disease/Patient StatisticsEMS System CapabilityEMS System PerformanceEMS Personnel PerformanceEMS Patient OutcomesEMS Education and Community Outreach
Cardiac Arrest Etiology
Arrest Location Type
Utstein Template
Community Outreach
43
EMS Acute Cardiac Care
(STEMI)Toolkit
44
EMS Acute Cardiac Care Toolkit
EMS Acute Cardiac Care OverviewData QualityCounty CV Disease/Patient StatisticsEMS System CapabilityEMS System PerformanceEMS Personnel PerformanceEMS Patient OutcomesEMS Education and Community Outreach
45
Overview
46
Patient Selection
47
County Statistics
48
System Capabilities
49
System Performance
50
Personnel Performance
51
Outcomes
Number needed to Treat = 15
52
Community Education/Prevention
53
EMS Acute Stroke Care
Toolkit
54
EMS Acute Stroke Care Toolkit
EMS Acute Cardiac Care OverviewData QualityCounty CV Disease/Patient StatisticsEMS System CapabilityEMS System PerformanceEMS Personnel PerformanceEMS Patient OutcomesEMS Education and Community Outreach
55
Patient Selection
56
Patient Demographics
57
System Capabilities
58
Personnel Performance
59
Outcomes
Number needed to Treat = 12
60
EMS Acute Pediatric Care
Toolkit
61
Pediatric Hot Issues
Airway ManagementCirculatory SupportPain ManagementSpecial NeedsEducation and Prevention
62
Patient Selection
In Summary
65
Questions ?