Transcription
MATTHEW CONSTANTINEDIRECTOREMERGENCY MEDICAL SERVICESSYSTEM COLLABORATIVEMEETINGThursdayFebruary 7, 2019
Agenda-EMS System CollaborativeWhatWhoWhyIntroductions/WelcomeJeff FarissParticipant familiarizationEMS RestructureJeff FarissDiscuss changes to EMSAMA PolicyJeff FarissImplementation DateClosed Call RuleJeff FarissDiscuss CVA Closed Call Change and impact on agenciesMADDY FundJeff FarissDiscuss the use and improvements to the systemCPAPJeff FarissCPAP/BLS Basic ScopeKern County Health Care CoalitionCharles BrockettPOD2019 Regional ExerciseCharles BrockettRegional Functional ExerciseReddiNet and use of MCI ModuleMargaret MyszReview previous months’ performance of the ReddiNetsystem and compliance by organizationsBravoMargaret MyszOctober review of BravoALS to BLS HandoffMargaret MyszDiscuss results of QI data reviewAmbulance Patient Offload TimesMargaret MyszReview of APOTStop the Bleed High school programGeorge BakerScheduled trainings so farPotential partnering for stakeholdersPediatric DesignationGeorge BakerUpdate on State ProgressAnnouncementsAllAdjournAll
MATTHEW CONSTANTINEDIRECTORINTRODUCTIONS
Agenda-EMS System CollaborativeWhatWhoWhyIntroductions/WelcomeJeff FarissParticipant familiarizationEMS RestructureJeff FarissDiscuss changes to EMSAMA PolicyJeff FarissImplementation DateClosed Call RuleJeff FarissDiscuss CVA Closed Call Change and impact on agenciesMADDY FundJeff FarissDiscuss the use and improvements to the systemCPAPJeff FarissCPAP/BLS Basic ScopeKern County Health Care CoalitionCharles BrockettPOD2019 Regional ExerciseCharles BrockettRegional Functional ExerciseReddiNet and use of MCI ModuleMargaret MyszReview previous months’ performance of the ReddiNet systemand compliance by organizationsBravoMargaret MyszOctober review of BravoALS to BLS HandoffMargaret MyszDiscuss results of QI data reviewAmbulance Patient Offload TimesMargaret MyszReview of APOTStop the Bleed High school programGeorge BakerScheduled trainings so farPotential partnering for stakeholdersPediatric DesignationGeorge BakerUpdate on State ProgressAnnouncementsAllAdjournAll
Agenda-EMS System CollaborativeWhatWhoWhyIntroductions/WelcomeJeff FarissParticipant familiarizationEMS RestructureJeff FarissDiscuss changes to EMSAMA PolicyJeff FarissImplementation DateClosed Call RuleJeff FarissDiscuss CVA Closed Call Change and impact on agenciesMADDY FundJeff FarissDiscuss the use and improvements to the systemCPAPJeff FarissCPAP/BLS Basic ScopeKern County Health Care CoalitionCharles BrockettPOD2019 Regional ExerciseCharles BrockettRegional Functional ExerciseReddiNet and use of MCI ModuleMargaret MyszReview previous months’ performance of the ReddiNet systemand compliance by organizationsBravoMargaret MyszOctober review of BravoALS to BLS HandoffMargaret MyszDiscuss results of QI data reviewAmbulance Patient Offload TimesMargaret MyszReview of APOTStop the Bleed High school programGeorge BakerScheduled trainings so farPotential partnering for stakeholdersPediatric DesignationGeorge BakerUpdate on State ProgressAnnouncementsAllAdjournAll
Agenda-EMS System CollaborativeWhatWhoWhyIntroductions/WelcomeJeff FarissParticipant familiarizationEMS RestructureJeff FarissDiscuss changes to EMSAMA PolicyJeff FarissImplementation DateClosed Call RuleJeff FarissDiscuss CVA Closed Call Change and impact onagenciesMADDY FundJeff FarissDiscuss the use and improvements to the systemCPAPJeff FarissCPAP/BLS Basic ScopeKern County Health Care CoalitionCharles BrockettPOD2019 Regional ExerciseCharles BrockettRegional Functional ExerciseReddiNet and use of MCI ModuleMargaret MyszReview previous months’ performance of the ReddiNet systemand compliance by organizationsBravoMargaret MyszOctober review of BravoALS to BLS HandoffMargaret MyszDiscuss results of QI data reviewAmbulance Patient Offload TimesMargaret MyszReview of APOTStop the Bleed High school programGeorge BakerScheduled trainings so farPotential partnering for stakeholdersPediatric DesignationGeorge BakerUpdate on State ProgressAnnouncementsAllAdjournAll
Agenda-EMS System CollaborativeWhatWhoWhyIntroductions/WelcomeJeff FarissParticipant familiarizationEMS RestructureJeff FarissDiscuss changes to EMSAMA PolicyJeff FarissImplementation DateClosed Call RuleJeff FarissDiscuss CVA Closed Call Change and impact on agenciesMADDY FundJeff FarissDiscuss the use and improvements to the systemCPAPJeff FarissCPAP/BLS Basic ScopeKern County Health Care CoalitionCharles BrockettPOD2019 Regional ExerciseCharles BrockettRegional Functional ExerciseReddiNet and use of MCI ModuleMargaret MyszReview previous months’ performance of the ReddiNet systemand compliance by organizationsBravoMargaret MyszOctober review of BravoALS to BLS HandoffMargaret MyszDiscuss results of QI data reviewAmbulance Patient Offload TimesMargaret MyszReview of APOTStop the Bleed High school programGeorge BakerScheduled trainings so farPotential partnering for stakeholdersPediatric DesignationGeorge BakerUpdate on State ProgressAnnouncementsAllAdjournAll
Agenda-EMS System CollaborativeWhatWhoWhyIntroductions/WelcomeJeff FarissParticipant familiarizationEMS RestructureJeff FarissDiscuss changes to EMSAMA PolicyJeff FarissImplementation DateClosed Call RuleJeff FarissDiscuss CVA Closed Call Change and impact on agenciesMADDY FundJeff FarissDiscuss the use and improvements to the systemCPAPJeff FarissCPAP/BLS Basic ScopeKern County Health Care CoalitionCharles BrockettPOD2019 Regional ExerciseCharles BrockettRegional Functional ExerciseReddiNet and use of MCI ModuleMargaret MyszReview previous months’ performance of the ReddiNet systemand compliance by organizationsBravoMargaret MyszOctober review of BravoALS to BLS HandoffMargaret MyszDiscuss results of QI data reviewAmbulance Patient Offload TimesMargaret MyszReview of APOTStop the Bleed High school programGeorge BakerScheduled trainings so farPotential partnering for stakeholdersPediatric DesignationGeorge BakerUpdate on State ProgressAnnouncementsAllAdjournAll
CONTINUOUS POSITIVE AIRWAY PRESSURE (CPAP) PROCEDUREARE ALL OF THE FOLLOWING PRESENT? AGE 8 YEARS OLD PATIENT ALERT, ORIENTED, AND ABLE TO FOLLOW COMMANDS PATIENT HAS THE ABILITY TO MAINTAIN AN OPEN AIRWAY(GCS 10) SYSTOLIC BP 90MMHGIF YES,ARE TWO OF THE FOLLOWING PRESENT? RESPIRATORY RATE 25 BREATHS PER MIN RETRACTIONS OR ACCESSORY MUSCLE USE PULSE OXIMETRY 94% ADVENITIOUS (ABNORMAL) OR DIMINISHED LUNG SOUNDSIF YES,ARE ANY OF THE FOLLOWING PRESENT? AGONAL OR ABSENT RESPIRATIONS SUSPECTED PNEUMOTHROAX OR PENETRATING CHEST TRAUMA PATIENT HAS TRACHEOSTOMY SYSTOLIC BP OF 90 MMHG RISK FOR ASPIRATION (VOMITING, EPISTAXIS, FACIAL TRAUMA)IF YES, THEN PATIENT CANNOT RECEIVE CPAPIF NO, THEN UTILIZE CPAP AND MONITOR PATIENT CLOSELY FORUNTOWARD EFFECTSCAUTIONS AND POTENTIAL COMPLICATIONS DECREASED MENTAL STATUS OR UNABLE TO COOPERATE WITHPROCEDURE RECENT GI BLEED OR EPIGASTRIC SURGERY MAY CAUSE HYPOTENION RELATED TO INCREASE ININTRATHORACIC PRESSURE MAY CAUSE PNEUMOTHORAX, GASTRIC DISTENTION, CORNEALDRYING
Agenda-EMS System CollaborativeWhatWhoWhyIntroductions/WelcomeJeff FarissParticipant familiarizationEMS RestructureJeff FarissDiscuss changes to EMSAMA PolicyJeff FarissImplementation DateClosed Call RuleJeff FarissDiscuss CVA Closed Call Change and impact on agenciesMADDY FundJeff FarissDiscuss the use and improvements to the systemCPAPJeff FarissCPAP/BLS Basic ScopeKern County Health Care CoalitionCharles BrockettPOD2019 Regional ExerciseCharles BrockettRegional Functional ExerciseReddiNet and use of MCI ModuleMargaret MyszReview previous months’ performance of the ReddiNet systemand compliance by organizationsBravoMargaret MyszOctober review of BravoALS to BLS HandoffMargaret MyszDiscuss results of QI data reviewAmbulance Patient Offload TimesMargaret MyszReview of APOTStop the Bleed High school programGeorge BakerScheduled trainings so farPotential partnering for stakeholdersPediatric DesignationGeorge BakerUpdate on State ProgressAnnouncementsAllAdjournAll
PUBLIC HEALTH NURSING PODEXERCISEFebruary 15TH, 2019Nursing Staff Development Day
Willy Wonka’s Everlasting Gobbstoppers Pod Allow the participants toexperience roles,responsibilities, and situationsthat contribute to a successfulpod site Recognize presenting &symptomatic public, adjust toinject characters and . Have fun!
The Players Public Health Nursing Staff CSUB Nursing Students Public Health Administrators
Importance of POD Exercises Teaches important players theproper mobilization &demobilization of a POD Allows staff to practice givingvaccinations and/or medicationsin an emergency situation Provides a hands-on experiencewith developing emergencyplans Assists in identifying gaps intraining/drill scenarios
Agenda-EMS System CollaborativeWhatWhoWhyIntroductions/WelcomeJeff FarissParticipant familiarizationEMS RestructureJeff FarissDiscuss changes to EMSAMA PolicyJeff FarissImplementation DateClosed Call RuleJeff FarissDiscuss CVA Closed Call Change and impact on agenciesMADDY FundJeff FarissDiscuss the use and improvements to the systemCPAPJeff FarissCPAP/BLS Basic ScopeKern County Health Care CoalitionCharles BrockettPOD2019 Regional ExerciseCharles BrockettRegional Functional ExerciseReddiNet and use of MCI ModuleMargaret MyszReview previous months’ performance of the ReddiNet systemand compliance by organizationsBravoMargaret MyszOctober review of BravoALS to BLS HandoffMargaret MyszDiscuss results of QI data reviewAmbulance Patient Offload TimesMargaret MyszReview of APOTStop the Bleed High school programGeorge BakerScheduled trainings so farPotential partnering for stakeholdersPediatric DesignationGeorge BakerUpdate on State ProgressAnnouncementsAllAdjournAll
2019 REGIONAL EXERCISE
2019 Regional Exercise Fulfills requirements by CDPH and EMSA inemergency preparedness planning Each region can decide format: table top(TTX), functional exercise(FE), or full-scaleevent (FSE) Region V is in the planning/ developmentstage for the 2019 regional functionalexercise
2019 Regional Exercise Potential Scenarios: AgriculturalOutbreak, Organo-phosphateIncident Region V will be collaborating,developing, and implementingthe regional exercise in thecoming months This will replace SWMHE andallow us to practice regional useof CHEMPACK
How Kern County Will Assist in 2019 RegionalExercise Providing training events andsituational awareness Encouraging stakeholders toparticipate by establishingcommunications and providingresources
Agenda-EMS System CollaborativeWhatWhoWhyIntroductions/WelcomeJeff FarissParticipant familiarizationEMS RestructureJeff FarissDiscuss changes to EMSAMA PolicyJeff FarissImplementation DateClosed Call RuleJeff FarissDiscuss CVA Closed Call Change and impact on agenciesMADDY FundJeff FarissDiscuss the use and improvements to the systemCPAPJeff FarissCPAP/BLS Basic ScopeKern County Health Care CoalitionCharles BrockettPOD2019 Regional ExerciseCharles BrockettRegional Functional ExerciseReddiNet and use of MCI ModuleMargaret MyszReview previous months’ performance of theReddiNet system and compliance by organizationsBravoMargaret MyszOctober review of BravoALS to BLS HandoffMargaret MyszDiscuss results of QI data reviewAmbulance Patient Offload TimesMargaret MyszReview of APOTStop the Bleed High school programGeorge BakerScheduled trainings so farPotential partnering for stakeholdersPediatric DesignationGeorge BakerUpdate on State ProgressAnnouncementsAllAdjournAll
ReddiNet2018 and Jan 2019 Responses
In 2018, no Kern County hospital has reached the targetof 100% response rate to MCI’s on ReddiNet.Kern Medical has the highest response rate 4%0%AHBAHTBHHBMHDRMCKMKVHMERMSWRRH
Kern Medical has also received the majority ofpatients for MCIs in %10%20%30%40%50%60%
For most hospitals, January 2019 responses did not showany improvement.However, Ridgecrest Regional is off to a good HB0%AHT0%BHHBMHDRMCKMKVHMERMSWRRH
ReddiNetBed Availability2018 Year ResponsesJan 2019 Responses
In 2018, no Kern County hospital reached the target (100%) forreporting bed availability twice a day, every day.AHT and KVH have a very poor response %0%5%0%AHBAHTBHHBMHDRMCKMCKVHRRH
So far, reporting bed availability has not improved for 0%AHT0%BHHBMHDRMCKMCKVHMERMSWRRH
Having Issues with ReddiNet?Need help setting it up or learning how to use it?Please Contact:Nick Lidgettlidgettn@kerncounty.comCharles Brockettbrockettc@kerncounty.comOr check out the training videos at:http://www.reddinet.net/support/videos.html
Agenda-EMS System CollaborativeWhatWhoWhyIntroductions/WelcomeJeff FarissParticipant familiarizationEMS RestructureJeff FarissDiscuss changes to EMSAMA PolicyJeff FarissImplementation DateClosed Call RuleJeff FarissDiscuss CVA Closed Call Change and impact on agenciesMADDY FundJeff FarissDiscuss the use and improvements to the systemCPAPJeff FarissCPAP/BLS Basic ScopeKern County Health Care CoalitionCharles BrockettPOD2019 Regional ExerciseCharles BrockettRegional Functional ExerciseReddiNet and use of MCI ModuleMargaret MyszReview previous months’ performance of the ReddiNet systemand compliance by organizationsBravoMargaret MyszOctober review of BravoALS to BLS HandoffMargaret MyszDiscuss results of QI data reviewAmbulance Patient Offload TimesMargaret MyszReview of APOTStop the Bleed High school programGeorge BakerScheduled trainings so farPotential partnering for stakeholdersPediatric DesignationGeorge BakerUpdate on State ProgressAnnouncementsAllAdjournAll
Bravo Code ChangesOctober-November 2018
Between Oct 15Nov 30, 4470Bravo calls weremade.Of those calls,1702 (38%) weredowngraded38%downgraded
The majority of downgraded calls were canceledwithout patient contact35%Canceled13%AMA10%ALS InterventionRequested ALS1%Transported Code 31%
Agenda-EMS System CollaborativeWhatWhoWhyIntroductions/WelcomeJeff FarissParticipant familiarizationEMS RestructureJeff FarissDiscuss changes to EMSAMA PolicyJeff FarissImplementation DateClosed Call RuleJeff FarissDiscuss CVA Closed Call Change and impact on agenciesMADDY FundJeff FarissDiscuss the use and improvements to the systemCPAPJeff FarissCPAP/BLS Basic ScopeKern County Health Care CoalitionCharles BrockettPOD2019 Regional ExerciseCharles BrockettRegional Functional ExerciseReddiNet and use of MCI ModuleMargaret MyszReview previous months’ performance of the ReddiNet systemand compliance by organizationsBravoMargaret MyszOctober review of BravoALS to BLS HandoffMargaret MyszDiscuss results of QI data reviewAmbulance Patient Offload TimesMargaret MyszReview of APOTStop the Bleed High school programGeorge BakerScheduled trainings so farPotential partnering for stakeholdersPediatric DesignationGeorge BakerUpdate on State ProgressAnnouncementsAllAdjournAll
ALS-BLS Handoff2018
The total number of ALS to BLS Handoffs hasincreased over the year.450400350300250200150100500Q1Q2Q3Q4
Compliance remains between 60-70%99% of non-compliant transports were due to extended BLS transport time in Q3 and Q4
Down Time for Non-Compliant Handoffs Time difference between BLS unit response time and time from ALSlocation to hospital (using Google Maps) On average for Q4, waiting for a BLS unit to arrive was 5.6 minutesslower than transporting directly to the hospital
However, the down time continues to decrease going into2019.109876543210Q1Q2Q3Q4
Agenda-EMS System CollaborativeWhatWhoWhyIntroductions/WelcomeJeff FarissParticipant familiarizationEMS RestructureJeff FarissDiscuss changes to EMSAMA PolicyJeff FarissImplementation DateClosed Call RuleJeff FarissDiscuss CVA Closed Call Change and impact on agenciesMADDY FundJeff FarissDiscuss the use and improvements to the systemCPAPJeff FarissCPAP/BLS Basic ScopeKern County Health Care CoalitionCharles BrockettPOD2019 Regional ExerciseCharles BrockettRegional Functional ExerciseReddiNet and use of MCI ModuleMargaret MyszReview previous months’ performance of the ReddiNet systemand compliance by organizationsBravoMargaret MyszOctober review of BravoALS to BLS HandoffMargaret MyszDiscuss results of QI data reviewAmbulance Patient Offload TimesMargaret MyszReview of APOTStop the Bleed High school programGeorge BakerScheduled trainings so farPotential partnering for stakeholdersPediatric DesignationGeorge BakerUpdate on State ProgressAnnouncementsAllAdjournAll
APOT-1Jan 2018- Jan 2019
Adventist Health BakersfieldBakersfield Heart HospitalBakersfield Memorial Hospital1008060402001131Kern Medical131Mercy Hospital13Mercy Southwest Hospital100806040200113113113
Kern Valley Healthcare DistrictDelano Regional Medical Center60504030201001131Ridgecrest Regional13Tehachapi Hospital403020100113113
4 Bakersfield hospitals saw improved APOT-1 fromJan 2018 to Jan 2019.BMH83Mercy SWKern MedicalMercyAHBBHH10264 68425450 52639480109
In contrast, APOT-1 worsened for the majority of outlyingarea hospitals from Jan 2018 and Jan 2019Tehachapi34 35DelanoRidgecrestKVHD29738343034
Are these changes REAL?Control ChartsAPOT-1: January 2018 through January 2019
Adventist Health Bakersfield10090UCL80APOT-1 (min)7060Avg504030LCL2010012345678Number of Months910111213
Bakersfield Heart Hospital140UCL120APOT-1 (min)10080Avg604020LCL012345678Number of Months910111213
Bakersfield Memorial Hospital140120UCLAPOT-1 (min)10080Avg6040LCL20012345678Number of Months910111213
Kern Medical7060UCLAPOT-1 (min)50Avg4030LCL2010012345678Number of Months910111213
Delano7060UCLAPOT-1 (min)50Avg4030LCL2010012345678Number of Months910111213
Ridgecrest Regional40UCL35APOT-1 (min)302520Avg15105LCL012345678Number of Months910111213
APOT-2Individual Hospital Data
APOT-2: January 2019Hospital2.1 (%)( 20 min)2.2 (%)(21-60 min)2.3 (%)(61-120 min)2.4 (%)2.5 (%)(121-180min)( 180min)TotalNumber ofTransportsAdventist Health Bakersfield31%59%10%1%0.1%845Adventist Tehachapi68%31%1%0%0%68Bakersfield Heart Hospital28%55%8%5%4%212Bakersfield Memorial 08Kern Medical42%55%3%0%0%382Kern Valley Healthcare District70%28%3%0%0%112Mercy Downtown41%52%6%1%0.3%304Mercy Southwest36%54%9%1%0.4%263Ridgecrest Regional76%23%1%0%0%176
Want individual hospital data?Contact information:Margaret ilMayJuneJulyAugSept
Agenda-EMS System CollaborativeWhatWhoWhyIntroductions/WelcomeJeff FarissParticipant familiarizationEMS RestructureJeff FarissDiscuss changes to EMSAMA PolicyJeff FarissImplementation DateClosed Call RuleJeff FarissDiscuss CVA Closed Call Change and impact on agenciesMADDY FundJeff FarissDiscuss the use and improvements to the systemCPAPJeff FarissCPAP/BLS Basic ScopeKern County Health Care CoalitionCharles BrockettPOD2019 Regional ExerciseCharles BrockettRegional Functional ExerciseReddiNet and use of MCI ModuleMargaret MyszReview previous months’ performance of the ReddiNet systemand compliance by organizationsBravoMargaret MyszOctober review of BravoALS to BLS HandoffMargaret MyszDiscuss results of QI data reviewAmbulance Patient Offload TimesMargaret MyszReview of APOTStop the Bleed High school programGeorge BakerScheduled trainings so farPotential partnering for stakeholdersPediatric DesignationGeorge BakerUpdate on State ProgressAnnouncementsAllAdjournAll
Stop the Bleed Update EMS will be training 14 members of the Tehachapi High School TeenCERT team 2/12/2019 Wasco Unified School District will receive the training over 2 sessionsin February. 70 Staff and Teachers per session. Corporate Sponsorship Is Being Fin
PUBLIC HEALTH NURSING POD EXERCISE February 15TH, 2019 . Public Health Nursing Staff CSUB Nursing Students Public Health Administrators. Importance of POD Exercises . Fulfills requirements by CDPH and EMSA in emergency preparedne
