EMERGENCY MEDICAL SERVICES SYSTEM COLLABORATIVE MEETING Thursday - - PowerPoint PPT Presentation

EMERGENCY MEDICAL SERVICES SYSTEM COLLABORATIVE MEETING

Thursday February 1, 2018

MATTHEW CONSTANTINE DIRECTOR

INTRODUCTIONS

MATTHEW CONSTANTINE DIRECTOR

ReddiNet

Bed Availability / MCI Response

MCI Response

December Alerts Responses BHH 9 2 BMH 9 6 DRMC 3 3 KMC 9 8 KVH 2 2 MER 9 6 MSW 9 6 RRH 2 2 SJCH 9 7 Tehach 2 1

10 20 30 40 50 60 70 80 90 BHH BMH DRMC KMC KVH MER MSW RRH SJCH Tehach 48.75% 69.88% 69.44% 89.29% 67.65% 78.05% 60.98% 74.29% 93.75% 12.12% 39 58 25 75 23 64 50 26 75 4 80 83 36 84 34 82 82 35 80 33

Year To Date

Alerts Responses

January Notice Resp BHH 3 1 BMH 3 3 DRMC 2 1 KMC 3 3 KVH 1 1 MER 3 3 MSW 3 3 RRH 1 1 SJCH 3 3 Tehach 1 1

Patient Distribution

2017

I D M Total BHH 0.00% BMH 1 4 14 19 7.76% DRMC 1 3 4 1.63% KMC 19 33 86 138 56.33% KVH 0.00% MER 1 22 23 9.39% MSW 1 13 14 5.71% RRH 2 9 11 4.49% SJCH 5 23 28 11.43% Tehach 8 8 3.27% Total 245 100.00% Pt Dist

Bed Availability

December Number of Days B.A. Reported Number of Days B.A. not reported Number of Days B.A. reported >1 BHH 30 1 19 BMH 31 31 DRMC 29 2 22 KMC 29 2 26 KVH 1 30 MER 31 28 MSW 31 30 RRH 31 27 SJH 31 31 THD 26 5 18 Bed Availability Reporting

290 365 349 345 106 364 361 363 364 343 139 343 256 293 3 326 324 311 336 306 50 100 150 200 250 300 350 400 BHH BMH DRMC KMC KVH MER MSW RRH SJH THD

2017

Number of Days B.A. Reported Number of days B.A. reported >1

January Number of Days B.A. Reported Number of Days B.A. not reported Number of Days B.A. reported >1 BHH 27 4 18 BMH 30 1 28 DRMC 28 3 15 KMC 27 4 22 KVH 3 28 MER 30 1 28 MSW 30 1 25 RRH 30 1 26 SJH 29 2 28 THD 23 8 10 Bed Availability Reporting

Patient Transport to Triage

• Will be posted for a 30 day comment period

beginning tomorrow

• Please submit your comments using the

comment table

APOT‐1: January 2018

Rank Hospital Number of Transports APOT‐1 (minutes) 1 Ridgecrest Regional 281 6.0 2 Delano Regional Medical Center 283 29.4 3 Tehachapi Hospital 116 32.9 4 Kern Valley Healthcare District 154 35.5 5 Mercy Hospital 557 49.5 6 Kern Medical 787 53.8 7 Mercy Southwest Hospital 524 68.5 8 Bakersfield Heart Hospital 282 80.1 9 Adventist Health Bakersfield 1604 93.7 10 Bakersfield Memorial Hospital 1357 102.4

APOT‐1: June 2017 – January 2018

20 40 60 80 100 120 140 June July August September October November December January APOT‐1 (minutes) Bakersfield Hospitals

Adventist Health Bakersfield Bakersfield Heart Hospital Bakersfield Memorial Hospital Kern Medical

APOT‐1: June 2017 – January 2018

5 10 15 20 25 30 35 40 June July August September October November December January APOT‐1(minutes)

Outlying Area Hospitals

Delano Regional Medical Center Kern Valley Healthcare District Ridgecrest Regional Tehachapi Hospital

APOT‐2: January 2018

Hospital 2.1 (N, %) 2.2 (N, %) 2.3 (N, %) 2.4 (N, %) 2.5 (N, %) Total Number

• f Transports

Bakersfield Memorial Hospital 378 (27.8%) 727 (53.6%) 137 (10.1%) 62 (4.6%) 53 (3.9%) 1357 Adventist Health Bakersfield 418 (26.1%) 859 (53.4%) 233 (14.5%) 68 (4.2%) 26 (1.6%) 1604 Bakersfield Heart Hospital 100 (35.6%) 140 (49.7%) 29 (10.3%) 6 (2.1%) 7 (2.5%) 282 Mercy Southwest Hospital 204 (38.9%) 252 (48.1%) 49 (9.4%) 10 (1.9%) 9 (1.7%) 524 Kern Medical 260 (33.0%) 471 (59.9%) 54 (6.7%) 2 (0.3%) 0 (0.0%) 787 Mercy Hospital 261 (46.7%) 256 (45.9%) 34 (6.1%) 4 (0.7%) 2 (0.4%) 557 Kern Valley Healthcare District 130 (84.4%) 14 (9.1%) 7 (4.6%) 2 (1.3%) 1 (0.7%) 154 Tehachapi Hospital 76 (65.5%) 36 (31.0%) 4 (3.5%) 0 (0.0%) 0 (0.0%) 116 Delano Regional Medical Center 232 (81.9%) 48 (16.9%) 3 (1.1%) 0 (0.0%) 0 (0.0%) 283 Ridgecrest Regional 274 (97.5%) 5 (1.8%) 1 (0.4%) 1 (0.4%) 0 (0.0%) 281

APOT‐2: June 2017 – January 2018 by Hospital

Bakersfield Memorial Hospital

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 June, 1292 total July, 1502 total Aug, 1775 total Sept, 1731 total Oct, 1147 total Nov, 1291 total Dec, 1351 total Jan, 1357 total Percent of Total Transports Month and Number of Total Transports 2.1 2.2 2.3 2.4 2.5

Adventist Health Bakersfield

10 20 30 40 50 60 70 80 90 100 June, 1648 total July, 1949 total Aug, 2285 total Sept, 2097 total Oct, 1397 total Nov, 1514 total Dec, 1560 total Jan, 1604 Percent of Total Transports (%) Month and Total Number of Transports 2.1 2.2 2.3 2.4 2.5

Bakersfield Heart Hospital

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 June, 35 total July, 313 total Aug, 366 total Sept, 372 total Oct, 194 total Nov, 248 total Dec, 267 total Jan, 282 total Percent of Total Transports Month and Total Number of Transports 2.1 2.2 2.3 2.4 2.5

Mercy Hospital

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 June, 575 total July, 699 total Aug, 823 total Sept, 764 total Oct, 494 total Nov, 519 total Dec, 513 total Jan, 557 total Percent of all Transports (%) Month and Total Number of Transports 2.1 2.2 2.3 2.4 2.5

Mercy Southwest

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 June, 509 total July, 586 total Aug, 778 total Sept, 711 total Oct, 452 total Nov, 518 total Dec, 555 total Jan, 524 total Percent of Total Transports (%) Month and Number of Total Transports 2.1 2.2 2.3 2.4 2.5

Kern Medical

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 June, 927 total July, 1016 total Aug, 1264 total Sept, 1130 total Oct, 727 total Nov, 820 total Dec, 755 total Jan, 787 total Percent of Total Transports Month and Total Number of Transports 2.1 2.2 2.3 2.4 2.5

Kern Valley Healthcare District

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 June, 168 total July, 182 total Aug, 162 total Sept, 133 total Oct, 143 total Nov, 112 total Dec, 146 total Jan, 154 total Total Percent of Transports (%) Month and Total Number of Transports 2.1 2.2 2.3 2.4 2.5

Tehachapi Hospital

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 June, 75 July, 112 Aug, 138 Sept, 123 Oct, 97 Nov, 114 Dec, 137 Jan, 116 total Percent of Total Transports (%) Month and Number of Total Transports 2.1 2.2 2.3 2.4 2.5

Delano Regional Medical Center

0.00 10.00 20.00 30.00 40.00 50.00 60.00 70.00 80.00 90.00 100.00 June, 306 total July, 303 total Aug, 464 total Sept, 407 total Oct, 284 total Nov, 269 total Dec, 287 total Jan, 283 total Percent of Total Transports (%) Month and Total Number of Transports 2.1 2.2 2.3 2.4 2.5

Ridgecrest Regional

0.0 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 100.0 June, 235 total July, 240 total Aug, 257 total Sept, 185 total Oct, 206 total Nov, 198 total Dec, 237 total Jan, 281 total Percent of Total Transports (%) Month and Total Number of Transports 2.1 2.2 2.3 2.4 2.5

HP‐CPR PROTOCOL CHANGES

System Collaborative February 1st 2018

EMT Protocol Changes

EMT Protocol Changes

ALS Protocol Changes

Public Comment

• 30 Day comment period.
• Address comments to

Bakerg@kerncounty.com

• Go live date is tentatively the first week of

march.

Stroke System of Care

• 2nd Public comment ended on January 19th
• Subcommittee met this week to discuss the

received comments

• Many of the comments were regarding the

definitions of things, which we are working on updating

Stroke System of Care

• The plan:

– There seems to be much confusion – The state “draft” regulations have some additional changes – We will pull the document out of public comment – We will revise and work with the subcommittee

• n clarifying the document

– We will come back in April with a new stronger document

EMT Protocols

• Epi has been added to the EMT protocols

– (If auto injector must carry adult & pediatric)

• Blood Glucose analysis has been added

– ALOC protocol was updated to reflect the procedure

• Both of these items are part of basic scope
• Both of these items will be required to carry

for all Providers, transport, and non‐transport

EMT Protocols

• Epi

– If using auto injectors, no further training is required – If your agency decides to use vials and allow your EMT’s to “draw‐up” the medication, further training is required – We have a very good power point available, and Boundtree has a training kit that costs approx. $60

Blood Glucose considerations

• All Kern County Providers shall provide and

maintain records of training provided for use

• f glucometer
• The Division is looking to add an Diabetic

Emergency Protocol to the EMT Protocols to better define the appropriate use of blood glucose analysis

Waveform Capnography

• The Division wants Capnography used on all

patients for confirmation of tube placement

• This includes EMT’s and paramedics using King

Airway, I‐Gel, ET

• This has been added to the EMT protocols as

Optional Scope

Waveform Capnography

• What does this mean?

– If your agency is going to allow your EMT’s to place a King Airway or an I‐Gel, they will be required to confirm placement with waveform capnography – This is in the optional scope section of the EMT protocol as required equipment

Public Comment

• February 2nd, 2018‐March 2nd, 2018
• Submit comments to Nick Lidgett

– lidgettn@kerncounty.com

• Goal is to have implementation on July 1st,

2018

ANNOUNCEMENTS

MATTHEW CONSTANTINE DIRECTOR

THANK YOU FOR COMING

MATTHEW CONSTANTINE DIRECTOR