SYSTEM COLLABORATIVE MEETING Thursday April 5, 2018 MATTHEW - PowerPoint PPT Presentation

MATTHEW CONSTANTINE DIRECTOR EMERGENCY MEDICAL SERVICES SYSTEM COLLABORATIVE MEETING Thursday April 5, 2018

MATTHEW CONSTANTINE DIRECTOR IN INTRODUCTIONS

ReddiNet Bed Availability / MCI Response

MCI Response

February Notice Resp BHH 4 0 BMH 4 4 DRMC 2 1 KMC 4 4 KVH 3 1 MER 4 4 MSW 4 4 RRH 3 3 SJCH 4 4 Tehach 3 3

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

Year To Date 12 10 8 6 Alerts Responses 4 2 0 BHH BMH DRMC KMC KVH MER MSW RRH SJCH Tehach 40.00% 80.00% 66.67% 100.00% 60.00% 100.00% 100.00% 100.00% 90.00% 100.00% 4 8 4 10 3 10 10 5 9 5 10 10 6 10 5 10 10 5 10 5

Patient Distribution

Pt Dist I D M Total BHH 0 0 0 0 0.00% BMH 0 0 5 5 14.29% DRMC 0 0 2 2 5.71% KMC 2 0 9 11 31.43% KVH 0 0 0 0 0.00% MER 2 0 2 4 11.43% MSW 0 0 0 0 0.00% RRH 0 2 8 10 28.57% SJCH 1 0 2 3 8.57% Tehach 0 0 0 0 0.00% Total 35

Bed Availability

Bed Availability Reporting Number of Number of Number of Days Days Days B.A. B.A. B.A. not reported >1 Reported reported February BHH 28 0 20 BMH 28 0 28 DRMC 27 1 19 KMC 28 0 27 KVH 4 24 1 MER 28 0 28 MSW 28 0 27 RRH 28 0 27 SJH 28 0 27 THD 11 17 0

Bed Availability Reporting Number of Number of Number of Days Days Days B.A. B.A. B.A. not reported >1 Reported reported March BHH 31 0 22 BMH 31 0 30 DRMC 27 4 20 KMC 30 1 24 KVH 3 28 0 MER 31 0 30 MSW 31 0 30 RRH 31 0 29 SJH 31 0 29 THD 10 21 0

2018 Number of Days B.A. Reported Number of days B.A. reported >1 100 89 89 89 89 88 90 86 86 86 85 84 82 82 82 80 73 70 60 60 54 50 44 40 30 20 10 10 10 1 0 BHH BMH DRMC KMC KVH MER MSW RRH SJH THD

Patient Offload to Triage • Public Comment Period ended March 5 th . • One comment was received Our triage and acceptance protocols are designed to expedite the transfer of care from the ambulance to our ED staff. Our APOD times demonstrate our ability to manage this process. Our new ED when completed isolates the “Ambulance Entrance” from the “Public Entrance” significantly. While this policy would not work at our facility, we do not want to inhibit its adoption and implementation elsewhere.

Effective Date • Effective date is Monday, April 9 th , at 12:01hrs.

APOT March 2018

APOT-1: March 2018 Rank Hospital Number of Transports APOT-1 (Minutes) 1 Ridgecrest Regional 218 7.7 2 Kern Valley Healthcare District 142 13.4 3 Delano Regional Medical Center 250 22 5 Tehachapi Hospital 107 34.1 6 Mercy Hospital 500 38.4 6 Kern Medical 763 46.3 7 Mercy Southwest Hospital 548 46.9 8 (9) Adventist Health 1564 49.8 (93.5) 9 Bakersfield Memorial 1365 78.6 10 Bakersfield Heart Hospital 248 81.4

APOT-1 Bakersfield Hospitals: June 2017-March 2018 140 120 100 APOT-1 (minutes) 80 60 40 20 0 June July August September October November December January February March Month Adventist Health Bakersfield Bakersfield Heart Hospital Bakersfield Memorial Hospital Kern Medical Mercy Hospital Mercy Southwest Hospital

APOT-1 Outlying Area Hospitals: June 2017- March 2018 45 40 35 APOT-1(minutes) 30 25 20 15 10 5 0 June July August September October November December January February March Month Delano Regional Medical Center Kern Valley Healthcare District Ridgecrest Regional Tehachapi Hospital

APOT-1 and Transport Volume March 2018, Weekly

Bakersfield Hospitals 160 1200 1100 140 1000 Total Volume of Transports 120 900 Apot-1 Time (Minutes) 800 100 700 80 600 500 60 400 40 300 200 20 100 0 0 Week 1 Week 2 Week 3 Week 4 Week (March 2018) Adventist Health Bakersfield Bakersfield Heart Hospital Bakersfield Memorial Hospital Kern Medical Mercy Hospital Mercy Southwest Hospital

Outlying Area Hospitals 60 200 180 50 160 Total Transport Volume 140 APOT-1 (Minutes) 40 120 30 100 80 20 60 40 10 20 0 0 Week 1 Week 2 Week 3 Week 4 March 2018 Delano Regional Medical Center Kern Valley Healthcare District Ridgecrest Regional Tehachapi Hospital

APOT-2 Individual Hospital Data

APOT-2: March 2018 Hospital 2.1 (N, %) 2.2 (N, %) 2.3 (N, %) 2.4 (N, %) 2.5 (N, %) Total Number (<=20 min) (21-60 min) (61-120 min) (121-180 min) (>180 min) of Transports Bakersfield Memorial Hospital 390 (28.6) 759 (55.6) 161 (11.7) 3 (2.4) 23 (1.7) 1367 Adventist Health Bakersfield 628 (40.2) 853 (54.5) 70 (4.5) 12 (0.77) 0 (0) 1564 Bakersfield Heart Hospital 87 (35.1) 127 (51.2) 18 (7.3) 9 (3.6) 7 (2.8) 248 Mercy Hospital 265 (54) 220 (44.8) 6 (1.2) 0 (0) 0 (0) 548 Kern Medical 285 (37.4) 447 (58.6) 29 (3.8) 2 (0.3) 0 (0) 763 Mercy Southwest Hospital 242 (44.2) 286 (52.2) 19 (3.5) 1 (0.2) 0 (0) 500 Kern Valley Healthcare District 135 (95.1) 5 (3.5) 2 (1.4) 0 (0) 0 (0) 142 Tehachapi Hospital 73 (68.2) 32 (30) 2 (1.9) 0 (0) 0 (0) 107 Delano Regional Medical Center 220 (88.4) 28 (11.2) 1 (0.4) 0 (0) 0 (0) 249 Ridgecrest Regional 216 (99.1) 2 (0.9) 0 (0) 0 (0) 0 (0) 218

Adventist 100 2500 90 Percent of Total Transports (%) 80 2000 Total Transport Volume 70 60 1500 50 40 1000 30 20 500 10 0 0 June July Aug Sept Oct Nov Dec Jan Feb March Month 2.1 2.2 2.3 2.4 2.5

Bakersfield Memorial 100.0 2000 90.0 1800 80.0 1600 Percent of Total Transports Total Transport Volume 70.0 1400 60.0 1200 50.0 1000 40.0 800 30.0 600 20.0 400 10.0 200 0.0 0 June July Aug Sept Oct Nov Dec Jan Feb March Month 2.1 2.2 2.3 2.4 2.5

Bakersfield Heart Hospital 100.0 400 90.0 350 80.0 Percent of Total Transports 300 Total Transport Volume 70.0 250 60.0 50.0 200 40.0 150 30.0 100 20.0 50 10.0 0.0 0 July Aug Sept Oct Nov Dec Jan Feb March Month 2.1 2.2 2.3 2.4 2.5

Proportion of Kern County ED Visits Reporting ILI with Fever: 2017-2018 12.0 10.0 8.0 Percent Ill 6.0 4.0 2.0 0.0 September October November December January February March Month Data prepared by Jyoti Kaur, MPH

Kern County: Total Number of Acute Care Interactions, Oct 2017-March 2018 40000 32707 35000 36540 30000 32316 Total Number 25000 20000 15000 10000 5000 0 October November December January February March Month

Extra Slides

Transport Volume By Hospital Week 1 Week 2 Adventist Health Adventist Health Bakersfield Bakersfield 107, 9% Bakersfield Heart Bakersfield Heart 139, 12% Hospital Hospital 349, 30% 134, 11% Bakersfield Bakersfield 126, 11% 384, 32% Memorial Hospital Memorial Hospital Kern Medical Kern Medical 168, 14% 55, 5% 185, 16% 321, 28% Mercy Hospital Mercy Hospital 67, 6% 310, 26% Mercy Southwest Mercy Southwest Hospital Hospital

Transport Volume by Hospital, Cont. Week 3 Week 4 Adventist Health Adventist Health 111, 10% Bakersfield Bakersfield Bakersfield Heart 133, 12% Bakersfield Heart Hospital Hospital 89, 8% 328, 31% Bakersfield 367, 33% 111, 10% Bakersfield Memorial Hospital Memorial Hospital 187, 18% Kern Medical 155, 14% Kern Medical 41, 4% 60, 6% Mercy Hospital 312, 29% 277, 25% Mercy Hospital Mercy Southwest Mercy Southwest Hospital Hospital

Transport Volume by Hospital Week 1 Week 2 Delano Regional Delano Regional Medical Center Medical Center 19, 12% 24, 14% 51, 31% Kern Valley Kern Valley 64, 37% Healthcare District Healthcare District 55, 33% 51, 30% Ridgecrest Ridgecrest Regional Regional 40, 24% 33, 19% Tehachapi Hospital Tehachapi Hospital

Transport Volume by Hospital, Cont. Week 3 Week 4 Delano Regional Delano Regional Medical Center Medical Center 25, 16% 29, 19% 50, 32% Kern Valley Kern Valley 62, 40% Healthcare District Healthcare District 41, 27% 54, 34% Ridgecrest Ridgecrest Regional Regional 28, 18% 21, 14% Tehachapi Hospital Tehachapi Hospital

ALS to BLS November 2017- February 2018

November percentage

November 2017

December Percentage

December 2017

January Percentage

January 2018

February Percentage

February ry 2018

EMD QI • Emailed the QI group first meeting will be April 19 th 11:00 – 12:00. • We will start looking at EMD cards starting with Bravo cards. • Discuss on ways to improve the EMD process/QI

EMT Regulations Effective July 2018