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

▶
system collaborative
SMART_READER_LITE
LIVE PREVIEW

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

Jan 07, 2023 165 likes •837 views

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

slide-1
SLIDE 1

EMERGENCY MEDICAL SERVICES SYSTEM COLLABORATIVE MEETING

Thursday April 5, 2018

MATTHEW CONSTANTINE DIRECTOR

slide-2
SLIDE 2

IN INTRODUCTIONS

MATTHEW CONSTANTINE DIRECTOR

slide-3
SLIDE 3
slide-4
SLIDE 4
slide-5
SLIDE 5

ReddiNet

Bed Availability / MCI Response

slide-6
SLIDE 6

MCI Response

slide-7
SLIDE 7

February Notice Resp BHH 4 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

slide-8
SLIDE 8

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

slide-9
SLIDE 9

2 4 6 8 10 12 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

Year To Date

Alerts Responses

slide-10
SLIDE 10

Patient Distribution

slide-11
SLIDE 11

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

slide-12
SLIDE 12

Bed Availability

slide-13
SLIDE 13

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

slide-14
SLIDE 14

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

slide-15
SLIDE 15

86 89 82 85 10 89 89 89 88 44 60 86 54 73 1 86 82 82 84 10 10 20 30 40 50 60 70 80 90 100 BHH BMH DRMC KMC KVH MER MSW RRH SJH THD

2018

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

slide-16
SLIDE 16
slide-17
SLIDE 17

Patient Offload to Triage

  • Public Comment Period ended March 5th.
  • 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.

slide-18
SLIDE 18

Effective Date

  • Effective date is Monday, April 9th, at 12:01hrs.
slide-19
SLIDE 19
slide-20
SLIDE 20

APOT

March 2018

slide-21
SLIDE 21

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

slide-22
SLIDE 22

APOT-1 Bakersfield Hospitals: June 2017-March 2018

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

slide-23
SLIDE 23

APOT-1 Outlying Area Hospitals: June 2017- March 2018

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

slide-24
SLIDE 24

APOT-1 and Transport Volume

March 2018, Weekly

slide-25
SLIDE 25

Bakersfield Hospitals

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

slide-26
SLIDE 26

Outlying Area Hospitals

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

slide-27
SLIDE 27

APOT-2

Individual Hospital Data

slide-28
SLIDE 28

APOT-2: March 2018

Hospital 2.1 (N, %) (<=20 min) 2.2 (N, %) (21-60 min) 2.3 (N, %) (61-120 min) 2.4 (N, %) (121-180 min) 2.5 (N, %) (>180 min) Total Number

  • f 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

slide-29
SLIDE 29

Adventist

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

slide-30
SLIDE 30

Bakersfield Memorial

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

slide-31
SLIDE 31

Bakersfield Heart Hospital

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

slide-32
SLIDE 32

Proportion of Kern County ED Visits Reporting ILI with Fever: 2017-2018

0.0 2.0 4.0 6.0 8.0 10.0 12.0 September October November December January February March Percent Ill Month

Data prepared by Jyoti Kaur, MPH

slide-33
SLIDE 33

Kern County: Total Number of Acute Care Interactions, Oct 2017-March 2018

36540 32316 32707 5000 10000 15000 20000 25000 30000 35000 40000

October November December January February March

Total Number

Month

slide-34
SLIDE 34

Extra Slides

slide-35
SLIDE 35

Transport Volume By Hospital

Week 1 Week 2

349, 30% 55, 5% 321, 28% 168, 14% 134, 11% 139, 12%

Adventist Health Bakersfield Bakersfield Heart Hospital Bakersfield Memorial Hospital Kern Medical Mercy Hospital Mercy Southwest Hospital

384, 32% 67, 6% 310, 26% 185, 16% 126, 11% 107, 9%

Adventist Health Bakersfield Bakersfield Heart Hospital Bakersfield Memorial Hospital Kern Medical Mercy Hospital Mercy Southwest Hospital

slide-36
SLIDE 36

Transport Volume by Hospital, Cont.

Week 3 Week 4

328, 31% 41, 4% 312, 29% 187, 18% 89, 8% 111, 10%

Adventist Health Bakersfield Bakersfield Heart Hospital Bakersfield Memorial Hospital Kern Medical Mercy Hospital Mercy Southwest Hospital

367, 33% 60, 6% 277, 25% 155, 14% 111, 10% 133, 12%

Adventist Health Bakersfield Bakersfield Heart Hospital Bakersfield Memorial Hospital Kern Medical Mercy Hospital Mercy Southwest Hospital

slide-37
SLIDE 37

Transport Volume by Hospital

Week 1 Week 2

51, 31% 40, 24% 55, 33% 19, 12%

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

64, 37% 33, 19% 51, 30% 24, 14%

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

slide-38
SLIDE 38

Transport Volume by Hospital, Cont.

Week 3 Week 4

50, 32% 28, 18% 54, 34% 25, 16%

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

62, 40% 21, 14% 41, 27% 29, 19%

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

slide-39
SLIDE 39
slide-40
SLIDE 40

ALS to BLS

November 2017- February 2018

slide-41
SLIDE 41

November percentage

slide-42
SLIDE 42

November 2017

slide-43
SLIDE 43

December Percentage

slide-44
SLIDE 44

December 2017

slide-45
SLIDE 45

January Percentage

slide-46
SLIDE 46

January 2018

slide-47
SLIDE 47

February Percentage

slide-48
SLIDE 48

February ry 2018

slide-49
SLIDE 49
slide-50
SLIDE 50

EMD QI

  • Emailed the QI group first meeting will be April 19th

11:00 – 12:00.

  • We will start looking at EMD cards starting with Bravo

cards.

  • Discuss on ways to improve the EMD process/QI
slide-51
SLIDE 51
slide-52
SLIDE 52

EMT Regulations

Effective July 2018

slide-53
SLIDE 53

EMT Regulations

  • Effective July 1, 2017 Blood glucose testing, Epinephrine and

Naloxone are in the EMT’s basic scope of practice.

  • EMT regulations required EMT course content include Tactical

Casualty Care, Naloxone Epinephrine and assessing a blood glucose with a glucometer.

  • The Epinephrine and Naloxone must be a minimum of 2 hours. The

Tactical Casualty Care must be a minimum of 4 hours.

  • Training programs must submit evidence of compliance within 12
  • months. Training programs and provider will be getting a letter for

evidence of compliance and will need to submit for approval.

slide-54
SLIDE 54
slide-55
SLIDE 55

HP-CPR

  • HP-CPR Protocol changes are through 30 day public

comment period with no comments received.

  • Implementation will be tomorrow April 9th 2018, at

12:01am.

  • All providers should be ready to implement if they

have not already done so.

slide-56
SLIDE 56
slide-57
SLIDE 57

Pediatric Determination of Death

  • Recent studies and current best practices suggest that on scene

resuscitation efforts provide a far higher ROSC and survival rate than resuscitation efforts while transporting for both Adult and Pediatric populations.

  • On scene resuscitation is more effective for patients and is far safer

for providers, patients, family and the general public.

  • If the scene becomes unstable then transport is encouraged, it is up

to provider discretion with base consult as to whether resuscitation should be continued during transport.

slide-58
SLIDE 58

Determination of Death Pediatric Change

  • Currently all patients under 18 years are immediately transported if

no signs of obvious death.

  • Proposed change is to work pediatric patients on scene for 30

minutes as we do with adults currently. Standard exception for social issues and unsafe scene will remain.

  • Base contact for termination of efforts for all patients < 15 shall be

required.

slide-59
SLIDE 59
slide-60
SLIDE 60

Mandatory ry Paramedic Update Training

slide-61
SLIDE 61

Mandatory ry Paramedic Update Training

  • MONDAY THE 21ST AND FRIDAY THE 25TH WILL BE

MORNING SESSIONS ONLY, 4 HOURS EACH SESSION.

  • TUESDAY, WEDNESDAY, AND THURSDAY THE

22ND,23RD & 24TH WILL BE MORNING AND AFTENOON SESSIONS 4 HOURS EACH SESSION.

slide-62
SLIDE 62

AGENDA

Time Presenter Topic 0805-0810 1305-1310 Jeff Fariss Welcome/Local Accreditation 0810-0820 1310-1320 Kimberly Tollison IGel 0820-0835 1320-1335 Kimberly Tollison Core Measures 0835-0850 1335-1350 Nick Lidgett Paramedic Handoff/Transport directly to the waiting room/Wellbeing Notification of Death Online Program 0850-0905 1350-1405 Nick Lidgett Chem Pack 0905-0935 1405-1435 George Baker Protocol Changes/New Protocol Format. EMT Epi Administration/ D-10 Administration/Intubation 0935-0950 1435-1450 Charles Brockett PCR Review/Documentation 0950-1000 1450 -1500 Break Break 1000-1025 1500-1525 Jeff/Dr. STEMI Center Presentation 1030 1055 1530-1555 George/Dr. Pediatric Center Presentation 1100-1125 1600-1625 Charles Brockett/Dr. Trauma Center Presentation 1130-1155 1630-1655 Kim/DR. Stroke Center Presentation

slide-63
SLIDE 63
slide-64
SLIDE 64
slide-65
SLIDE 65

ANNOUNCEMENTS

MATTHEW CONSTANTINE DIRECTOR

slide-66
SLIDE 66

THANK YOU FOR COMING

MATTHEW CONSTANTINE DIRECTOR