Ohio Emergency Medical Services for Children Conference 2018
The Ohio EMS for Children aims to provide uninterrupted care for pediatric patients through established performance measures and partnerships with key agencies. Learn about the origins of EMSC, current objectives, and the role of a Pediatric Emergency Care Coordinator in enhancing pediatric emergency services.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
You are allowed to download the files provided on this website for personal or commercial use, subject to the condition that they are used lawfully. All files are the property of their respective owners.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.
E N D
Presentation Transcript
OHIO EMERGENCY MEDICAL SERVICES FOR CHILDREN Ohio EMS Medical Director Conference 2018
Objectives Understand the origins of EMSC as it relates to its current goals Summarize the current results of the EMS agency survey and reflect how your agency may perform if participating Reflect on the role of a pediatric emergency care coordinator (PECC) and how this position could be incorporated into your agency
EMSC The Beginning 1966: NHTSA was established and the EMS Systems Act of 1973 helped create state EMS 1975-79: Adult care significantly improved with EMS, but children outcomes were not 1984: EMSC established Dr. Sia (president of the Hawaii Medical Association) had a vision for a multifaceted system of EMS to improve outcomes for children and sponsored by Senator Inouye
Your National Resource for EMSC Information https://emscimprovement.center/
Ohio EMS for Children Established to serve the needs of ill and injured children to reduce death and disability Goal is to provide uninterrupted care for pediatric patients State Partnership grants provided by Maternal and Child Health Bureau, Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (DHHS) Grantees, including the Ohio Department of Public Safety (ODPS), are responsible for implementing Performance Measures
Ohio EMS for Children Performance Measures Prehospital Measures (prior to 2017) Improve pediatric medical direction online and offline Improve access to pediatric equipment on ambulances Require pediatric continuing education for recertification at all levels of service Federal EMSC Program retired these measures due to the general level of success nationwide
Ohio EMS for Children Performance Measures Hospital Measures Establish emergency department categorization system for pediatrics Increase number of hospitals with written transfer agreements and written patient guidelines which include pediatrics Systemic Measures Improve the degree of permanence of EMS for Children program in Ohio
Ohio EMS for Children Projects Emergency Departments: Pediatric Prepared Recognition system for emergency departments Covers pediatric trauma and pediatric medical emergencies Most important element is a Pediatric Emergency Care Coordinator (PECC) for nurses and physicians Based on Guidelines for Care of Children in the Emergency Department, joint publication of AAP/ACEP/ENA Working closely with Ohio Hospital Association and Ohio Department of Health on new approach
Ohio EMS for Children Projects Educational Conferences Pediatric Emergency Medicine Fellows Conference (held annually 2013-2015) EMS Medical Directors Conference (2016) Ohio ITLS Conference pediatric break-out sessions (since 2006) Concepts in Process Improvement Workshops (since 2015) for prehospital providers Pediatric Emergency Care Coordinator Workshops (2017-18)
Ohio EMS for Children Projects Collaboration with other groups Ohio Pediatric Disaster Preparedness Coalition Partnership with Ohio Hospital Association Initial work included state pediatric burn surge plan Ongoing work includes family reunification and state-level planning efforts Currently working on Pediatric Coordinators in the ED Involvement includes Ohio Department of Health s Hospital Preparedness Program Ohio Injury Prevention Partnership Member of group led by Ohio Department of Health Direct involvement with Child Injury Action Group
Interaction with EMFTS Board Equipment list for EMS Grants reviewed by EMS for Children Committee EMFTS Board has recommended EMSC pediatric equipment lists to Ohio EMS agencies EMS for Children Committee receives requests from other committees and EMFTS Board for input and expertise for pediatric care Board and committee members take information from EMS for Children Committee to their constituent organizations/facilities
Ohio EMS for Children Performance Measures Prehospital Measures (beginning 2017) Submission of NEMSIS-compliant data to state EMS office Designated Pediatric Emergency Care Coordinator (PECC) Process for EMS providers to physically demonstrate the correct use of pediatric equipment (skill acquisition and retention)
Why a Pediatric Emergency Care Coordinator (PECC)? Recommendation of IOM report Emergency Care for Children: Growing Pains (2007) EDs found to have higher pediatric care scores if a PECC is present (2015) Should be a member of the EMS agency and be familiar with the day-to-day operations and needs at the agency Can coordinate pediatric care over multiple agencies (county/region) This person is your pediatric champion
What will a PECC Roles and Responsibilities be? Ensuring that the pediatric perspective is included in the development of EMS protocols Ensuring that fellow providers follow pediatric clinical practice guidelines Promoting pediatric continuing education opportunities Overseeing pediatric process improvement Ensuring the availability of pediatric medications, equipment, and supplies Promoting agency participation in pediatric prevention programs Promoting agency participation in pediatric research efforts Liaises with the emergency department pediatric emergency care coordinator Promoting family-centered care at the agency
EMS Agency Survey Survey conducted 11/1/17 - 1/31/18 Survey collected baseline data for NEW performance measures Pediatric Emergency Care Coordinator (PECC) Skill demonstration Response rate: 67% (299/444)
Pediatric Emergency Care Coordinator 286 responses National EMSC Program Target By 2020, 30% of EMS agencies will have a Pediatric Emergency Care Coordinator By 2023, 60% By 2026, 90% Yes (29%) + Interested (21%) + Planning (5%) = 55% Yes = 83/286 (29%) No = 126/286 (45%) Interested in Adding = 60/286 (21%) Plan to Add = 14/286 (5%)
Pediatric Emergency Care Coordinator (PECC)
Comments on PECC Need resources Protocols drive pediatric care Just starting process EMS Coordinator fills role What is family-centered care?
Pediatric Equipment Skills Demonstration Examples of skills to be demonstrated: Airway adjunct use/ventilation Clearing airway/suctioning CPR AED use/cardio-monitoring IV/IO insertion and administration of fluids Weight/length-based tape use Child safety restraint vehicle installation and pediatric patient restraint Processes for skill demonstration: - Skill stations - Simulated events - Field encounter
How is Skill Verification Done? At a SKILL STATION (not part of a simulated event), does your agency have a process which REQUIRES your EMS providers to PHYSICALLY DEMONSTRATE the correct use of PEDIATRIC SPECIFIC equipment? 195/286 (68%) of Ohio EMS agencies replied Yes and a majority at least once/year Within a SIMULATED EVENT ...? 187/286 (65%) of Ohio EMS agencies replied Yes and majority at least once per year During an actual PEDIATRIC PATIENT ENCOUNTER, does your agency have a process which REQUIRES your EMS providers to be observed by a FIELD TRAINING OFFICER, MEDICAL DIRECTOR, or SUPERVISOR to ensure the correct use of PEDIATRIC SPECIFIC equipment? 79/286 (28%) of Ohio EMS agencies replied Yes and a majority at least once/ year
Comments on Skill Verification Training needs met/recognize need for more training with lower volume (4%) Don t do skill checks/not required (2%) No money for training/equipment (2%) Use PALS for verification (1%) Time constraints (1%) Part of QI process (1%) Need to practice at pediatric hospital (1%)
Survey Results Good initial result for Pediatric Emergency Care Coordinators Very close to meeting 2020 goal already Could be close to meeting 2023 goal with some effort Will need to improve skills demonstration efforts Good to see 68% of agencies use skill stations Good to see 65% of agencies use simulated events Need to improve frequency of use of both Need to improve use of field encounter demonstration
Next Steps Promote PECC state wide Recipient of demonstration grant (with 9 other states) to identify best practices for implementation Continue and enhance education for PECC Address presence/frequency of pediatric skill verification and retention Encourage agencies with research information Make more funding available for training equipment
Ohio EMSC Communications EMSC Website Current activity information State and national resources Pediatric hospital information Public Events Handouts at educational events Presentations at meetings EMS GovDelivery System E-mail service from Division of EMS
Ohio EMS for Children Documents available at http://www.ems.ohio.gov/emsc.aspx Questions? Contact Joe Stack, EMS for Children Coordinator EMSC@dps.ohio.gov 614-387-1949
