Strengthening EMS Systems of Care 2007 HDSP State Programs Training Atlanta, Georgia

1. Strengthening EMS Systems of Care 2007 HDSP State Programs Training Atlanta, Georgia 3:30-5:00 PM Sept. 18, 2007 Dory Masters, M.Ed., CHES Director, Heart Disease & Stroke Prevention Community Health and Chronic Disease Prevention SC Dept. Health & Environmental Control

2. EMS in SC

4. Different Regional Structures

5. HDSP-EMS Collaboration Important partners and EMS champions EMS Division, SC DHEC SC EMS Association - Board SC EMS Educator�s Association Doug Silk, NREMT-P American Heart /American Stroke Association

6. 2007 South Carolina EMS Capacity survey Victor Grimes & Khosrow Heidari Div of Emergency Medical Services & Chronic Disease Epidemiology

7. Describe the EMS Community EMS Agencies Number Level of service Location Size Volume EMS Personnel Numbers Level (EMT, EMT-Intermediate, EMT-Paramedic Location Patients Number of events Number of patients Numbers based upon population and service area

8. Survey Methodology: Paper and pencil N = 190 ? 46 County + 144 Other n = 103 completed response (54%) County EMS: 27 ? 59% response rate Other EMS: 76 ? 53% response rate

9. Software utilization? (based on n=103 responses) Yes: 38% computer data enter: 26 commercial, 5 State developed and 5 in-house software to enter PCR data No: 62%

10. What land mass does your agency provide service for? (based on n=82 Primary responses)

11. How many Square miles are in the service area:

12. What is the population of the area that your system serves (the resident population)? (based on n=82 Primary responses)

13. How many EMS 911 dispatches and patient contacts did your service have in the last 6 months (July to December), including all types of calls?  (based on n=82 Primary responses)

14. Survey Conclusions: The majority (59%) of the primary respondents do not use any software for their data entry. 71% of those who do their own data entry use a commercially developed product and aren�t considering changing it within next year. The largest data documentation of the calls takes place at the station, then at the hospital by primary EMS. The majority of the written documentation usually takes place within 30 minutes (socially desirable response?) by EMS personnel.

15. National Efforts

16. Active Data System Status

17. Lessons Learned � Other States Legislation: need support for an electronic data system Funding: need $ for maintenance, personnel, upgrades & hardware Human Resources: qualified people are needed for technical development, system design, program management, training, marketing and other Hardware: EMS Data Warehouse, EMS data via Internet Data Entry Equipment Software (in house, commercial . . .etc) Training Marketing Implementation Maintenance Reporting

18. Standard Protocols SC EMS Board Adopted Univ. of Miami�s Emergency Neurologic Deficit Exam (MEND) as part of statewide protocols (2002) MEND training approved for CEUs by SC EMS Advisory Council (2003) MEND checklist incorporated in EMS training curriculum (National) MEND rebranded ASLS Advanced Stroke Life Support

19. Provider Training AHA/ASA Operation Stroke sponsored 1 EMT-P in Univ. of Miami�s Emergency Neurologic Deficit (MEND) master train the trainer course (2003) Operation Stroke disbanded (2004) ?�How to sustain MEND course & support instructors?

20. Training Process SC HDSP sponsored MEND TTT course at the SC Annual Emergency Care Symposium (FY �04) SC HDSP sponsored 4 regional MEND trainings (FY �05) SC HDSP and HDSP funded regions sponsored 4 regional ASLS trainings (FY �06) SC HDSP and HDSP funded regions sponsored 4 regional ASLS-H trainings (FY �07) SC HDSP committed to ongoing ASLS-H support � priority with hospitals pursuing JCAHO Stroke Center and disparate areas

22. ASLS Train the Trainer Challenges� Secondary trainings Training support/advocacy (EMS service level) Training materials availability/costs Tracking/reporting of trainings not comprehensive as reporting not required by Division of EMS Individual EMS provider CE records updated with recertification (3 yr) at state system level State EMS CE system not electronic or easily searchable Registry of trainers & courses Current trainer registry not within EMS system Current ASLS-H trainer courses coordinated by HDSP

23. Activity: Data linkage Less than 30 services report electronically Capacity to link to hospital records exist but so do challenges� Financial (local & state) Proprietary feelings

24. Next Steps Regional ASLS Hospital course Targets pre-hospital & hospital providers Supported by HD&SP funded regions Explore additional venues for education Data linkage Impact & outcome measures

26. Conclusion Establishing a strong relationship with the EMS Division staff is essential in developing successful policy to enhance EMT capacity Cultivating such a relationship requires a long term vision, mutual trust and respect. Future activities will focus on ED staff NEMSIS Rehab centers

27. EMS providers eager for continuing education Systems changes seen at county level Protocol changes Annual training requirements for staff Must link data (our biggest challenge)

28. Thank You! Check us out www.scdhec.gov/hdsp