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Cardiac Level 1 Network Community Outreach and Education. Julie Mcdonald rn , bsn , cphq Providence regional medical center Everett October 2009. Providence Regional Medical Center, Everett Valley General Hospital, Monroe Cascade Valley Hospital, Arlington
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Cardiac Level 1 NetworkCommunity Outreach and Education Julie Mcdonald rn, bsn, cphq Providence regional medical center Everett October 2009
Providence Regional Medical Center, Everett Valley General Hospital, Monroe Cascade Valley Hospital, Arlington Whidbey General Hospital, Coupeville Skagit Valley Hospital, Mount Vernon Island Hospital, Anacortes United General Hospital, Sedro Woolley All EMS companies Cardiac Level 1 Network Members
~350 bed acute care hospital >105,000 ED visits in 2008 3 cath labs with 2500 procedures / year 8 Interventional cardiologists ~900 PCI’s / year ~250+ Primary PCI’s 70% direct to PRMCE – 30% transfer-in Most of our service area is within 30 minutes travel time STEMI Receiving Center
Extending the reach of patient care Partnering with referral hospitals and EMS systems Care starts with the first patient contact How can we get patients to contact us earlier? Door to Dilation is not enough
3q08-2q09 First time our onset to arrival time has been less than national Fewer patients (mostly walk-in’s) have first EKG in hospital…
3q08-2q09 Timing of field EKG is difficult to find in current documentation…
Appropriate dispatch Field EKG’s Don’t “set up camp” Field Activation of CVL Or field transmission of ECG’s Transport to appropriate receiving facility Assess all activities for whether they slow down or speed up the field times What happens (helps) in the field
EMS Quarterly Run Review Directed by MPD Focused on ECG interpretation skills and review of protocols Quarterly EMS / ED “Trauma” Lunch Case Review at District Stations prn EMS participation in Cardiology Quality Committee EMS representation in Cardiac Level 1 Network Cardiology presentations at referral hospitals Annual Cardiovascular Nursing Update Conference Outreach Activities with Partners
Why don’t they call 9-1-1? Lights & sirens All the neighbors will know It is probably a false alarm Unaware of the signs and symptoms DENIAL What is the cost? Who covers it? Will I have to pay out of pocket? People drive themselves to the ED
Comparison of Cities’ Fees for EMS Transport(The Everett Herald, Sept 29, 2009) Arlington Advanced life support: $527-$781 Basic life support: $283-$340 Mileage: $10.30 per mile Everett (proposed) Advanced life support: $675 Basic life support: $475 Mileage: $15 Lake Stevens Advanced life support: $475-$620 Basic life support: $350 Mileage: $10 Supplies charged separately. Marysville Advanced life support: $325-$425 Basic life support: $275 Mileage: $8 Supplies charged separately Monroe Advanced life support: $450-$550 Basic life support: $350-$450 Mileage: $10.25 Supplies charged separately.
Cardiac Level 1 care is different – but how? Care starts with the first patient contact Providers share information with each other Providers focused on hand offs and transitions – getting the patient to the cath lab “World class care” in your home Community partners Leverage existing messaging strategies Working with community press Creating a brand identification Changing the world… Education
Community outreach – leverage existing infrastructure Places where people gather Senior Centers, Community Centers, Churches Malls, Event Centers Schools Bus stops, DMV (!) (places where people wait!) Tell personal stories Word of mouth All members of the family Changing the world… Education
Changing the world… Education Community outreach – leverage existing infrastructure Publications that are routinely produced Hospital newsletters Fire District community news Employers’ newsletters Tell personal stories All age groups Local politicians Vendor /payor support