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ROAD SAFETY FORUM 2014. Road Safety: Everybody’s Responsibility PNP Multi-Purpose Center, Main Hall National Headquarters Camp Crame Quezon City, Metro Manila May 16, 2014 8:00 AM – 5:00 PM. DOH RESPONSE TO POST-CRASH CARE. CLARITO U. CAIRO, JR., MD, DPSVI, DPCOM
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ROAD SAFETY FORUM 2014 Road Safety: Everybody’s Responsibility PNP Multi-Purpose Center, Main Hall National Headquarters Camp Crame Quezon City, Metro Manila May 16, 2014 8:00 AM – 5:00 PM
DOH RESPONSE TO POST-CRASH CARE CLARITO U. CAIRO, JR., MD, DPSVI, DPCOM ACCREDITED SAFETY AND HEALTH PRACTITIONER PROGRAM MANAGER, VIOLENCE AND INJURY PREVENTION ESSENTIAL NON-COMMUNICABLE DISEASE DIVISION DISEASE PREVENTION AND CONTROL BUREAU Email: dokclar@yahoo.com / dokclar@gmail.com
DEPARTMENT ORDER NO. 2008-0055 “Guidelines on the Disbursement / Utilization of Road Safety Trust Funds for the Operationalization of the National Electronic Injury Surveillance System (NEISS) in Philippine Orthopedic Center, Jose Reyes Memorial Medical Center, East Avenue Medical Center, Quirino Memorial Medical Center, Davao Medical Center, and Vicente Sotto Medical Center”
ONEISS CY 2010-2013 http://uhmis1.doh.gov.ph/unifiedhmis NO. OF HOSPITALS IN THE PHILIPPINES: 1,821 DOH 70 GOVERNMENT 662 PRIVATE 1,089
DEPARTMENT ORDER NO. 2011-0047 “Creation of the Philippine Network for Injury Data Management System (PNIDMS)” MEMBERS DOH, DOTC, DPWH, UNICEF, WHO, PNP-HPG, MMDA, SAFE KIDS PHILIPPINES, LTO, DOLE, DSWD, UP-NCTS, NBI, BFP, CHED, NSO, PHILHEALTH, PCW, PIRA, DEPED http://uhmis2.doh.gov.ph/pnidms
ADMINISTRATIVE ORDER NO. 2013-005 “National Policy on the Unified Registry Systems of the Department of Health (Chronic Non-Communicable Diseases, Injury-Related Cases, Persons with Disabilities, and Violence Against Women and Children Registry System)
ADMINISTRATIVE ORDER No. 2014 - 0002 “Revised National Policy on Violence and Injury Prevention”
REVISED NATIONAL POLICY ON VIOLENCE AND INJURY PREVENTION ROAD TRAFFIC INJURIES
ADMINISTRATIVE ORDER No. 2014 - 0007 “National Policy on the Establishment of Prehospital Emergency Medical Service System”
RATIONALE As an integral part of the Revised National Policy on Violence and Injury Prevention (AO 2014-0002), there is a need to establish a prehospital EMS system at the national and local level in order to prevent deaths due to injuries and to minimize or mitigate occurrence of disabilities.
GENERAL OBJECTIVE Institutionalize a comprehensive, accessible and integrated system of prehospital emergency medical services from the scene of incident to the appropriate health care facility or hospital at the national and local level.
SPECIFIC OBJECTIVES • Develop, implement, monitor and evaluate evidence-based and customized standards and guidelines for best practices in prehospital emergency medical services; • Enhance capacity of Regional Offices (ROs), Local Government Units (LGUs), and other stakeholders as well as strengthen collaboration with them towards establishing an efficient and sustainable prehospital EMS system; and • Ensure full operationalization and implementation of the prehospital EMS system from the national level down to the grassroots level.
Action Framework for Prehospital Emergency Medical Service System
Emergency Dispatch • involves the immediate identification and prioritizing of emergency situations, the timely dispatch of the most appropriate resources and full endorsement to the receiving hospital. Dispatch encompasses all aspects of communication including request processing, coordination and support, and documentation and monitoring
Emergency Response and Care • involves arrival of resources at the scene and the timely initiation of appropriate interventions
Emergency Transport • involves transporting the patient to the most appropriate facility and continued provision of care en route
Inter-Facility Referral and Transport • involves the transport of patient with medical escorts, if necessary, from one facility to another, as the patient requires services that are not available in the referring facility
Existing Healthcare Delivery Systems • involves the various levels of health units, e.g. barangay health stations, rural health units, free standing clinics, etc., and referral units, i.e. inter-local health zones
Available Groups of Service Providers and Stakeholders • begins with the organizational structure and dynamics of the Program Management Committee which coordinates the strategies and implementation of the National Policy on Violence and Injury Prevention, and shall later include healthcare professionals, accredited EMT / paramedics, barangay health workers, and volunteer organizations
Support Facilities and Systems • refer to accessible communication and transport facilities
Legal Framework • defines the contractual liabilities of all stakeholders (individuals, agencies, and hospitals) as defined in appropriate policy mechanisms and instruments. It also involves developing and operationalizing procedures and guidelines for policy implementation
Governance •system management and supervision at the national (or local) level by a council/network/coalition, which may include representation from the government and other stakeholders under the chairmanship of an appropriate authority. It will coordinate the implementation of the EMS system within the country (or province or city) through standardization, regulation, accreditation, policy making, monitoring and evaluation, technical and capability building, resource sharing and management, and steering inter-sectoral coordination. Also, it will manage and supervise at the local level by the local chief executive through a fitting office that will overlook functioning of the EMS system at the grassroots level.
ROLES AND RESPONSIBILITIES Regional Offices (ROs) shall provide technical assistance to the LGUs and oversee the local institutionalization of prehospital EMS system. They shall also establish the standards for an efficient hospital referral system within the locality.
ROLES AND RESPONSIBILITIES DOH Hospitals shall ensure provision of quality promotive, preventive, curative, rehabilitative, and palliative care for patients involved in violence and injury.
ROLES AND RESPONSIBILITIES Local Government Units (LGUs) shall adopt and implement the prehospital EMS system and provide services and necessities in primary health care facilities and hospitals in their localities.
ROLES AND RESPONSIBILITIES Non-government organizations, professional groups, other national government agencies / organizations, private sector, and the academe shall assist in the implementation of this Order.
Prehospital Emergency Medical Service Committee (PEMSC) DOJ, DILG, DOTC, DEPED, PCEM, PRC, DOH
PREHOSPITAL EMS SYSTEM ORGANIZATIONAL / STRUCTURAL FRAMEWORK
LAUNDRY LIST OF PLANS PER SUBCOMMITTEE SERVICE DELIVERY CAPACITY DEVELOPMENT POLICY-MAKING • DEVELOPMENT OF POLICY OR ORDINANCE FOR THE ESTABLISHMENT OF SAFETY EMERGENCY MEDICAL SERVICE SYSTEM AT THE LOCAL LEVEL • DEVELOPMENT OF GUIDELINES FOR THE ESTABLISHMENT AND OPERATIONALIZATION OF LOCAL PREHOSPITAL EMS SYSTEM • DEVELOPMENT OF GUIDELINES FOR MEDICOLEGAL CARE OF THE VICTIMS OF VIOLENCE AND INJURIES • DEVELOPMENT OF GUIDELINES FOR MENTAL HEALTH CARE AFTER TRAUMA-RELATED EMERGENCIES • DEVELOPMENT OF TRIAGE GUIDELINES AND PROTOCOLS FOR INTERFACILITY TRANSFER • FORMATION OF FUNCTIONAL MULTISECTORAL PREHOSPITAL EMS TEAM • INCLUSION OF PREHOSPITAL TRAUMA CARE IN PHILHEALTH BENEFIT PACKAGES • DEVELOPMENT OF TOOL OR METRIC FOR SAFETY RISK ASSESSMENT AND MANAGEMENT IN THE COMMUNITY • AVAILABILITY OF MENTAL HEALTH AND PSYCHOSOCIAL SUPPORT FOR VICTIMS OF VIOLENCE AND INJURIES AND THEIR FAMILIES • AVAILABILITY OF IEC MATERIALS ON SAFETY PROMOTION AND VIOLENCE AND INJURY PREVENTION • AVAILABILITY OF EMERGENCY TRANSPORT SERVICES IN EVERY COMMUNITY • STANDARDIZATION OF EMS TRAININGS • ACCREDITATION AND REGULATION OF EMS TRAINING AND EMERGENCY TRANSPORT PROVIDERS • ACCREDITATION, CERTIFICATION, AND REGISTRATION OF EMS PRACTITIONERS • AVAILABILITY OF TRAINED AND CERTIFIED FIRST RESPONDERS IN EVERY BARANGAY / COMMUNITY • AVAILABILITY OF TRAINED AND CERTIFIED FIRST RESPONDERS IN SCHOOLS, WORKPLACES, MALLS AND OTHER INSTITUTIONS • ORIENTATION AND TRAINING OF ONEISS AND PNIDMS USERS
SAFETY AND EMERGENCY MEDICAL SERVICE SYSTEM AT THE LOCAL LEVEL
UPDATES PhilHealth Circular No. 012 – 2014 Z Benefit Rates for Selected Orthopedic Implants June 1, 2014
UPDATES RESEARCH TOPICS 2014-2015 • “Determination of Incidence of Injuries from Vehicular Crashes in the Philippines (2011-2013)” • “Study on the Socio-Economic Burden of Violence in the Philippines” • “Study on the Socio-Economic Burden of Road Traffic Injuries in the Philippines”
NEXT STEPS • Issuance of the Department Order on the Guidelines for the Establishment and Operationalization of Prehospital EMS System at the Local Level • Piloting of Prehospital EMS System: at least one province per region • Development of Training Modules on Basic and Advanced Prehospital Trauma Care
NEXT STEPS • Drafting of the “National Policy on the Prevention and Control of Harmful Alcohol Use” • Organizing the National Summit on Safety Promotion and Violence and Injury Prevention • Development of Action Framework for Each Subprogram of VIPP