Allina Health EMS Community Report 2013

8/12/2019 Allina Health EMS Community Report 2013

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Community Report 2013

Allina Health

Emergency Medical Services


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CaringAt Allina Health Emergency Medical Services

everything we do comes from our deep

commitment to careits the driving force

to provide the very best for our patients.

As emergency medical services (EMS)

clinicians, we know that the people we

encounter may be having the worst day of

their lives. But we have the opportunity to be

the best part of that day through the things w

do. Big things, like restarting a stalled heart.

Little things, like putting a hand on a patient

shoulder and offering a reassuring smile.

Nearly 90,000 times a year, people place thei

dignity, their well-being, even their lives or th

lives of their loved ones in our hands. Thats

a profound responsibility, and we never stoptrying to be worthy of it. Every day, every nigh

on every call, we strive to show we care.

Its why were hereEMT April Anderson provides both

reassurance and medical expertise

to a patient experiencing pregnancy

complications. Everything we do comes

from our deep commitment to care.


3/19

Helping

Allina Health Emergency Medical Services clinicians care for

approximately 1 million people in more than 100 communities

in the Minneapolis/St. Paul metropolitan area and out-state. W

employ 570 paramedics, emergency medical technicians (EMT

dispatchers, special transportation drivers, and maintenance,

administration and support personnel. Were not-for-profit,self-managed and self-sustaining.

But Allina Health EMS does much more than respond to

emergencies and provide medical transportation. As industry

leaders, we set performance standards and goals, measure

and document our successes, then implement and share new

techniques and devices shown to improve lifesaving care as w

as increase access to it.

We sponsor community outreach and volunteer programs

that range from helping make resuscitation equipment widely

available to donating bikes to kids in need so they can enjoy

healthier childhoods.

And we partner with public and private organizations whose

needs and values mesh with our own, throughout Minnesota a

beyond, to help them succeed, often in unique ways.

At Allina Health EMS, we care deeply about helping the

communities we serve.

Its what we doOne of our paramedic units responds to a911 call on a busy Friday night. An AllinaHealth EMS dispatcher is already directing

the caller in pre-arrival patient care.


4/19

We Respond to

Emergencies

In 2013, our 90+ vehicles responded to

approximately 62,000 emergency calls across a

1,600-square-mile area.

OUR PARAMEDICS AND EMTsrespond to 911

calls and handle both routine and emergency

transfers between health care facilities 24 hours

a day, seven days a week.

OUR DISPATCHERSremain on the phone

with 911 callers to give them the informationthey need to handle an emergency medical

situation, such as choking, sudden cardiac

arrest or imminent childbirth, until the

ambulance arrives. We work constantly to

maximize our performance in this area, and

we are well on our way to achieving our goal

of ACE (Accredited Center of Excellence)

accreditation from the International Academies

of Emergency Dispatch (IAED) in 2014.

OUR MOBILE COMMUNICATIONS UNIT

brings dispatching capabilities onsite to

prescheduled events and emergency situations.

This resource is shared among EMS agencies

statewide to assist with natural disasters and

other large-scale emergencies.

OUR SYSTEM STATUS MANAGEMENTand

MEDICAL PRIORITY DI SPATCH SYSTEMS

ensure that someone who is experiencing an

injury or other medical emergency receives a

response from a properly equipped ambulance

and from professionals appropriately trained to

handle that particular emergency.

We Provide

Non-Emergency Services

Allina Health EMS handles approximately

26,000 non-emergency calls and interfacility

patient transfers each year.

OUR SCHEDULED AMBULANCE SERVICE

provides transportation for non-emergency

patients who are unable to ride in a wheelcha

Many are hospice or nursing home patients w

need skilled help when going to and from clin

hospitals or therapy centers. We also provide

scheduled ambulance service at all care levelsfrom basic life support to critical care transpor

OUR WHEELCHAIR SERVICE allows our driv

to assist with non-emergency wheelchair

discharges from Allina Health hospitals in the

metro area.

OUR GREATER MINNESOTA PROGRAM

transports patients to and from medical care

providers in the Minneapolis/St. Paul area.


5/19

We Extend Our Reach Through

Mobile Integrated Health Care

In 2013, Allina Health EMS began a pilot project in Anoka County,

Minn., to serve patients with a history of repeated emergency

department visits, behavioral health issues, or frequent hospital

readmissions for congestive heart failure, pneumonia or heart

attack. In this program, our goal is to connect these patients, many of whom are not adept at navigatin

the health care system, with the resources and clinicians they need while reducing nonessential

emergency room visits and hospital readmissions.

The project employs community paramedics, who have undergone an additional 200+ hours of

specialized training and are working in the mobile integrated health care environment. In a typical

scenario, a patient who meets the criteria is visited by a community paramedic, who can offer an

alternative care plan.

Currently, Minnesota is the only state in the nation to certify community paramedics with this new

credential. Allina Health EMS employs about 20 such paramedics, and the program is growing.

We Stand By at Special Events

From heat stroke to heart attacks, medical emergencies often

happen in crowded areas, impeding potentially lifesaving medical

responses. Thats why we collaborate with sponsors of special

events taking place in our primary service area to pre-plan and

station our clinicians at civic gatherings, sporting events and the

like. Examples of such coverage include:

LIFE SUPPORT GOLF CARTA paramedic certified in advanced life support, or an EMT certified in basic

life support, will patrol the event site in a specially equipped golf cart.

BASIC OR ADVANCED LIFE SUPPORT UNIT COVERAGETwo EMTs with an ambulance equipped to

provide basic life support, or at least one paramedic and one EMT with an ambulance equipped to

provide advanced life support, will stand by.

BIKE TEAM COVERAGEA team of EMS professionals that includes at least one paramedic will circulate

throughout hard-to-reach areas on bicycles. These include parade routes, race courses and parks. The

team carries equipment to stabilize patients and arranges for them to be transported from the area.

Emergency responses are just one way

we serve. We also provide non-emergency

services, special event coverage and

community paramedicine.


6/19

Pursuing Clinical

Excellence

Allina Health EMS is much more than an ambulance and

medical transportation service, says Medical Director Charles

Lick, MD. One of our highest priorities is aggressively

investigating new EMS technologies and techniques,

determining their value based on the latest science, then putti

those methods and devices to work as early as possible.

This focus has evolved along with the growing recognition of

the value of evidence-based medicine. As EMS departments

became more sophisticated, we began to realize that we shou

become more data-driven so that we could document reasons

for everything we did, says Susan Long, director of Clinical an

Support Services. More recently, this change is also being driv

by health care reform: Why should individuals and insurers pay

for things that have not been shown to work?

Our approach has given us a reputation in the EMS field as no

just early adopters, but innovators. More important, it lets us

bring the latest proven clinical advances to our patients more

quickly than most EMS systems.

Its how we stand ouOperations Manager Jeff Lanenberg

explains the LUCAS automated CPR device

to candidates in our New Employee Academy.

Only the best candidates graduate from the

program and are selected for field work.


7/19

NO-HANDS CPRWe attribute our highcardiac arrest survival rate which is more

than double the national averageto our

forward thinking approach. For example, in

2007, we implemented the LUCASportable

computerized device for performing automated

CPR. We were the first to use the LUCAS

device, and we have widely shared our results

and the knowledge we gained from its use with

others, says Dr. Lick.

According to the manufacturer, Allina Health

EMS has used the LUCAS device more than

any other single EMS systemmore than 1,600

patient uses to date.

GETTING THE BLOOD FLOWINGAnother

factor responsible for our high cardiac arrest

survival rate is our widespread use of the

ResQPODand ResQGARDdevices. The

former augments blood flow to the vital organs

during CPR, while the latter increases blood

pressure in patients with low blood pressure

from a variety of causes.

EVALUATING CPR PERFORMANCESinceSeptember 2013, we have been using CODE

STAT, a software system that extracts data

from EKGs and allows us to evaluate our

clinicians performance on every cardiac arres

call. I send a graphical representation of how

well the CPR was managed to the crew within

24 hours of the event for their self-review, sa

Carol Frazee, a paramedic and field training

officer who oversees the system. Studies

show that such timely feedback improves

performancewhich, hopefully, will translate

into increased patient survival.

MAPPING LIFESAVING TECHNOLOGYAllin

Health EMS is one of the first EMS systems in

the nation to be linked to the Atrus National

AED Registry. This system alerts participatin

911 agency dispatchers to the location of

automated external defibrillators (AEDs) so th

can be found and used quickly when needed

to help victims of cardiac arrest. To date,

approximately 2,500 AEDs have been listed i

the registry statewide.

Here are some of the clinical areas in which weve been

at the forefront of the industry:


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At Allina Health EMS, our numbers are

large enough that we have enough data to

do statistically valid research comparatively

quickly, Susan Long says. And we feel we

have an obligation to help the industry by

sharing the results of that research.

For the past 10 years, the Clinical Services

department at Allina Health EMS has sponsored

Pulse Check Hot Topics in EMS, an annual

conference for EMS clinicians, fire and policedepartments and others. Presentations at

the 2013 conference included Autism and

First Responders and Trauma: A Patients

Perspective, as well as a panel discussion on

community paramedicine.

In 2013, we created something unique: a clinical

resident fellowship in our Division of Applied

Research, intended to allow paramedics to

develop the skills needed to conduct and

disseminate research. In September, paramedic

supervisor Jon Kamrud was named our first

fellow in this program.

Disseminating what weve learned in professional

publications such as the Journal of Emergency

Medicineand the Journal of Emergency

Medical Services (JEMS)helps clinicians and

their patients everywhere while increasing

our own presence in the industry. So does our

participation in conferences sponsored by such

groups as the National Association of EMS

Physicians (NAEMSP) and the American College

of Emergency Physicians (ACEP).

Here is some of the research we have presented

in such venues:

Our PROSE(PREHOSPITAL RECOGNITION

OF SEPSIS)study was a pilot investigation of

a procedure not typically performed by EMS

providers. It found that the use of lactate

meters and temporal artery thermometers

by paramedics could help diagnose sepsis

approximately two hours sooner than it is

currently detected.

Our study of the prevalence of CERVICAL

SPINE FRACTURES AMONG ELDERLY

PATIENTS WHO SUFFER HIP FRACTURES

during low-level falls concluded that less

aggressive use of spinal immobilization may

sometimes be warranted for such patients.

Another study found that MECHANICAL

CHEST COMPRESSION WITH THE LUCAS

DEVICEdoes not appear to increase the risk

of related injuries or complicate recovery in

cardiac arrest survivors.

Our research also found thatLIMITING

THE USE OF LIGHTS AND SIRENto only

those situations for which its truly warranted

improves safety and benefits nursing home

residents by alleviating anxiety and disruption.

We Share What We Learn Our Care Goals Help Us Improve

Few EMS agencies nationwide measure the

impact of clinical interventions as closely as we

do. At the beginning of each year, we commit

ourselves to a patient Care Goal, a specific

clinical improvement that we want to achieve

by the end of that year. Why do we do this?

Because our clinicians are always looking for

better ways and reasons to do things.

We also use our Care Goals to train our peop

to do a better job of documenting data and

outcomes, which helps with consistency. Sett

Care Goals also helps us hard-wire best

practices into our organization year after yea

It has allowed us to change the behaviors

of the entire ambulance service, explains

Associate Medical Director Paul Satterlee, MD

A NEW WAY TO PROTECT OUR PEOPLE, OUR PATIENTS AND THEPUBLIC Research shows that paramedics and EMTs nationwide are approximately five timesmore likely to be killed in a crash than the average worker. In fact, we experienced firsthand the

devastation of an EMS vehicle crash in early 2014, when one of our ambulances was involvedin a serious collision. To protect our employees, our patients and the motoring public, and

to decrease maintenance, liability and insurance costs, we began installing a system called

Road Safety in all our vehicles in 2013. Road Safety provides each driver with real-time audio

feedback on speed, acceleration, braking and cornering, allowing for immediate correction

and safer operation. Early results look promising, and Road Safety will be fully installed and

operational in 2014.


9/19

Our 2013 Care Goal was to optimize the

treatment of patients who are evaluated

by ambulance staff but not transported to

a health care facility. These patients have a

higher potential for bad outcomes than those

who are taken in for further evaluation. While

many do have minor complaints that dont

require an emergency department visit, some

choose not to go in because of other factors,

such as concerns about cost, drug or alcohol

use, or a lack of recognition of the severity

of their condition. But the patient education

and documentation that occur during these

interactions are important.

In working to achieve this and our previous

Care Goals, we followed a similar protocol,

explains Dr. Satterlee. We reviewed our

previous experiences with this type of call,

looked at cases of poor outcomes or near

misses, and identified recurring contributing

factors and clinical indicators, he says. In this

case, we then developed a list of clinical factors

that, if present, required consultation with a

physician before our clinicians left the patient.

For each of our Care Goals, we also reviewed

our charting habits and identified areas

of documentation that were consistently

inadequate, Dr. Satterlee adds. We then

tracked each case, providing feedback to

clinicians if they did well, if any documentation

was absent, or if clinical indicators were

overlooked or not fully assessed. We provided

regular education on documentation and

measured our rates of adherence to protocols

and documentation. The results were

impressive: We achieved a 12.8 percent

improvement in the number of patients who

received optimal care.

PATIENTS IN SUDDEN CARDIAC ARREST (SCA)

These patients have a low survival rate nationally,

despite many recent efforts to improve

treatment. However, a number of interventions

are being shown to improve survival rates,

particularly when they are used together. With

that in mind, we incorporated pit-crew CPR and

continued our emphasis on using the ResQPOD

and mechanical CPR device (LUCAS) with

minimal breaks in chest compressions.

RESULTS: OUR SCA SURVIVAL RATE IS NOW

AMONG THE BEST IN THE NATION

PATIENTS WITH PRESUMED ACUTE STROKE

It is imperative that EMS accurately recognizes

acute stroke, treats it quickly and efficiently

and alerts the receiving hospital of the

pending arrival. We educated all our clinicians

in the basics of stroke, its presentation and

assessment tools, incorporated our hospital

systems best practices and ensured that our

protocols fit with the hospitals needs.

RESULTS: 29.4 PERCENT IMPROVEMENT

PATIENTS WITH SHORTNESS OF BREATH

Shortness of breath can have a number of

causes, from simple to life-threatening, most

often congestive heart failure, asthma, COPD

acute heart attack. Each has specific and uniq

treatment requirements, but we found that to

many of our patients were treated for any and

all possible causes rather than targeted thera

RESULTS: 13.3 PERCENT IMPROVEMENT

PATIENTS WITH ACUTE MYOCARDIALINFARCTION Because the blocked artery to t

heart must be identified and the obstruction

resolved quickly, we took steps to recognize

these patients promptly, doing an EKG and

accurately identifying the abnormality that

indicated a STEMI. We also ensured that our

treatments were consistent with the programs

at the hospitals we take patients to and that o

interactions with those hospitals were seamles

RESULTS: 19.2 PERCENT IMPROVEMENT (99

PERCENT OF STEMI PATIENTS NOW RECEIVE

CARE UNDER THE LATEST BEST PRACTICES)

In previous years, our Care Goals have included

optimizing our care of the following:

Setting annual Care Goals has helped us

improve our performance, says Associate

Medical Director Paul Satterlee, MD.

OUR CARES NUMBERS ARE STELLARThe U.S. Centers for Disease Controland Preventions Cardiac Arrest Registry to Enhance Survival (CARES) was created to help EMS

providers improve their performance in cases of out-of-hospital cardiac arrest (OHCA). It provides

agencies with a confidential, Web-based program that allows EMS providers to compare theirperformance with other participating communities. Data show that Allina Health EMS boasts

significantly higher OHCA survival rates than the rest of the country. In the first half of 2013, the

figures for Utstein Bystander Survival (OHCA cases that were witnessed by a bystander, found in a

shockable rhythm and received some bystander intervention, such as CPR and/or AED) were 69.2

percent for Allina Health EMS, 42.9 percent for Minnesota and 28.9 percent nationally. In 2013, we

had 741 cardiac arrest calls, worked 504 of those, transported 278 and had 58 survivors.


10/19

Living Up toOur Values

At Allina Health EMS, we have the unique opportunity to act

as ambassadors for the Allina Health Values: Integrity, Respec

Trust, Compassion and Stewardship.

As emergency responders, our values are constantly on displa

in public. We bring them with us into peoples homes at all ho

of the day and night, and often under extremely difficult or ev

tragic circumstances. At times like that, our values guide us an

give us strength. More important, they can have a profound

influence on patients, family members and others we encounte

in the course of our work.

Our enduring belief in these values is what defines us, both as

individuals and as an organization. Every day, at every level, it

shapes our attitudes and our actions.

Its who we areParamedic Jeremiah Gleitzs smile reflects

his commitment to such values as integrity,

respect and compassion. As emergency

responders, our values are constantly on

display in public.


11/19

INTEGRITY

WHAT IT MEANS:

We match our actions to our words.

HOW WE LIVE IT:

Integrity means keeping promises and owning

your actions. If I make a mistake, I admit it and

try to learn from it, and share what I learned so

others dont repeat it.

RENEE ROSENBERG, SUPERVISOR

RESPECT

WHAT IT MEANS:

We treat everyone with honor, dignity and

courtesy.

HOW WE LIVE IT:

I approach everything I do by asking myself,

`Is this what I would like done to my mom? We

often find patients in embarrassing situations

perhaps theyve fallen in the tuband I try to

minimize their discomfort in any way I can, such

as by making sure they are covered up as much

as possible or by asking neighbors to step out

of the room momentarily.

CAROL FRAZEE, PARAMEDIC

TRUST

WHAT IT MEANS:

We act in the best interests of our patients,

physicians, communities and each other.

HOW WE LIVE IT:

Trust is earned in all the little things we

dodriving courteously, presenting ourselves

professionally, explaining to patients what were

doing to them and why. We also live up to th

trust the community places in us by pursuing

the latest medical knowledge and maintainin

our skills and equipment so were prepared f

any possibility.

JEFF LANENBERG, OPERATIONS MANA

COMPASSION

WHAT IT MEANS:

We create a caring environment for our patie

and one another.

HOW WE LIVE IT:

Compassion as a corporate value recognize

that even those of us who do not practice

medicine still participate in health care. I ofte

drive patients who are under a lot of stress, a

knowing this, I dont let their behavior set the

tone for our interaction.

ROSE HOLMES, SPECIAL TRANSPORTATION DRI

STEWARDSHIP

WHAT IT MEANS:

We use our resources wisely.

HOW WE LIVE IT:

Stewardship can be as simple as driving

smoothly to improve fuel mileage and decrea

unnecessary repairs. The money we save can

put back into buying new medical equipment

or providing enhanced training to help us tak

better care of patients.

MATT BOUTHI

PARAMEDIC FIELD TRAINING OFFI

These are the principles that underlie our decisions and

operations at every level.


12/19

All Allina Health EMS paramedics, EMTs and

dispatchers are required to maintain state and,

in some cases, national certification, and our

Continuing Education department helps them

meet the requirements by subsidizing the cost

of necessary classes.

An innovative staff development program

is our monthly case review, an EMS version

of health cares mortality and morbidity

conferences, at which individual patient cases

are reviewed. This training is shared via the

Web, allowing partner agencies, as well as our

own geographically dispersed employees, to

participate remotely. In 2013, we even had EMS

friends in Croatia join us for these reviews.

In return for having high expectations, we

provide our employees with a high level of

support. We expect our people to

know the protocols for their job and

treat others well, and to know that

in turn, we will have their backs,

says Allina Health EMS President

Brian LaCroix.

Even though many of our

employees work different shifts

and in widespread locations, we try

hard to stay in touch with them and

let them know what were doing

and why. We encourage them

to participate in decision making,

provide them with clear direction,

give them the tools and support they need,

then get out of the way and let them do their

jobs, LaCroix adds. As a result, Allina Health

EMS has particularly low employee turnover: 15

percent of our caregivers have been with us for

20 years or more.

Our People

Our employees are encouraged to share their

concerns and feedback with us and to know

that we will work with them to address any

issues and suggestions they may have.

I can go to my supervisors at any time

with any personal issue I might have and

trust that they will work with me to help

resolve it, says Emergency Medical

Dispatcher Anton Fehrenbach. And when

we dispatchers meet with each other to

talk about ways we can improve, then

bring our ideas to management, we feelconfident that they will respond. This

relationship starts at the top, he adds.

Because our supervisors treat us well, we

in turn work harder for them.

A Culture of Giving

Employee volunteerism and community

involvement are part of our culture. A program

called Mission Matters helps employees

get involved in their communities through

volunteering and also determines where

charitable contributions are made.

Each year we set goals for participation, and

after an employee logs 20 volunteer hours wi

a qualifying organization, a $100 contribution

is made to the nonprofit organization of his o

her choice. Each employee can do this up to

three times a year. As of the end of 2013, All

Health EMS employees had completed 6,221

hours of community service.

GUARDING AGAINST BURNOUT, STRESS AND BOREDOMAccording toLori Boland, senior research scientist at Allina Health, studies looking for evidence of burnout, stressand trauma have generally focused on police officers and firefighters, and few, if any, ambulance

services in the U.S. have systematically assessed these risks. This makes our ongoing internal

initiative in which we survey our field staffs emotional and mental well-being rather unique in the

industry. We also conduct a yearly employee engagement survey that measures to what degree our

people stay motivated and personally invested in the jobs they do. Allina Health EMS also has a

half-time chaplain, Russ Myers, who is deeply involved in employee well-being.

OUR LEADERS ARE ENGAGED IN THE INDUSTRYAllina Health EMS leadersare active in professional organizations. Our president, Brian LaCroix, serves on the board of the

National EMS Management Association. He is also chairman of the Century College EMS Advisory

Committee and immediate past chairman of the Hennepin County EMS Council. Susan Long,director of Clinical and Support Services, is president of the North Central EMS Institute, and Bruce

Hildebrandt, our operations manager, is a board member of the Institutes sister organization,

the North Central EMS Cooperative. William Snoke, our director of external affairs, serves on the

Minnesota Ambulance Association, as do our operations directors, Kevin Miller (incoming president

and Jeff Czyson (board member), as well as our regional operations manager, Brian Nord (board

member). Czyson also serves as chairman of the Dakota County EMS Council.


13/19

Working Together

Allina Health EMS provides ambulance service in more than

100 communities, but our help goes well beyond that through

outreach initiatives, says Operations Director Jeff Czyson.

These efforts are designed to improve the overall health of a

our citizens, and we began doing this before health care refor

took hold because its simply the right thing to do.

Events such as safety fairs, bike helmet programs, car seat

clinics, senior citizen health fairs, as well as CPR, AED and first

aid classes, are all geared toward prevention. Participation in

career days, parades and coverage of special events, including

pre-planning and providing onsite medical coverage for major

events held in the Twin Cities area, increases our visibility and

raises awareness of career opportunities in EMS.

Its how we serveParamedic/RN Barb Schley and Critical Care

EMT Gui Muvundamina are flanked by members

of the Spring Lake Park-Blaine-Mounds View Fire

Department. We work with more than 100 partner

organizations in our community outreach efforts.


14/19

MAKING COMMUNITIES

HEART SAFE

Sudden cardiac arrest (SCA) can happen

anywhere, at any time, to anyone, including

seemingly healthy young people. And unless

treated immediately, its almost always fatal.

Thats why, 13 years ago, Allina Health launched

Heart Safe Communities. This effort, founded

by our medical director, Dr. Charles Lick, seeksto prevent SCA deaths by making grants

available for obtaining automated external

defibrillators (AEDs) and placing them in public

and private places; developing SCA training

and educational materials for public use;

working to increase awareness of SCA and

heart disease; and training people in bystander

CPR and AED use.

Today, more than 2, 500 AEDs have been

placed and maintained in Minnesota and

western Wisconsin, and close to 50,000

individuals have been trained in their use

as well as in CPR, says Allina Heart Safe

Supervisor Katie Tewalt.

In 2009, Allina Health brought the Heart Safe

designation program to Minnesota, and by

2013, it had grown to a statewide partnership

with other agencies. The designation

acknowledges a city, county or organizations

efforts to prepare its staff and citizens to

recognize when someone suffers a sudden

cardiac arrest and know how to respond. To

date, more than 25 communities have earned

the designation.

HELPING KIDS BE HEALTHY

Our outreach mission includes fostering

volunteer opportunities among our employees,

their friends and families in 82 communities,

says Executive Assistant Kathy Quinn.

The goal of one nonprofit volunteer program

that we sponsor is to help children in need

enjoy happier, healthier lives by providing them

with bicycles. Every October, Allina Health

partners with Free Bikes 4 Kidz to collect

bicycles from employees and other members

of the community. In 2013, thanks to the help

of 900 volunteers, more than 5,000 bikes were

collected and, when necessary, reconditioned.

Despite the subzero temperatures, volunteers

then distributed the bikes to kids in December,

along with helmets and booklets on bike safety

and concussion education.

PROVIDING THE HUMAN TOUCH

Allina Health EMS supports community groups

that are dedicated to the well-being of EMS

personnel and their families. For example, we

raise donations from employees to support the

Minnesota EMS Honor Guard, which ensures

that EMS and other public safety workers who

die in the line of duty are provided with a

dignified funeral service and family support.

Heres a more in-depth look at a few of our major

community outreach programs:

COMMUNITIES WE SERVEThe 911 primary service area of Allina Health EMS stretchesacross portions of 11 Minnesota counties, with non-emergency services having an even broader

geographic reach. Bases of operation are spread throughout the area, and multiple posting sites

are incorporated into our deployment strategy. Principal report-to-work locations are in the cities

of Apple Valley, Buffalo, Cambridge, Hutchinson, Mounds View, New Ulm, Savage and St. Paul.

One million residents (20 percent of the states population) live within our primary service area,

and literally millions more travel through at places like the Minneapolis/St. Paul International

Airport and the Mall of America.

WRIGHT

SHERBURNEISANTI

ANOKA

HENNEPIN

MCLEOD

SCOTT

DAKOTA

NICOLLET

BROWN

RAMSEY

A team from Allina Health EMS works with the

Metro Critical Incident Stress Management

(CISM) Team, which provides crisis counseling

to EMS personnel and first responders who

wish to receive it after a traumatic work event.

Its caregiver talking to caregiver, says Chuck

Kaufman, Communications Center director.

And to help protect our communitys young

people, we participate in several mock

automobile crashes at area high schools

throughout the year. These emotional scenari

are a powerful way to teach students about t

devastating impact that the decision to drink

and driveor to get in a car with a driver who

has been drinkingcan have.


15/19

We live our mission, vision and values through

partnerships within the 100+ communities

where we provide ambulance service, as well as

in the broader community of patients who look

to us to provide exceptional care.

Because were a not-for-profit organization,

the partnerships we choose reflect our

commitment to being a good corporate

citizen working to solve community health care

challenges, says Director of External AffairsWilliam Snoke. In fact, in 2013, Allina Health

was the proud recipient of The International

Leadership Institutes International Corporate

Citizen Award, primarily due to work done in

Kenya by Operations Manager Jeff Lanenberg

and other Twin Cities public safety leaders.

While growing and making money are not our

foremost objectives, being financially healthy

is essential to our ability to fulfill our mission,

and growth is a component of any healthy

organization. Helping our partners be successful

has helped us to double in size in the past six

years. In turn, we learn from our partners andtheir leaders, a symbiotic relationship that

advances the quality of emergency medical

services throughout the region.

We have close working relationships with 20

911 call centers statewide. Their emergency

medical calls are transferred to us so

that they are handled smoothly, with no

redundancies or dropped calls.

Partnerships with the cities of Coon Rapidsand Roseville reflect our commitment to using

evidence-based medicine in identifying and

evaluating innovative and leading-edge first

responder delivery models.

Several Minnesota communities contract with

us to provide ambulance service under their

locally controlled licenses. These include

Apple Valley, Lakeville and Farmington (ALF),

as well as Hutchinson. We used to operate

our own ambulances but found ourselves

increasingly facing challenges with issues

like education, technology and compliance,

says Steve Mulder, MD, president and CEO

of Hutchinson Health, a private, nonprofit

organization. Allina Health EMS excels in

these areas due to their economies of scale,

their exclusive focus on EMS and their high

level of training and expertise. As a result,

they have been able to maintain the high

level of personal service our community

expects, improve our ambulance response

times and provide broader coverage of

shifts, Mulder adds.

We partner with the city of Elk River to

provide paramedic staffing, teaming up wit

local fire department EMTs.

We provide education to local fire and

police departments to ensure the availabilit

of properly trained first responders. Ourequipment replacement programs also allo

local agencies to restock disposable supplie

used on calls.

Our certified emergency managers provide

regional training with multple agencies for

large-scale incidents. This collaboration with

local partners has extended to supporting a

participating in community events, conducti

active shooter training in Arden Hills and

Roseville, and leading ambulance strike team

deployments to the 2009 Red River Valley

flooding. A number of our clinicians also sta

the MN-1 Disaster Medical Assistance Team

(DMAT), which has deployed to areas struck

numerous disasters, including Hurricane San

Allina Health EMS leaders have more than

500 years of combined EMS management

experience that we routinely share. For

example, we have provided management

consulting to help the city of River Falls

evaluate its ambulance service, and training

to Maplewood paramedics on legal issues.

LOBBYING FOR POSITIVE CHANGE Allina Health EMS is an active memberof the Minnesota Ambulance Association. This trade association represents Minnesotas EMS

providers by working for and monitoring legislation that impacts EMS recruitment and retention,

financial issues, education and leadership.

We Partner With Others

Here are some of the unique and innovative ways

in which our partnerships work:


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Safeguarding Our

Financial HealthMaintaining financial strength is one of the core

responsibilities of any EMS system. Thats particularly

important as health care and reimbursement practices

evolve nationwide.

At Allina Health EMS, we take this responsibility

seriously, especially because we receive no tax subsidies

from the local communities we serve. Our entire budget

is supported by fees for service, allowing us to provide

exceptional prehospital care without any added tax

burden to our communities.

Our careful stewardship of our finances also allows us to

give back to the community in the form of grants, CPR

training, community health and safety initiatives, and oth

forms of outreach.

Its part of keepin

our promiseFiscal health is essential to excellent patientcare, says Allina Health EMS President BrianLaCroix. Its part of our commitment to the

communities we serve.


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Our Balanced

Approach Pays Off

The economics of health care are

fundamentally changing throughout the U.S.,

creating ever-increasing financial challenges.

In this environment, the balanced approach

we take in managing our organization lets usboth continue to meet day-to-day needs and

ensure long-term success.

One example of this is the salaries and

benefits were able to provide our employees,

which allow us not only to attract the best

candidates, but also to retain them. In fact,

compared to other EMS systems, were proud

to have one of the lowest employee turnover

rates in the nation (just 7 percent annually,

with half of those moving to other positions

within Allina Health).

A healthy retention rate helps us avoid the

high cost of constant hiring and training,

says Kevin Miller, out-state operations

director. And perhaps more important,

it results in a team of highly qualified,

experienced clinicians who care deeply about

their organization, their patients and the

communities they serve.

Heres a snapshot of how our approach pays

off with strong finances and healthy growth:

2003

GROSSREVENUE NETREVENUE

20092006 20122004 20102007 20132005 2011

20092006 201220102007 20132005 2011

34%41 %

51% 52%

67% 72%

80% 84 %

87 %

2008

2008

EMPLOYEE ENGAGEMENT2013 REVENUE SOURCES

Employee Engagement is much more than just employee satisfaction. An engaged employee is a person wh

is fully involved in, and enthusiastic about, his or her work and committed to the interests and objectives o

the organization. Since we began measuring, weve seen employee engagement increase by 2 1/2 times.

NUMBER OF RESPONSES

FINANCIAL PERFORMANCE

NUMBER OF EMPLOYEES

40K

$36M

$23M

$48M

$23M

$47M

$27M

$59M

$31M

$54M

$29M

$65M

$34M

$74M

$39M

$81M

$37M

$88M

$43M

$107M

$45M

$118M

$53M

362

385

414 424

473

57

455

423

395375376

43K46K

55K

72K

90K

42K45K

50K

60K

87K

2003 20032009 20092006 20062012 20122004 20042010 20102007 20072013 202005 20052011 20112008 2008

911 CALLS

71.5%

INTERFACILITY

CALLS

23.2%

SPECIAL

TRANSPORTATION

2.6%

OTHER

2.7%

911 Calls $38,286,568

Interfacility Calls $12,419,276

Special Transportation $1,408,771

Other (FlightCare, Education, etc.) $1,423,036

TOTAL* $53,537,651

* Includes more than $7M in patient bad debt absorbed by Allina Health EMS

Salaries & Benefits $32,101,071

Supplies & Drugs $1,484,343

Services (Laundry, Equipment Maintenance, etc.) $528,258

Depreciation $2,640,774

Corporate Legal, Payroll, HR, IS & Financing $2,748,325

Utilities, Rent & Maintenance $2,041,210

Other(Minnesota Care Tax, Insurances, Workers Comp) $2,333,355

Fuel $1,521,920

Capital Use (Vehicle & Equipment Purchases, etc.) $8,138,395

TOTAL EXPENSES $53,537,651

59.9%

15.2%

2.8%

1%4.9%

5.1%

3.8%

4.4%

2.8%

2013 EXPENSES


18/19

Number of times we

responded to a REQUEST

FOR AMBULANCE

SERVICEin 2013:

87,925

Number of CAREGIVERS

AND SUPPORT STAFFwe

employ: 570

Number of Allina

Health EMPLOYEES

SYSTEMWIDE: 23,869

Number of FULL-TIME

RESIDENTSin our 911

response area:

>1 million

Percentage of

Minnesotans who GET AN

ALLINA HEALTH EMS

AMBULANCEwhen they

call 911: 20

Number of PASSENGERS

TRAVELING THROUGHMinneapolis/St. Paul

International Airport

annually (within our primary

service area):

33 million

Number of ANNUAL

VISITORS TO THE MALL

OF AMERICA (within our

primary service area):

40 million

Number of IVs STARTED

BY OUR PARAMEDICS

in the field in 2013:22,064

Number of times we used

the LUCAS AUTOMATED

CPRdevice in 2013: 373

Number of times we

APPLIED CERVICAL

COLLARSto patients with

suspected neck injuries:

3,289

TOTAL YEARS OF

EMS MANAGEMENT

EXPERIENCEamong our

supervisors, managers,

directors and president:

513

Average years of

EMS MANAGEMENT

EXPERIENCEamong our

leadership team: 14.6

Number of hours of

PERSONAL VOLUNTEER

SERVICEdonated by Allina

Health EMS employees:

6,221

NUMBER OF CHARITIES

that benefited from Allina

Health EMS employeevolunteer activities:

97

Number of

MILES OUR

AMBULANCES DROVE:

3,938,242

Equivalent number of

LAPS AROUND THE

EARTHat its equator:

158

Equivalent round-trip

VOYAGES TO THE

MOON:

8.2

GALLONS OF FUELwe

used: 305,013

Average MILES PER

GALLON: 12.9

Percentage INCREASE

IN TOTAL MILESdriven

between 2012 and 2013:

3.4

Percentage DECREASE,

BETWEEN 2012 AND

2013, in total fuel burned,thanks to IDLE AND

SPEED REDUCTION

EFFORTS(despite increase

in miles driven):2.1

Number of gallons

of MOTOR OIL WE

RECYCLED: 1,400

Number of times

our vehicle service

technicians CLEANED

AND RESTOCKED THE

AMBULANCESin our fleet:

14,196

NUMBER OF PHONE

CALLSmanaged by

our Dispatch Center:

323,000

TOTAL NUMBER OF

911 CALLSlogged:

80,000

Number of callers our

dispatchers provided

with PRE-ARRIVAL

INSTRUCTIONS:

33,000

Number of seconds of

ARMER 800 MHZRADIO

USAGE: 30,427,200

Number of disposable

one-size-fits-all Tyvek

HAZMAT SPLASH SUITS

USEDper year: 612

Number of times

we responded to

calls INVOLVING

AN OBSTETRIC

EMERGENCY: 385

Number of times

our dispatchers gavepre-arrival instructions

over the phone to

help a 911 caller

DELIVER A BABY: 5

Number of BABIES

DELIVEREDby our crew

in the field: 12

Number of BABIES

NAMED AFTER THE

ALLINA HEALTH EMS

CAREGIVERwho helpe

deliver her: 1(baby Fiona Garret)

ABOUT ALLINA HEALTH Allina Health EMS, a part of Allina Health, is dedicated to the preventionand treatment of illness and enhancing the greater health of individuals, families and communities

throughout Minnesota and western Wisconsin. A not-for-profit health care system, Allina Health cares for

patients from beginning to end-of-life through its 90+ clinics, 12 hospitals, 15 pharmacies, specialty care

centers and specialty medical services that provide home care, senior transitions, hospice care, oxygen and

home medical equipment, and emergency medical transportation services. Learn more at allinahealth.org.

Our Vitals


19/19

lli h l h /

Allina Health EMS Community Report 2013

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Transcript of Allina Health EMS Community Report 2013