Identifying Opportunities to Improve - NEDARC€¦ · Workshop “Identifying Opportunities to...

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Identifying Opportunities to Improve Performance Measure Results NEDARC Workshop Agenda San Diego, CA; October 9-11, 2012

This document includes active links. Click on any subject located in a blue box on this page and you will be taken to that section.

Day 1

8:00 – 8:30 am Equipment Check 8:30 – 9:00 am Welcome & Introduction 9:00 – 10:00 am What is Process

Improvement (PI)? 10:00 – 10:15 am BREAK 10:15 – 11:30 am Looking at Your Data 11:30 – 1:00 pm LUNCH ON OWN 1:00 – 2:00 pm Looking at Your Data

(cont’d) 2:00 – 3:00 pm Mail Merge – Reporting

Made Easy! 3:00 – 3:15 pm BREAK 3:15 – 5:00 pm Mail Merge (cont’d)

Day 2

8:30 – 10:15 am Equipment Add-Inn & Reporting

Day 2 (cont’d)

10:15 – 10:30 am BREAK 10:30 – 11:30 am Equipment Add-In &

Reporting (cont’d) 11:30 – 1:00 pm LUNCH ON OWN 1:00 – 2:00 pm Process Improvement 2:00 – 3:15 pm State Examples of PI 3:15 – 3:30 pm BREAK

3:30 – 5:00 pm MapPoint Introduction

Day 3

8:30 – 9:30 am Pushpins & MapPoint 9:30 – 10:00 am Multiple Symbols &

MapPoint 10:00 – 10:15 am BREAK 10:15 – 12:00 am Intermediate MapPoint

10/18/2012

1

What is Process Improvement?

• A rose by any other name…– QI/QA/TQM/CI/CQI/etc.

• A structured effort: • to demonstrate a

continuous process • for improving processes

to meet new goals/objectives

Why Should EMSC Care About PI?

• THE KIDS!PI is a structured effort

informed by data:By EMSC;To demonstrate a continuous

process for improving care for ill and injured children

10/18/2012

2

Okay…but how do we do it?

• Projects are the core activity of PI

• PI projects help you identify & rectify processes that have variation

• Improving the process, not just outcomes

A Few Models of PI

• Fishbone

• Plan/Do/Check/Act –Deming

• DMAIC (Define, Measure, Analyze, Improve, Control) –Six Sigma

10/18/2012

3

Fishbone

Barriers to PM 73

FundingJustification

Allocation

Rules & Regulations

Not Required

Not in Statute

Don’t Need

Infrequent use

Out of scope

Room on rigs

Expiration

Urban vs. rural

Not evidence‐based

Nature of PMs

Unreasonable standard

Disclaimer: This example is purely for demonstration purposes and is not an exhaustive list.

10/18/2012

4

P l an /Do / Check /Ac t• Plan

– Establish objectives and expected outputs• Do

– Implement the plan, execute the process, collect data

• Check – Study actual results and compare to

expected results– Look for deviation in implementation from

the plan

• Act– Request corrective actions on significant

differences between actual and planned results.

– Analyze the differences to determine their root causes

– Determine where to apply changes that will improve the process

Results of the survey were used for future protocol revisions

Comments from EMS agencies led to the determination that offline protocols needed updating

Protocols were updated & distributed to Medical Directors & EMS agencies. Webinars were recorded & distributed

Six months later medical directors were surveyed on whether they’d adopted the protocols and if not, why?

10/18/2012

5

Define Measure Analyze Improve Control

DMAIC Model

EMSC Performance Measures

DMAIC Model

Define:• Scope• Deliverables• Goals• Timeline• Team

Define

Measure:• Baseline

capabilities• Verify

measurements• Initiate RCA• Develop

project plan

Measure

Analyze:• Data• Process

Problems• Performance

Gaps• Variation

Sources• Execute

project plan

Analyze

Improve:• Define best

practices• Develop

implementation plan

• Innovate

Improve

Control:• Implement

improvements• Document

changes• Verify sustained

results

Control

10/18/2012

6

ExcelIdentifying Needs

Comments

Mail

Merge

Customized Communication

Can reach many people

Equipment Add‐In Report

See complex data easily

Communicate results

MapPointNew way to visualize data

See trends geographically

EMSC PI Projects – Let’s Discuss

• Tomorrow we’ll hear from a few you

• What projects have you done ?

• Or have wanted to do?

http://school.discoveryeducation.com/clipart/new.html

Workshop “Identifying Opportunities to Improve Performance Measure Results” Multiple Excel Sheets

Multiple Excel Sheets The purpose of these instructions is to help you make multiple Excel sheets for various purposes.

I. Preparing the Hospital Data:

1. At the bottom of your Excel screen you will see a single worksheet named xx7677 (for your state’s PMs 76 and 77 data).

a. You will need to add 7 more worksheets (for a total of 8) by clicking on the icon just to the right of the name of your hospital and inserting new worksheets.

b.To rename the worksheets, double-click on the tab and enter the following names: Comments InDevGuide NoGuidelines NoAgreements AllComp SomethingMissing InDevAgree

2. Go back to the worksheet called xx7677

a. Click on the View tab located on the ribbon.

b. Click on the down arrow for the Freeze Panes icon and select Freeze Top Row

3. Click on the Home tab.

a. Click on the down arrow for the Sort & Filter icon.

b. Select Filter

© NEDARC updated 10/18/2012 7


II. Utilizing Filters:

1. Comment Filter

a. Go to the comments column (AA in the practice dataset).

b. Click on the down arrow

c. Deselect the (Blanks) checkbox

d. Click on the OK button.

e. Select the entire comments column by clicking on the letter(s) above the name comments (AA in the practice dataset).

f. Right click anywhere in the selected column.

g. Select Column Width… from the options.

h. A Column Width box will open. Enter 100 in the Column width: field.

i. Click on the OK button.

j. The comments column should still be highlighted. Right click anywhere in the selected column.

k. Select the Format Cells… option.

l. A Format Cells box should appear. Click on the Alignment tab

m. Click on Wrap text option located under the Text control area.

n. Click on the OK button.



o. Copy the top row and all of records with comments and paste into data into the Comments worksheet.

p. Take a moment to review each of the comments.

q. Go back to the xx7677 worksheet.

r. On the Home tab, click on the down arrow for the Sort & Filter icon.

s. Select Clear

2. Guideline Filter - Note: Hospitals in the process of developing inter-facility guidelines

a. Click on the down arrow for the guidelines column (O in the practice dataset)

b. Deselect all options except for inDev.

c. Click on the OK button.

d. Copy the top row and all of record(s) and paste into data into the InDevGuide worksheet.

e. Go back to the xx7677 worksheet.

f. On the Home tab, click on the down arrow for the Sort & Filter icon.

g. Select Clear



3. Guideline Filter - Note: Hospitals with NO inter-facility guidelines


b. Deselect all options except for N.


d. Copy the top row and all of record(s) and paste into data into the NoGuidelines worksheet.



g. Select Clear

4. Agreement Filter - Note: Hospitals with NO inter-facility agreements

a. Click on the down arrow for the agreements column (Y in the practice dataset)

b. Deselect all options except for N.


d. Copy the top row and all of record(s) and paste into data into the NoAgreements worksheet.



g. Select Clear

5. Component Filter: Part 1- Note: Hospitals with ALL the inter-facility components

Note: do not clear any of the filters until specified in step u.

a. Click on the down arrow for component_roles_y/n column (P in the practice dataset)

b. Deselect all options except for Y.

c. Click on the down arrow for component_facility_y/n column (Q in the practice dataset)



d. Deselect all options except for Y.

e. Click on the down arrow for component_staff _y/n column (R in the practice dataset)

f. Deselect all options except for Y.

g. Click on the down arrow for component_transfer_y/n column (S in the practice dataset)

h. Deselect all options except for Y.

i. Click on the down arrow for component_record _y/n column (T in the practice dataset)

j. Deselect all options except for Y.

k. Click on the down arrow for component_ consent_y/n column (U in the practice dataset)

l. Deselect all options except for Y.

m. Click on the down arrow for component_ belongings_y/n column (V in the practice dataset)

n. Deselect all options except for Y.

o. Click on the down arrow for component_ directions_y/n column (W in the practice dataset)

p. Deselect all options except for Y.

q. Highlight all of the record(s) remaining.

r. Copy the top row and all of record(s) and paste into data into the AllComp worksheet.

s. Go back to the xx7677 worksheet.

t. On the Home tab, click on the down arrow for the Sort & Filter icon.

u. Select Clear

6. Component Filter: Part 2 - Note: Hospitals missing at least one inter-facility component


b. Select the Filter by Color option.

c. Then select the No Fill option.

d. Copy the top row and all of record(s) and paste into data into the SomethingMissing worksheet.





g. Select Clear

7. Agreement Filter - Note: Hospitals in the process of developing inter-facility agreements

a. Click on the down arrow for the agreements column (Y in the practice dataset)

b. Deselect all options except for inDev.


d. Copy the top row and all of record(s) and paste into data into the InDevAgree worksheet.



g. Select Clear

8. SAVE your document III. Following up:

Now that you have successfully built multiple sheets, how will you utilize them?


Workshop “Identifying Opportunities to Improve Performance Measure Results” Exploring Data with Pivot Tables

Exploring Your Performance Measures Data Using Pivot Tables in Excel

I. List of variables for reports:

1. ResponseID: unique identifying ID number assigned to each response by the online

survey software.

2. offlineProtocols: whether the agency has pediatric protocols available to providers.

3. emsLevel: the level of care provided by the agency.

4. medDirComments: comments by the survey respondent (optional).

5. offlineAvailable: how frequently pediatric protocols are carried on vehicles operated by the EMS agency.

6. tryContact: whether personnel from the EMS agency tried to contact on-line medical

direction when treating a pediatric patient in the last year.

7. onlineAvailable: how frequently on-line medical direction was available when treating a pediatric patient.

II. Steps for inserting a Pivot Table:

1. Select your StateEMS.xls file and click Open. Click the Insert tab on the Ribbon and click the top half of the PivotTable icon at the far left.



2. Excel will sense the data range it thinks your PivotTable should refer to, and in most cases it does a good job. Just make sure it has captured the entire data range by using your horizontal and vertical scroll bars. Make sure the New Worksheet button is checked, and then click OK.

III. Example Pivot Table exercises:

1. In your Pivot Table Field List, click the ResponseID box. Right click on Sum of Response ID and click Count under Summarize Values By. The resulting number indicates how many records are in your PM 71-73 data sheet.



2. Click the offlineProtocols box to see how many agencies do not have pediatric protocols. Double-click that number in your PivotTable and Excel will produce a complete copy of those records in a new sheet (this is called “drilling down”). Double click and rename the new sheet No Protocols for easy identification.

a. Note: It is a good idea to save your file each time you create a new sheet so you don’t unexpectedly lose any of your work.



3. Now return to your PivotTable (Sheet1, unless otherwise named). Uncheck the offlineProtocols box and check the offlineAvailable box to show how frequently protocols are carried on EMS vehicles operated by agencies in your state

a. Select the response choices shown other than almostAlway, always, and (blank).

You can reorder any of these by right clicking on the response choice and moving it up or down under the Move function until in the desired order.



b. Collapse the detail under Group1 by clicking on the dash to the left (or double clicking on the cell itself). You can also rename Group1 to something more descriptive by double clicking in the formula bar and typing new text. Just as before, double-clicking on the Count of ResponseID for Group1 (or its new name) will produce a sheet of agencies which carry protocols on their vehicles less than 90% of the time. You can rename this new sheet Protocols Available <90%.

4. Now you can review the availability of on-line medical direction. Return to your PivotTable and remove the offlineAvailable field.

a. Click the box next to onlineAvailable.You may have several that show up as (blank), which you will want to remove through the next step.

b. Drag tryContact from the field list to the Report Filter area. Above the PivotTable, click the drop down arrow on the tryContact filter, click on Y, and then on OK.



c. You can now group those respondents answering something other than always or almostAlways, drill down on that number, and you’ll have a spreadsheet of those agencies who report having access to on-line medical direction less than 90% of the time.

5. Finally, you can determine if/how many agencies report having both on-line and off-line medical direction less than 90% of the time, which would be a cause for concern.

a. In your PivotTable, keep the results displayed regarding availability of on-line medical direction from step 4 above. Now drag offlineAvailable to the Column Labels area.

b. Look for any results displayed in any of the cells shown below in the red box. We can see there is one agency that reported “usually” having availability to on-line medical direction AND “rarely” having availability to off-line medical direction. Both of these are less than the 90% availability standard of the Performance Measures, so we probably want to follow up specifically with this agency to see how we can help improve these results.

6. Move your XX7173 worksheet so that it is the first worksheet in your dataset Note: important step to make sure equipment add-inn report works

7. SAVE your document


Workshop “Identifying Opportunities to Improve Performance Measure Results” Mail Merge – EMS Performance Measures

Mail Merge – EMS Performance Measures

I. List of variables for report: Performance Measure 72—Offline Pediatric Medical Direction:

1. Variables inserted manually by EMSC Program Manager (in red font) a. statute #: state statute number for states that require all EMS agencies use statewide

protocols Possible values: Optional

b. protocol link: URL where state protocols available for download Possible values: Optional

c. manager name: first and last name of the state/territory EMSC Program Manager

d. phone: telephone number of state/territory EMSC Program Manager

e. email: email address of state/territory EMSC Program Manager

f. state EMSC website link: URL of state/territory EMSC Program

Possible values: Optional

g. Facebook address: state/territory EMSC Program Facebook page


h. Twitter ID: state/territory EMSC Program Twitter account name e.g., @msemsc1 Possible values: Optional

2. Variables imported from EMS performance measure dataset

a. agency: name of the responding agency

b. name: name of the person who completed the survey

c. address: street/mailing address of the responding agency

d. city: city of responding agency

e. state: state or territory

f. zip: zip code of responding agency

II. Steps for preparing PI data and report files: 1. Prepare your EMS dataset; refer to the Multiple Excel Sheets handout.

2. Edit report template letter(s) for content and letterhead/logo.



a. AvailabilityprotocolsTemplate.doc: template report for agencies that indicated they

had protocols but protocols not available 90%+ on vehicles or providers.

b. NOprotocolsTemplate.doc: template report for agencies that indicated they did not have any protocols.

III. EMS Report steps: Note: You cannot have the data file open to run this report(s).

1. Create two folders– one for each of your EMS reports:

a. No Protocols

b. Protocols not available

2. Open one of the EMS report templates: AvailabilityprotocolsTemplate.doc or NOprotocolsTemplate.doc

3. Enter manual Program Manager variables (see I. List of variables for report on previous page).

4. Save document.

5. Start mail merge

a. Select Mailings tab

b. Click the down arrow for the Start Mail Merge

c. Select Letters

d. Click the down arrow for the Select Recipients

e. Select Use Existing List…

f. Choose your state/territory EMS dataset (e.g., AKEMS.xlsx)

g. A Select Table message box will appear listing all of the available worksheets in the document you chose in the previous step Note: your variable names should be on the first row of your dataset and therefore the First row of data contains column headers should be checked.

Select the appropriate worksheet depending on report template

Report template Worksheet name

AvailabilityprotocolsTemplate.doc Protocols Available <90%

NOprotocolsTemplate.doc No Protocols

h. Select/highlight the first variable in the report to be imported e.g., [agency] (see I. List of variables for report on previous page).

i. Click the down arrow for the Insert Merge Field

j. Select agency; [agency] will then appear as <<agency>>



k. Complete steps h. through j. for each variable to be imported. Note: the report template variable name is an exact match to the Insert Merge Field names

l. Remove the yellow highlight from report template once you have all fields done.

m. On the Mailings tab click on Preview Results

Conduct a quick review of each individualized report by clicking on the forward and backward arrows.

If you need to make any changes to one, all, or some of the reports, click on the down arrow for Finish and Merge

Select Edit Individual Documents…

A Merge to New Document message box will appear. Choose whether you want to edit all, only the copy that's currently visible, or a subset of the set—which you specify by record number. Word compiles the copies that you want to edit into a single file, with a page break between each copy of the document.

After you finish editing the new file of documents, you can print the documents by clicking the File tab, and then selecting Print.

n. SAVE your document

o. Once you have approved each individual report you will want to save/print the reports…

Option 1 is to immediately print each personalized report and/or save a single Word Document containing every agency letter for mailing.

a. Click on the down arrow for Finish & Merge

b. Select Print Documents…

An individual report will print for each EMS agency listed in the worksheet you imported data from

c. Then click on the down arrow for Finish & Merge again

d. Select Edit Individual Documents…

e. A Merge to New Document message box will appear.



f. Select whether you want all, only the copy that's currently visible, or a subset of the set of the reports as a single Word document

g. Word will create a new document that has each letter as a new page. Go to the File tab and Save the document in either the No Protocols or Protocols not available folder you created in step 1—dependent on which report you are creating. It is suggested you include the year and state name in the name of the document e.g., 2012AKagnencies.

Note: Remember that merged documents that you save are separate from the main document. It's a good idea to save the main document itself if you plan to use it for another mail merge.

When you save the main document, you also save its connection to the data file. The next time that you open the main document, you are prompted to choose whether you want the information from the data file to be merged again into the main document.

Option 2 is to immediately email each personalized report (as body of email)

Note: you would NOT want to use this option if you were going to attach/send a copy of the protocols with the report.

a. Sign in to your work email account.

b. Click on the down arrow for Finish & Merge

c. Select Send E-mail Messages…

d. A Merge to E-mail message box will appear.

e. Make sure the To: field has an email variable selected such as emailAddress

f. Enter something to the Subject line: field

g. The Mail format: field defaults to HTML. Note: some email addresses only accept text messages.

h. Select whether you want all, only the copy that's currently visible, or a subset of the set of the reports.

i. Select the OK button

Options 3 & 4 are only available for those who have Adobe Acrobat Pro 9 or X installed on their computer!

Option 3 is to create PDFs of each personalized report to be printed and mailed or emailed as an attachment later.

a. Click on the Merge to Adobe PDF

b. An Acrobat PDFMaker – Mail Merge message box will appear.

c. Select whether you want all, only the copy that's currently visible, or a subset of the set of the reports as a PDF.



d. Optional: enter a name for Specify PDF file name:

e. Select the OK button.

f. A Browse For Folder message box. Select either the No Protocols or Protocols not available folder you created in step 1—dependent on which report you are creating.

g. Select the OK button.

h. An Acrobat PDFMaker – Mail Merge message box will appear.

i. Click the OK button. Note: The PDF reports will be saved in the folder you selected in step f of this option.

Option 4 is to immediately email a generic message to every agency with the personalized PDF of report attachment.

Note: you would NOT want to use this option if you were going to attach/send a copy of the protocols with the report.


b. In the report you have been editing, click on the Merge to Adobe PDF

c. An Acrobat PDFMaker – Mail Merge message box will appear.

d. Select whether you want all, only the copy that's currently visible, or a subset of the set of the reports as a PDF.

e. Optional: enter a name for Specify PDF file name:

f. Check Automatically send Adobe PDF files by Email

g. The To: field should be defaulted to emailAddress; if not, search the drop down box for the appropriate variable.

h. Enter a subject in the Subject line: field

i. Enter a generic email message in the Message: field that applies for all of the agencies who will be receiving a report. The appropriate personalized attached PDF report will be sent to the associated EMS agency.

j. Select the OK button.

k. A Browse For Folder message box. Select either the No Protocols or Protocols not available folder you created in step 1—dependent on which report you are creating.

l. Select the OK button.

m. An Acrobat PDFMaker – Mail Merge message box will appear.

n. Click the OK button.

p. Repeat steps 2 through 5 for your other EMS report



Option 2 Example

Option 4 Example (this option available only to those with Adobe Acrobat Pro 9 or X)


Workshop “Identifying Opportunities to Improve Performance Measure Results” Mail Merge – Hospital Performance Measures

Mail Merge – Hospital Performance Measures

I. List of variables for report: Performance Measures 76 & 77—Inter-facility Transfer Guidelines & Agreements:

1. Variables inserted manually by EMSC Program Manager (in red font) a. manager name: first and last name of the state/territory EMSC Program Manager.

b. phone: telephone number of state/territory EMSC Program Manager.

c. email: email address of state/territory EMSC Program Manager.

d. state EMSC website link: URL of state/territory EMSC Program.


e. Facebook address: state/territory EMSC Program Facebook page.


f. Twitter ID: state/territory EMSC Program Twitter account name e.g., @msemsc1 Possible values: Optional

2. Variables imported from Hospital performance measure dataset

a. hospital: name of the responding hospital.

b. name: name of the person who completed the survey.

c. address: street/mailing address of the responding agency.

d. city: city of responding agency.

e. state: state or territory.

f. zip: zip code of responding agency.

II. Steps for preparing PI data and report files: 1. Prepare your EMS dataset; refer to the Multiple Excel Sheets handout.

2. Edit report template letter(s) for content and letterhead/logo. a. IPagreementTemplate.doc: template report for hospitals that indicated they were in

the process of developing inter-facility agreements.

b. IPguidelinesTemplate.doc: template report for hospitals that indicated they were in

the process of developing inter-facility guidelines.

c. NOagreementsTemplate.doc: template report for hospitals that indicated they did

not have inter-facility agreements.



d. NOcomponentsTemplate.doc: template report for hospitals that indicated they have

inter-facility guidelines but the guidelines did not have all the EMSC components.

e. NOguidelinesTemplate.doc: template report for hospitals that indicated they did not have inter-facility guidelines.

III. Hospital Report steps: Note: You cannot have the data file open to run this report(s).

1. Create five folders – one for each of your hospital reports:

a. Developing agreements

b. Developing guidelines

c. No agreements

d. Missing guideline components

e. No guidelines

2. Open one of the Hospital report templates: IPagreementTemplate.doc, IPguidelinesTemplate.doc, NOagreementsTemplate.doc, NOcomponentsTemplate.doc, or NOguidelinesTemplate.doc

3. Enter manual Program Manager variables (see I. List of variables for report on previous page).

4. Save document.

5. Start mail merge.

a. Select Mailings tab

b. Click the down arrow for the Start Mail Merge

c. Select Letters

d. Click the down arrow for the Select Recipients

e. Select Use Existing List…

f. Choose your state/territory Hospital dataset (e.g., AKHospital.xlsx).

g. A Select Table message box will appear listing all of the available worksheets in the document you chose in the previous step Note: your variable names should be on the first row of your dataset and therefore the First row of data contains column headers should be checked.

Select the appropriate worksheet depending on report template


IPagreementTemplate.doc InDevAgree

IPguidelinesTemplate.doc InDevGuide




NOagreementsTemplate.doc NoAgreements

NOcomponentsTemplate.doc SomethingMissing

NOguidelinesTemplate.doc NoGuidelines

h. Select/highlight the first variable in the report to be imported e.g., [hospital] (see I. List of variables for report on previous page).

i. Click the down arrow for the Insert Merge Field

j. Select hospital; [hospital] will then appear as <<hospital>>

k. Complete steps h. through j. for each variable to be imported. Note: the report template variable name is an exact match to the Insert Merge Field names.

l. Remove the yellow highlight from report template once you have all fields done.

m. On the Mailings tab click on Preview Results

Conduct a quick review of each individualized report by clicking on the forward and backward arrows.

If you need to make any changes to one, all, or some of the reports, click on the down arrow for Finish and Merge

Select Edit Individual Documents…

A Merge to New Document message box will appear. Choose whether you want to edit all, only the copy that's currently visible, or a subset of the set—which you specify by record number. Word compiles the copies that you want to edit into a single file, with a page break between each copy of the document.

After you finish editing the new file of documents, you can print the documents by clicking the File tab, and then selecting Print.

n. SAVE your document

o. Once you have approved each individual report you will want to save and/or print the reports…



Option 1 is to immediately print each personalized report and/or save a single Word Document containing every agency letter for mailing.

a. Click on the down arrow for Finish & Merge

b. Select Print Documents…

An individual report will print for each EMS agency listed in the worksheet you imported data from.

c. Then click on the down arrow for Finish & Merge again.

d. Select Edit Individual Documents…

e. A Merge to New Document message box will appear.

f. Select whether you want all, only the copy that's currently visible, or a subset of the set of the reports as a single Word document.

g. Word will create a new document that has each letter as a new page. Go to the File tab and Save the document in either the No Protocols or Protocols not available folder you created in step 1—dependent on which report you are creating. It is suggested you include the year and state name in the name of the document e.g., 2012AKhospitals.

Note: Remember that merged documents that you save are separate from the main document. It's a good idea to save the main document itself if you plan to use it for another mail merge.

When you save the main document, you also save its connection to the data file. The next time that you open the main document, you are prompted to choose whether you want the information from the data file to be merged again into the main document.

Option 2 is to immediately email each personalized report (as body of email).

Note: you would NOT want to use this option if you were going to attach/send a copy of the inter-facility guidelines and/or agreements template with the report.


b. Click on the down arrow for Finish & Merge

c. Select Send E-mail Messages…

d. A Merge to E-mail message box will appear.

e. Make sure the To: field has an email variable selected such as emailAddress

f. Enter something in the Subject line: field

g. The Mail format: field defaults to HTML. Note: some email addresses only accept text messages.



h. Select whether you want all, only the copy that's currently visible, or a subset of the set of the reports.

i. Select the OK button.

Options 3 & 4 are only available for those who have Adobe Acrobat Pro 9 or X installed on their computer!

Option 3 is to create PDFs of each personalized report to be printed and mailed or emailed as an attachment later.

a. Click on the Merge to Adobe PDF

b. An Acrobat PDFMaker – Mail Merge message box will appear.

c. Select whether you want all, only the copy that's currently visible, or a subset of the set of the reports as a PDF.

d. Optional: enter a name for Specify PDF file name:

e. Select the OK button.

f. A Browse For Folder message box. Select the appropriate folder you created in step 1—dependent on which report you are creating.

g. Select the OK button.

h. An Acrobat PDFMaker – Mail Merge message box will appear.

i. Click the OK button. Note: The PDF reports will be saved in the folder you selected in step f of this option.

Option 4 is to immediately email a generic message to every hospital with the personalized PDF of report attachment.

Note: you would NOT want to use this option if you were going to attach/send a copy of the inter-facility guidelines and/or agreements template with the report.


b. In the report you have been editing, click on the Merge to Adobe PDF

c. An Acrobat PDFMaker – Mail Merge message box will appear.

d. Select whether you want all, only the copy that's currently visible, or a subset of the set of the reports as a PDF.

e. Optional: enter a name for Specify PDF file name:

f. Check Automatically send Adobe PDF files by Email

g. The To: field should be defaulted to emailAddress; if not, search the drop down box for the appropriate variable.

h. Enter a subject in the Subject line: field



i. Enter a generic email message in the Message: field that applies for all of the agencies who will be receiving a report or leave the default wording. The appropriate personalized attached PDF report will be sent to the associated hospital.

j. Select the OK button.

k. A Browse For Folder message box. Select the appropriate folder you created in step 1—dependent on which report you are creating.

l. Select the OK button.

m. An Acrobat PDFMaker – Mail Merge message box will appear.

n. Click the OK button.

p. Repeat steps 2 through 5 for your other Hospital reports.



Option 2 Example

Option 4 Example (this option available only to those with Adobe Acrobat Pro 9 or X)


Workshop “Identifying Opportunities to Improve Performance Measure Results” Excel Equipment Add-In: Installation

Excel Equipment Add-In & Reporting: Installation The purpose of these instructions is to save the Excel Equipment Add-In in a permanent location and install it in your Excel program.

I. Create Folder to store Excel Add-In:

1. Go to My Computer.

a. Open your C: drive.

b. Go to Users > Your Username > My Documents.

c. Create a New Folder in which you will save the Excel Add-In files.

i. Right-click and select New > Folder.

d. Name the folder Microsoft Office Files.

i. The file path following these steps will be: C:\Users\<your username>\Documents\Microsoft Office Files.

ii. If you saved the folder elsewhere or named it differently, record the file path here:

__________________________________________________________________

2. Go to the 2012 NEDARC Workshop Materials folder you copied from your jump drive.

a. Go to 01_Everyone > Excel Add-In Materials.

b. Copy the Medical Equipment Efficiency Analysis.xla Excel Add-In file with the red dot.

c. Paste this file into your new Microsoft Office Files folder.

Note: If you move or delete this add-in file from where you originally store it for the installation, you will get an error message every time you open Excel and the Add-In will no longer work in Excel.

II. Install Add-In:

1. Open Excel.

a. Go to File > Options > Add-Ins.


Workshop “Identifying Opportunities to Improve Performance Measure Results” Excel Equipment Add-In: Installation

b. Select Excel Add-ins in the Manage field at the bottom of the options window and click Go.

c. The Add-Ins window should come up.

d. Click Browse.

e. Navigate to where you stored the Add-In: C:\Users\<your username>\Documents\Microsoft Office Files.

f. Select the Medical Equipment Efficiency Analysis.xla Excel Add-In file and click OK.

g. The Add-In should now show up in the Add-Ins available list.

h. Make sure Medical Equipment Efficiency Analysis is checked and click OK.

i. The Add-Ins tab should show up in the Ribbon if it was not there already.

j. Go to the Add-Ins tab and you should see the Medical Equipment Efficiency Analysis button.

Note: The Equipment Add-In is now installed in your Excel program. You will not need to re-install it each time you want to use it.


Workshop “Identifying Opportunities to Improve Performance Measure Results” Excel Equipment Add-In: Reports

Excel Equipment Add-In & Reporting: Provider & Equipment Reports

I. List of variables for reports:

1. Agency: Name of the responding agency

2. Equipment: Extended description of ALS and BLS equipment items

3. Deficiency: The number of deficiencies for that equipment item at that agency Possible values: 1 to the number of PCUs for that agency (double the number of

PCUs for possible ET tube deficiency)

4. Units: The number of equipment units needed to remedy the deficiency (should match the number of deficiencies for that equipment item)

5. Unit Cost: The cost of one unit of each particular equipment item

6. Total: The total cost to remedy all equipment deficiencies for that agency (in Provider

Report) or that equipment item (in Equipment Report)

II. Steps for preparing PI data and report files:

1. Prepare your EMS dataset; refer to the Multiple Excel Sheets handout.

2. Make sure the Excel Equipment Add-In is installed and working. Refer to the Excel Equipment Add‐In & Reporting: Installation handout.

Note: You do not need to have the data file open to run this report. Once the Add-In report is selected it will ask you which data file you want to use.

III. Provider Report steps:

1. Select Provider Report from the Medical Equipment Analysis drop down menu under the Add-Ins tab in the Ribbon.



2. Excel will want you to open the data file you want to use.

a. Navigate to the 2012 NEDARC Workshop Materials folder you copied from your jump drive.

b. Select your StateEMS.xls file and click Open.

3. It will take a moment to process and then your Provider Report will open with the following tabs:

a. Original Data: Contains the original dataset from your StateEMS.xls file.

b. Deficiencies: Contains a list of deficient equipment items by agency (uses equipment variable name and is not visually clear).

c. Deficiency Report: Contains the final deficiency report by the provider Agency. This report also lists the Equipment items by their full description instead of their variable name, Deficiency, Units, Unit Cost, and Total.

IV. Equipment Report steps:

1. Select Equipment Report from the Medical Equipment Analysis drop down menu under the Add-Ins tab in the Ribbon.



2. Excel will want you to open the data file you want to use.

a. Navigate to the 2012 NEDARC Workshop Materials folder you copied from your jump drive.

b. Select your StateEMS.xls file and click Open.

3. It will take a moment to process and then your Equipment Report will open with the following tabs:

a. Original Data: Contains the original dataset from your StateEMS.xls file.

b. Deficiencies: Contains a list of deficient agencies by equipment item (uses equipment variable name and is not visually clear).

c. Deficiency Report: Contains the final deficiency report by the full description of the Equipment item. This report also lists each Agency missing that equipment item, Deficiency, Units, Unit Cost, and Total.


Workshop “Identifying Opportunities to Improve Performance Measure Results” Excel Equipment Add-In: Lookup Table

Excel Equipment Add-In & Reporting: Lookup Table

I. List of variables for table:

1. BLS Variable: List of the 35 BLS equipment items from the PM survey Possible values: b_SucCathTip_Num through b_PedTape_Num

2. ALS Variable: List of the 67 ALS equipment items from the PM survey

Possible values: a_SucCathTip_Num through a_ETTube8_Num

3. Quantity Per Ambulance: The number of that equipment item recommended for one vehicle according to national standards (1 for most items)


5. Box Cost: The cost per box of that equipment item (whether that item is packaged

individually or in bulk)

6. Units Per Box: The number of that equipment item that comes in one box





3. Run either the Provider or Equipment Report from the Excel Equipment Add-In. Refer to the Excel Equipment Add‐In & Reporting: Provider & Equipment Reports handout.

Note: You DO need to have one of the reports generated and open to access the Lookup Table.

III. Lookup Table steps:

1. With either the Provider or Equipment Report open, press Ctrl+Shit+A. This will open the Lookup Table spreadsheet with the variables listed above.


Workshop “Identifying Opportunities to Improve Performance Measure Results” Excel Equipment Add-In: Lookup Table

2. You can make changes to these equipment items and cost information to more accurately reflect the prices in your state. (Note: the Unit Cost will automatically recalculate based on changes to the Box Cost or Units Per Box values).

3. Once you have made your changes, press Ctrl+Shit+A again to exit the Lookup Table. DO NOT close the table by clicking the X in the upper right corner. The information will save upon closing it, but you can click Save as well. The changes will not be immediately reflected in the report you already generated. You will need to re-generate a report to see the unit and cost changes.

Note: The prices that are currently programmed into the Lookup Table are based on national averages and may not be accurate. You should check all of these prices before including them in letters to your EMS agencies.


Workshop “Identifying Opportunities to Improve Performance Measure Results” Excel Equipment Add-In: Deficiency Letters

Excel Equipment Add-In & Reporting: Deficiency Letters

I. List of variables for letter:

1. Agency: Name of the responding agency


3. Units: The number of equipment units needed to remedy the deficiency (should match the number of deficiencies for that equipment item)


5. Total: The total cost to remedy all equipment deficiencies for that agency (in Provider

Report) or that equipment item (in Equipment Report)




3. Run either the Provider or Equipment Report from the Excel Equipment Add-In. Refer to the Excel Equipment Add‐In & Reporting: Provider & Equipment Reports handout.

4. Make sure your state’s prices are accurate in the Lookup Table. Refer to the Excel Equipment Add‐In & Reporting: Lookup Table handout.

Note: You DO need to have one of the reports generated and open to run the deficiency letters.

III. Deficiency Letter steps:

1. Select Deficiency Letters from the Medical Equipment Analysis drop down menu under the Add-Ins tab in the Ribbon.

2. The Browse For Folder window will come up. Navigate to where you want to save the



agency deficiency letters you generate.

a. You can click on the Make New Folder button to create a specific location for the letters you generate.

3. Excel will then ask you to select the word document you want to use as the form for your deficiency letter.

a. Navigate to the 2012 NEDARC Workshop Materials folder you copied from your jump drive and select the Deficiency Letter Example file. Click Open.

Note: This Deficiency Letter Example is ONLY for testing the process, but can serve as a basis for your letter. You will want to customize the letter for your state.

4. You can select a specific agency to run the Deficiency Letter for, or you can select All to generate a letter for each agency with deficiencies in your dataset. Click Proceed.



5. It will take a moment to process and then a window will pop up indicating that your letters have been generated and where they were saved.

IV. Deficiency Letter customization:

1. Start with the Deficiency Letter Example file from your 2012 NEDARC Workshop Materials folder.

2. You will want to make sure you can see where the bookmarks are located.

a. Go to File > Options > Advanced.

b. Scroll down to the Show Document Content section and make sure Show bookmarks is checked and click OK.

c. You should see markers indicating the areas that will be populated for each letter you generate. Do not delete the bookmarks!



3. Go to the Insert tab in the Ribbon and click on Bookmark in the Links section to see the Bookmark manager window.

a. This window includes a list of the bookmarks in the document and the ability to Add and Delete bookmarks.

b. Select Sort by: Location to see where each bookmark occurs in the document. You can double-click on the name of the bookmark to move the cursor to that bookmark in the document.

4. You should check the following on your state deficiency form letter before proceeding:

a. Make sure you change “STATE” to your state abbreviation as this will not auto-populate from the dataset.

b. Update the contact information at the bottom to match yours.

c. Read through the content of the letter and make sure it is applicable and accurate for your state.

5. You can further customize your state deficiency form letter in the following ways:

a. You can post-date the letter at the top instead of using today’s date.

b. Insert your EMSC logo at the top or bottom of the letter.



c. You can use your organization’s letterhead.


Workshop “Identifying Opportunities to Improve Performance Measure Results” MapPoint - Pushpins

MapPoint – Pushpins 60-day free trial of Microsoft MapPoint 2011: http://www.microsoft.com/en-us/download/details.aspx?id=12602

I. Data Import Pushpins in MapPoint are similar to the ones you would stick in a wall map to mark places that you want to remember. You can create a pushpin to mark a single place, or to represent data you’ve imported.

1. Go to Data > Import data wizard…

2. Navigate to the folder on your desktop and select the PM 76‐77 Final Practice Dataset_Geo.xlsx file and click Open.

3. Select the worksheet called PM 76-77 Final Practice Dataset and click Next.

4. On the next screen choose the following data type for each variable and then click Finish:



ResponseID: <Other Data>

Started: <Skip Column>

LastEdit: <Skip Column>

state: State

Group: County

origName: <Skip Column>

hospital: Name

address: Address 1

city: City

zip: Zip Code

name: <Other Data>

jobTitle: <Other Data>

phone: <Other Data>

emailAddress: <Other Data>

guidelines: <Other Data>

component_roles_y/n: <Other Data>

component_facility_y/n: <Other Data>

component_staff_y/n: <Other Data>

component_transfer_y/n: <Other Data>

component_record_y/n: <Other Data>

component_consent_y/n: <Other Data>

component_belongings_y/n: <Other Data>

component_directions_y/n: <Other Data>

guidelinesDT: <Skip Column>

agreements: <Other Data>

agreementsDT: <Skip Column>

comments: <Skip Column>

5. You will be presented with several “unmatched” records if you are using the practice dataset. Look closely and find the best match. Select the most correct address and click on OK.



6. You will now be shown the Data Mapping Wizard:

II. Map Types 1. From Map Type Dialogue box > Select Pushpin > Next > Check the Fields to Display

State

Group

Address

City

Zip

job title

phone

emailAddress > Finish

2. Changing the Style of the push pin.



3. Right click on a pushpin to display information about that hospital and then select Show Information to display the fields that you selected above in a bubble on the map.

4. You can also add information to this bubble. (e.g., The URL for hospital). Navigate to a web browser and search for the hospital’s website in your bubble.

5. Right click to copy the URL > Go back to the bubble and double click on the empty line > Paste the hospital URL in that spot.



III. Email 1. File > Send to > Mail to

a. You can email the map as a picture in the body of an email or an attachment to an email. The attachment will be a MapPoint file so recipient will need MapPoint to open the map.

b.OR, you can right click on the map and choose Copy and then paste it directly into your email or any other document.

IV. Print 2. File > Print (opens Print dialogue box)

a. Select printer.

b. Choose layout (portrait or landscape).

c. Select what part(s) of map to print.

d. Check to include map legend and/or overview map.

e. Give map a title.



V. Save 3. File > Save as

a. Name file and save to specified directory.

4. File > Save as webpage (useful for adding to a website).


Workshop “Identifying Opportunities to Improve Performance Measure Results” Using Multiple Symbols in MapPoint 2011

Using Multiple Symbols in MapPoint 2011

I. Dataset used for this example:

Performance Measures 76 & 77 – Inter-facility Transfer Guidelines & Agreements: PM 76‐77 Final Practice Dataset.xlsx


1. Go to Data > Import data wizard…

2. Select the PM 76‐77 Final Practice Dataset.xlsx file and click Open.

3. If you are asked, select the sheet PM 76-77 Final Practice Dataset and click Next.


ResponseID: <Skip Column>



state: State

Group: County


hospital: Name

address: Address 1

city: City

zip: Zip Code

name: <Other Data>


phone: <Other Data>


guidelines: <Other Data>

component_roles_y/n: <Other Data>

component_facility_y/n: <Other Data>



component_staff_y/n: <Other Data>

component_transfer_y/n: <Other Data>

component_record_y/n: <Other Data>

component_consent_y/n: <Other Data>

component_belongings_y/n: <Other Data>

component_directions_y/n: <Other Data>

guidelinesDT: <Skip Column>

agreements: <Other Data>

agreementsDT: <Skip Column>

comments: <Skip Column>

5. You will be presented with several “unmatched” records (if you are using the practice dataset). Look closely and find the best match. Select the most correct address and click on OK.

6. You will now be shown the “Data Mapping Wizard.” Select Multiple symbol from the dialog box by clicking on that option and then click on Next.



7. You will now be asked for the data field to display on the map. We are going to look at the agreements variable. Scroll down until you see the variable agreements; select that variable by clicking on it. Also, make sure that the “Show the data by” box has “Street Address” selected. Click on Next.

8. You will now be shown the legend for your map. Notice that all the values for the legend come from the variable agreement – inDev, N, Y.

9. Click inside the “Legend title” and give it a meaningful name such as Inter‐facility Transfer Agreements.

10. Select symbols for each of the values and make them meaningful such as green for those that have agreements, red for those who don’t, and yellow for those hospitals that are developing agreements. While you are still in this dialog box, make the names for the values in the legend easier to understand. Towards the right side of the dialog box is the “Range label” for each value. Type the following:

Change inDev to Agreements in Development

Change N to Have NO Agreements



Change Y to Have Agreements

When you have typed in these details, the dialog box should look similar to the one below; to continue to the next step click on Finish.

11. The fictional hospitals are now plotted on a map and colored according to their current inter-facility agreement status. Take the time to format the map so that it is readable and easy to identify the symbols; consider using the “Map Settings” (see image below) to show counties and select the type of map you would like – road map, road and data map, data map, etc.



PRACTICE MAP EXAMPLE:



III. Next Steps

1. Take the time to plot your own hospital dataset.

2. Are there any data points in the map that seem to cluster together based on color?

3. How can you use this information to help you improve your inter-facility transfer agreements performance measure data?

IV. Putting Maps into PowerPoint

An often asked question is… “this is a great map, how can I put this into a PowerPoint presentation?” Here are some simple steps to follow:

1. If you want to include the Legend then the “Legend and overview” should be showing (available in the upper left corner). If you do not want to include the Legend then have the “Map Settings” view open (see image below). In this example, we will include the Legend.

2. Send the map to yourself as email with a picture. Go to File > Send to > Mail recipient (as picture). Note: if you use Mail recipient (as attachment), MapPoint will email you the MapPoint file not an image.

3. Your default mail program should automatically open up. You do not actually need to send the picture, click on the picture to select it and push ctrl+C (copy).

4. Open up PowerPoint, select the slide where you’d like to paste the map and push ctrl+V (paste).

5. The map will be pasted into PowerPoint. It will most likely be too large for your slide, select the image and size it to fit to the PowerPoint slide window.

6. Another option to avoid steps 2 thru 5 is to right click on your map and select Copy and then paste it into your email or any other document such as PowerPoint.



A MAP INSIDE OF POWERPOINT:


Workshop “Identifying Opportunities to Improve Performance Measure Results” Intermediate MapPoint 2011

Intermediate MapPoint 2011

I. Dataset used for this example:

Built in United State Demographic Data Performance Measures 71/72/73 – Online/Offline Medical Direction, and Equipment:

PM 71‐73 Final Practice Dataset.xlsx Performance Measures 76/66 – Inter-facility Transfer Guidelines & Agreements:

PM 76‐77 Final Practice Dataset.xlsx Utah Trauma Regions

utahTraumaRegions.xlsx

NOTE: Also included on your jump drive is a dataset entitled, UrbanInfluenceCodes_WithNEMSISDesignations.xls. Although not discussed in these examples you may find this dataset helpful to view the “Urbanicity” of the counties in your state as defined by the OMB/USDA Urban Influence Codes and the NEMSIS TAC Team – such as Urban, Sub-Urban, Rural, and Wilderness.i

II. Using Built in United States Demographic Data

MapPoint comes with several built in maps for visualizing demographic data such as population, income, occupation, square miles, etc. The data is provided by AGS (Applied Geographic Solutions)ii. Some of these datasets may be helpful in your efforts to visualize your data or understand the needs of your population.

One Variable – Sized Circles

In this first example, we are going to look at “Age: population, 0-14 years (2007)” by Sized circle. A sized circle shows data in two ways, 1) geographical location 2) the larger the circle the higher the value represented.iii

1. Create a new MapPoint file.

2. Select Data > Data mapping wizard.

3. In the “Data mapping wizard” dialog box select Sized circle and then click on Next.



4. On the next screen make sure the “Add demographics to the map” is checked and “United States demographic data” is selected in the drop down. Click on Next.



5. The following screen will prompt you to select the data you’d like to visualize on the map. Scroll down and select “Age: population, 0-14 years (2007).” Notice that you can view the data by various geographic levels, in the lower left corner of the wizard. Make sure “State” is selected. Click Next.

6. You will now be prompted to format the legend. You can choose various ways of displaying the data by changing the “Range type.” MapPoint tries to automatically choose the best type of display for the dataset you selected. In this case “Continuous logarithmic range,” is selected. You can also change the color of the circles shown on the map. We will use the defaults for this example. Click Finish.



7. You will be shown a map of the United States, showing the population, 0-14 years (2007), by sized circles. To view the actual population numbers for a state, roll-over the circle of interest; for example, if you roll-over the large circle on California you will see that as of 2007, California had 8,079,489 children ages 0-14 years.



One Variable – Shaded Area

One of the most useful ways of viewing data on a map is by “Shaded area.” This view helps maintain the shape of the map and lets you see data without overlapping data points at various geographic levels such as county. This is particularly helpful for looking at data for just your state instead of state by state comparisons. “The geographic areas by which you’ve chosen to display your data are represented by shades of color corresponding to values or ranges of values for those areas.” iv

1. Create a new MapPoint file.

2. Select Data > Data mapping wizard.

3. In the “Data mapping wizard” dialog box select Shaded area and then click on Next.

4. On the next screen make sure the “Add demographics to the map” is checked and “United States demographic data” is selected in the drop down. Click on Next.

5. The following screen will prompt you to select the data you’d like to visualize on the map. We are going to look at the same data we viewed earlier but in a more detailed way. Scroll down and select “Age: population, 0-14 years (2007).” Notice that you can view the data by various geographic levels, in the lower left corner of the wizard. Make sure “County” is



selected. Click Next.

6. You will now be prompted to format the legend. You can choose various ways of displaying the data by changing the “Range type.” First we are going to look at this data using the defaults selected by MapPoint (range type: continuous range); we will then customize the legend to see the data differently. For now, click Finish.

You can clearly see the areas with the highest population of children ages 0-14 years. However, the rest of the United States looks pretty much the same color and you cannot distinguish much variation. To see more detail we can customize the map to show the ranges we would like to see.

7. Right click on the legend title and choose “Format legend…”

8. In order to make your own legends, you sometimes have to select a range type and then



customize it to your needs. In the legend select a “Range type” of “Discrete equal ranges.” Change the “No. of ranges” to 7 and enter the ranges below into the boxes in the legend; notice as you type your custom values that the “Range type” will change to “Custom.”

The numbers above were chosen based on ranges being used for the National Pediatric Readiness Project with the addition of a few higher categories.

9. Choose a different color for the map such as orange and click Finish.

10. Now the map gives us more detailed information by county across the nation. Zoom into your state and roll-over the various counties. Is the information as you expected? What did you learn that was new to you? In the example below, you will see a screen shot from the state of Arizona. Notice the high population of children ages 0-14 years in Maricopa County as compared to the rest of the state. Which county in your state has the highest number of children ages 0-14 years?



11. Save this MapPoint file by going to File > Save. Call the file Population 0‐14 Years by County.

12. What if you want to see the actual data, i.e. the numbers? You can export the data to Microsoft Excel, by right clicking on the Legend Title and choosing “Export to Excel.”



13. The file will automatically open in Microsoft Excel. The first worksheet will be a document that indicates the data came from MapPoint and the second worksheet will have all the numbers in a nice format for further analysis (see below).

Two Variables – Shaded Area (Percentage)

You can also use a “Shaded Area” map to view data by percentages instead of total number. This can give you a different way of comparing counties; however, keep in mind what you are looking at. You could have a county with a high percentage of children only because that county also happens to have a smaller total population than an adjoining county; this could skew the interpretation of the data visualization or your message. Be careful to choose the correct map for your presentation / analysis.

1. We are going to modify the file that you saved in the last exercise, Population 0‐14 Years by County (open the file if necessary). Right click on the legend title and choose, “Format legend…”

2. Click on the Back button to go back to the data fields for display.

3. We are still going to look at “Age: population, 0-14 years (2007)” but we want to know the percentage of this population that is in each county instead of the total number. In the middle of the dialog box you will see “Divide the data you choose above by.” Using the drop down select the variable “Population: total (2007).” This will give us a percentage – the population 0-14 years (2007) divided by the total population (2007). Make sure “County” is still selected and click on Next.



4. The legend automatically adjusts for a percentage and again suggests a “Range type” of “Continuous range.” We will customize the values for our needs in order to see more detail. Select a “Range type” of “Discrete equal ranges;” change the “No. of ranges” to 5 and type in the values listed below for both the ranges and the range labels. Remember you are working in percentages so that is why the numbers are shown as decimals. When you are finished, click Finish.



The numbers chosen for these ranges are simply to create something that follows a bell curve shape in the data.

5. You now have the same data of population 0-14 years but it is shown by percentage. How does this change the visualization of the data? Why would you choose to display the data in this format? Why not? In the example below, you will see a screen shot from the state of Arizona again. Notice the high percentage of children ages 0-14 years in Navajo, Apache, and Santa Cruz Counties as compared to the rest of the state. How does this change the storyline? In this case, there are a higher percentage of children in those counties but not a higher number of children as shown in the last example. The overall population of Navajo (112,682), Apache (69,446), and Santa Cruz Counties (41,681) is much lower than Maricopa County (3,852,886) (plot the variable Population: total (2007) only); however, these counties have a higher percentage of children ages 0-14 than Maricopa County.

Look at your state. How does looking at the data in this way change your interpretation? Which version of the map gives you the most helpful information?



6. Save this MapPoint file by going to File > Save As. Call the file Population 0‐14 Years Percentage by County. Note: Make sure you use SAVE AS and not SAVE or you will overwrite the first map you saved.

III. Other MapPoint Map Types – More than One Variable

There are several other map types available in MapPoint such as Pie Charts, and Column Charts. We will not have time in this workshop to go over those types but we encourage you to play with them to see how they might fit your needs. You can use these for both the built in demographic data or for your own dataset that has more than one variable that you’d like to compare. Be careful on how you use the pie chart map type; make sure you know exactly what is being added together to represent 100% of the pie chart. Note: Some of these map types can make the map cluttered and hard to read.

Example Usage:

Below is a sample pie chart map type. It is used to show the percentages of vehicles in each agency (ALS, BLS); the pie chart = 100% of all vehicles. Notice that you do have to zoom in to



see the detail as the pie charts overlap at a larger view.

IV. Overlay Your Variable(s) on a Shaded Area Map

1. Open the file you made earlier by going to File > Open, browse to Population 0‐14 Years by County and click Open.

2. Zoom into the continental United States.

3. You can overlay different types of data in MapPoint. In this example, we are going to overlay the EMS agencies that responded to the survey on top of the population 0-14 years of age by county data. Go to Data > Import data wizard…

4. Select the PM 71‐73 Final Practice Dataset.xlsx file and click Open.

5. If asked, select the sheet PM 71-73 Final Practice Dataset and click Next.


ResponseID: <Skip Column>





state: State

Group: County


agency: Name

agencyID: <Other Data>

address: Address 1

city: City

zip: Zip Code

name: <Other Data>


phone: <Other Data>


respond911 to aCarryAll: <Other Data> (Note: This is a large set of variables)

equipComments: <Skip Column>

7. You will be presented with several "unmatched" records (if you are using the practice dataset). Look closely and find the best match; for most of these records in the practice dataset you can use the “postal code” only match. Select the most correct address and click on OK.

8. Select a “map type” of Multiple symbol, click on Next.

9. On the “choose data field to display” screen, scroll down and select transport and make sure that “Street Address” is selected in the “show the data by” box. Click on Next.

10. For the Legend, give this map a title of “Transport vs. Non-Transport.”

11. Give the value “N” a red symbol and the value “Y” a green symbol.

12. In the “Range label” type the following (as shown below), click Finish:



13. You end up with a geographic map showing the addresses of the agencies who responded to the survey, flagged as either having transport vehicles or not having transport vehicles overlaid on top of the population 0-14 years data. How could this type of map help you visualize and understand your EMS system? In this example (shown below), notice that there is one agency that responded to the survey in Iron County. This fictional agency does not transport patients; given that this county, in 2007, had about 9,592 children ages 0-14 years would that be of concern? What would you need to investigate further?



14. What other types of variables could you overlay onto the population data? Try this exercise with your own state data. Does that data display as you expected?

V. Territories

The last feature we will discuss in this workshop is setting up territories. This is a way of building your own color-coded areas for your state such as EMS Regions, Trauma Regions, etc. This can be handy if you want to overlay other data on top of some sort of grouping that has been setup in your state.

1. You can create territories by hand in MapPoint but it is easier if you already have them setup in Excel. The file utahTraumaRegions.xlsx, included on your jump drive, is a simple Excel file that is setup by county. The file contains a list of counties and their corresponding Trauma Region. The file only includes three variables, County, State, and Trauma Region as shown below. You can set this type of file up by zip code, three digit area code, etc. depending on your state; we will use county for this example.



2. In MapPoint, go to Data > Territories, select “Create from your own set of data” and click on Next.

3. You are given the option to import or link to your source file. If you have a file that is changing a lot you can chose to link to it and your territories will automatically update as you make changes. Make sure “Import your source file” is selected and click on Next.

4. Browse to the file utahTraumaRegions.xlsx, select it and click Open.

5. On the following screen select the sheet called “Utah Trauma Regions” and click Next.

6. On the final import screen you will need to make sure the following are mapped correctly:

County: County

State: State

Trauma Region: Territory



7. Click Finish.

8. What you see is a map showing the Utah Trauma Regions grouped together by county. Notice that MapPoint even prints the title of the “territory” on to the map.

9. We can change the Legend title “Custom Territories” by right clicking on the Legend title and choosing “Properties.” The Properties box will open. Type Utah Trauma Regions into the “Name” box as shown below and click OK.



10. Finally, you can change the color of each of the territories by right clicking on the Legend title and choosing “Territory colors.” Select the territory for which you want to change its color, and then click on a color. Click Close when you are finished.



11. As was shown in an earlier example you can overlay other data on top of your territories to further assist you in visualizing your data. The example below shows the fictional hospitals from the file PM 76‐77 Final Practice Dataset.xlsx overlaid on the Utah Trauma Regions territory map.

i See “Measuring Urbanicity: Urban Influence Codes” at http://www.nemsis.org/reportingTools/reports/nationalEMSDatabaseDescription.html. ii See http://www.appliedgeographic.com/ iii See “About data map types” at http://msdn.microsoft.com/en-us/library/aa723440.aspx. iv See “About data map types” at http://msdn.microsoft.com/en-us/library/aa723440.aspx.


Data Dictionaries for Performance Measures:

71 (online medical direction)

72 (offline medical direction)

73 (pediatric equipment)

76 (inter-facility transfer guidelines)

77 (inter-facility transfer agreements)


Workshop “Identifying Opportunities to Improve Performance Measure Results” Variable Names: Pediatric Medical Direction and Equipment

Variable Names: Pediatric Medical Direction and Equipment Survey

Variables generated from the survey software that appear in the dataset:

ResponseID – unique identifying ID number assigned to each response by the online survey software Started – The date and time the online survey was accessed and the response was started LastEdit– The date and time the online survey was completed State– The state that the respondent selected on www.emscsurveys.org origName – The agency name that the respondent selected on www.emscsurveys.org. The value of the variable origName may or may not be the same as the value for the variable agency because the respondent may have updated their agency name in the agency variable. Group – The county (or region) that the respondent selected on www.emscsurveys.org Values for the variables origName and Group will only appear in datasets of states that listed their agencies on www.emscsurveys.org. For states not listing their agencies on www.emscsurveys.org, these two columns will simply be blank.

Variables generated from Excel Equipment Add-In that appear in the dataset:

Agency– Name of the responding agency Equipment– Extended description of ALS and BLS equipment items Deficiency – The number of deficiencies for that equipment item at that agency Units– The number of equipment units needed to remedy the deficiency (should match the number of deficiencies for that equipment item) Unit Cost– The cost of one unit of each particular equipment item Total – The total cost to remedy all equipment deficiencies for that agency (in Provider Report) or that equipment item (in Equipment Report) BLS Variable – List of the 35 BLS equipment items from the PM survey



ALS Variable – List of the 67 ALS equipment items from the PM survey Quantity Per Ambulance – The number of that equipment item recommended for one vehicle according to national standards (1 for most items) Box Cost – The cost per box of that equipment item (whether that item is packaged individually or in bulk) Units Per Box – The number of that equipment item that comes in one box The remaining pages of this document give all of the survey questions with their variable names and the coding for each multiple choice response



Emergency Medical Services for Children: Pediatric Medical Direction and Equipment Survey

Beforeyougetstarted,pleasetellusaboutyouragencyincaseweneedtocontactyouforanyfollowupinformation…

1. Name of your EMS Agency: ____________________________________ agency

2. EMS Agency ID: _____________________________________________ agencyID

3. Address: ____________________________________________________ address

4. City: _______________________________________________________ city

5. Zip Code: ____________________________________________________ zip

6. Name of person completing survey: _______________________________ name

7. Job title of person completing survey: ______________________________ jobTitle

8. Agency phone number: ____________________ [format: (xxx) xxx-xxxx] phone

9. Email of person completing survey: ________________________________ (format:

[email protected]) emailAddress

10. Does your agency respond to 911 emergency medical calls (or emergency medical calls placed through other emergency access numbers if used in your region)? respond911 (select one)

Yes Go to 11 Y No N

If your agency DOES NOT respond to 911 emergency calls, you are finished with the survey. Thank you for your time.



11. Please indicate your highest level of state certification/licensure for your EMS agency:

(select one) emsLevel Basic Life Support (BLS)/Intermediate Life Support (ILS) BLS Advanced Life Support (ALS) ALS Note: The appearance of this question will differ by each state’s survey. Some states may group ILS agencies with ALS agencies or have other names for certification/licensure levels. However, for each state, these levels will all be grouped into two groups and those two groups will be coded as BLS and ALS in the dataset. This is also true of BLS and ALS patient care units in the equipment survey.

Next,pleasetellushowmedicaldirectionisutilizedinyouragency…

12. In the past year, have any of your providers attempted to contact on-line medical direction for medical advice when treating a pediatric patient, age 0-18 years? tryContact (select one) Yes Y No Skip to 15 N

13. In the past year, how often was on-line medical direction available to provide medical advice

to your providers when they were treating pediatric patients, ages 0-18 years? (Please IGNORE situations where on-line medical direction was not available due to equipment failure such as non-working radios or lack of cell phone signal.) onlineAvailable (select one) Always (100%) always Almost Always (90 to 99%) almostAlways Usually (50 to 89%) usually Occasionally (10 to 49%) occasionally Rarely (1 to 9%) rarely Never (0%) Skip to 15 never

14. In the past year, when on-line medical direction was available, what type of medical

professional PRIMARILY gave your providers medical advice when they were treating a pediatric patient, age 0-18 years? trainingLevel (select one) EMT-Basic Basic EMT-Intermediate Intermediate Paramedic Paramedic Nurse Nurse Nurse practitioner nursePrac Physician assistant PA Physician MD Do Not Know DNK Other Type of Medical Professional: ________________________________________________________________________________________________________________________________________________



15. Are written protocols or guidelines (paper or electronic) available to your providers for the

treatment of pediatric patients, ages 0-18 years? offlineProtocols (select one) Yes Y No Skip to 17 N

16. In the past year, how often were these pediatric protocols or guidelines physically available

(paper or electronic) in the EMS vehicle or carried by your providers during emergency calls? (select one) offlineAvailable Always (100%) always Almost Always (90 to 99%) almostAlways Usually (50 to 89%) usually Occasionally (10 to 49%) occasionally Rarely (1 to 9%) rarely Never (0%) never

17. If you have any additional thoughts about pediatric medical direction, please share them

here. medDirComments ________________________________________________________________________________________________________________________________________________________________________________________________________________________



Pleasetellusaboutthevehiclesoperatedbyyouragency…

18. Does your agency operate any ground vehicles that transport patients from scene to hospital? (select one) transport

Yes Go to 19 Y No N

If your agency does not operate any ground vehicles that transport patients from scene to hospital, you are finished with the survey. Thank you for your time.

19. Please indicate the total number of ground vehicles that your agency operates that transport patients from scene to hospital: vehTotal _____

20. How many of your transporting ground vehicles are Basic Life Support or Intermediate Life Support (BLS or ILS)? vehBLS _____

21. How many of your transporting ground vehicles are Advanced Life Support (ALS)? _____ vehALS

Note: The sum of #20 and #21 needs to match the answer to question #19.



PleasetellusaboutequipmentonyourBLS/ILStransportingvehicles.ThefollowingequipmentisrecommendedbytheNationalEMSforChildrenProgramandmaynotcorrespondwithyourstate’sequipmentlist.

Firstitisimportanttoreadtheinstructionsbelow…

If your agency does not operate any BLS/ILS transporting ground vehicles, skip to question 24.

In the list below you are indicating how many of your transporting ground vehicles carry at least 1 of each item. As a result, your responses cannot be greater than the number of BLS/ILS vehicles you reported in question 20 on page 5.

22. How many of your BLS/ILS transporting ground vehicles carry a(n): # of Vehicles

Rigid tonsil tip suction catheter b_SucCathTip_Num _____

Suction catheter in one of the following sizes: 6fr, 8fr, or 10fr b_SucCath6_10_Num _____

Suction catheter in one of the following sizes: 12fr, 14fr, or 16fr b_SucCath12_16_Num _____

Child size nasal cannula b_CanulaCh_Num _____

Adult size nasal cannula b_CanulaAd_Num _____

Child size non-rebreather mask b_NRBCh_Num _____

Adult size non-rebreather mask b_NRBAd_Num _____

Child size (450-750 ml) hand operated self-expanding bag (bag-valve mask) b_SEBCh_Num _____

Adult size (>1000 ml) hand operated self-expanding bag (bag-valve mask) b_SEBAd_Num _____

Neonate size mask for a bag-valve mask b_BVMNeo_Num _____

Infant size mask for a bag-valve mask b_BVMInf_Num _____

Child size mask for a bag-valve mask b_BVMCh_Num _____

Adult size mask for a bag-valve mask b_BVMAd_Num _____

Nasal airway in one of the following sizes: 16fr, 18fr, 20fr, 22fr, or 24fr (internal diameters 3.5mm to 6.0mm) b_NasAir16_24_Num _____

Nasal airway in one of the following sizes: 26fr, 28fr, 30fr, 32fr, or 34fr (internal diameters 6.5mm to 8.5mm) b_NasAir26_34_Num _____

Example: You have 5 vehicles and each vehicle carries 2 rigid tonsil tip suction catheters. Your answer should be 5, not 10.


Rigid tonsil tip suction catheter __5___




Either a size 0 or size 1 (50mm or 60mm) oral airway b_OralAir0_1_Num _____



Pulse oximeter with pediatric probes b_PulseOxPed_Num Note: Pulse oximeter may be independent or integrated with a monitor/defibrillator or other device _____

Pulse oximeter with adult probes b_PulseOxAd_Num Note: Pulse oximeter may be independent or integrated with a monitor/defibrillator or other device _____

OB kit b_OBKit_Num _____

Bulb suction for infants b_Bulb_Num Note: Bulb suction may be carried either separately or as part of the OB Kit _____

Either a thermal absorbent blanket and head cover or appropriate heat-reflective material b_Blanket_Num Note: May be carried either separately or as part of the OB Kit _____

Small rigid cervical immobilization device b_CervDevS_Num _____

Medium rigid cervical immobilization device b_CervDevM_Num _____

Large rigid cervical immobilization device b_CervDevL_Num _____

Child size lower extremity (femur) traction device b_LoExDevCh_Num Note: This could be a device that is adjustable based on patient size _____

Adult size lower extremity (femur) traction device b_LoExDevAd_Num Note: This could be a device that is adjustable based on patient size _____

Small extremity immobilization device b_ExImDevS_Num Note: This could be a device that is adjustable based on patient size _____

Medium extremity immobilization device b_ExImDevM_Num Note: This could be a device that is adjustable based on patient size _____

Large extremity immobilization device b_ExImDevL_Num Note: This could be a device that is adjustable based on patient size _____

Sphygmomanometer with a pediatric cuff b_SphygPed_Num _____

Sphygmomanometer with an adult cuff b_SphygAd_Num _____

AED or defibrillator with the appropriate paddles and/or pads to defibrillate children b_AED_Num _____

Length/weight based tape or appropriate reference material for pediatric equipment sizing and drug dosing b_PedTape_Num _____



23. How many of your BLS/ILS transporting ground vehicles carry ALL of the equipment items

listed on the previous pages? (Note that your answer cannot be greater than the smallest number previously provided for any of the BLS/ILS equipment items. See list below for a review of the equipment items.) _____ bCarryAll

Suction catheter – rigid tonsil tip Suction catheter in one of the following

sizes: 6fr, 8fr, or 10fr Suction catheter in one of the following

sizes: 12fr, 14fr, or 16fr Nasal canula – child size Nasal canula – adult size Non-rebreather mask – child size Non-rebreather mask – adult size Hand operated self-expanding bag (bag-

valve mask) – child size (450-750 ml) Hand operated self-expanding bag (bag-

valve mask) – adult size (>1000 ml) Mask for bag-valve mask – neonate size Mask for bag-valve mask – infant size Mask for bag-valve mask – child size Mask for bag-valve mask – adult size Nasal airway in one of the following

sizes: 16fr, 18fr, 20fr, 22fr, or 24fr (internal diameters 3.5mm to 6.0mm)

Nasal airway in one of the following sizes: 26fr, 28fr, 30fr, 32fr, or 34fr (internal diameters 6.5mm to 8.5mm)

Oral airway – either a size 0 or size 1 (50mm or 60mm)



Pulse oximeter with pediatric probes Pulse oximeter with adult probes OB kit Bulb suction for infants Thermal absorbent blanket with head

cover or appropriate heat-reflective material

Rigid cervical immobilization device – small

Rigid cervical immobilization device – medium

Rigid cervical immobilization device – large

Lower extremity (femur) traction device – child size

Lower extremity (femur) traction device – adult size

Extremity immobilization device – small Extremity immobilization device –

medium Extremity immobilization device – large Sphygmomanometer with a pediatric cuff Sphygmomanometer with an adult cuff AED or defibrillator that includes

pediatric capability Length/weight-based tape or appropriate

reference material for pediatric equipment sizing and drug dosing



PleasetellusaboutequipmentonyourALStransportingvehicles.ThefollowingequipmentisrecommendedbytheNationalEMSforChildrenProgramandmaynotcorrespondwithyourstate’sequipmentlist.

Firstitisimportanttoreadtheinstructionsbelow…

If your agency does not operate any ALS transporting ground vehicles, you are finished with

the survey. Thank you for your time.

In the list below you are indicating how many of your transporting ground vehicles carry at least 1 of each item. As a result, your responses cannot be greater than the number of ALS vehicles you reported in Question 21 on page 5.

24. How many of your ALS transporting ground vehicles carry a(n): # of Vehicles

Rigid tonsil tip suction catheter a_SucCathTip_Num _____

Suction catheter in one of the following sizes: 6fr, 8fr, or 10fr a_SucCath6_10_Num _____

Suction catheter in one of the following sizes: 12fr, 14fr, or 16fr a_SucCath12_16_Num _____

Child size nasal cannula a_CanulaCh_Num _____

Adult size nasal cannula a_CanulaAd_Num _____

Child size non-rebreather mask a_NRBCh_Num _____

Adult size non-rebreather mask a_NRBAd_Num _____

Child size (450-750 ml) hand operated self-expanding bag (bag-valve mask) a_SEBCh_Num _____

Adult size (>1000 ml) hand operated self-expanding bag (bag-valve mask) a_SEBAd_Num _____

Neonate size mask for a bag-valve mask a_BVMNeo_Num _____

Infant size mask for a bag-valve mask a_BVMInf_Num _____

Child size mask for a bag-valve mask a_BVMCh_Num _____

Adult size mask for a bag-valve mask a_BVMAd_Num _____

Example: You may have 5 vehicles and each vehicle carries 2 rigid tonsil tip suction catheters. Your answer should be 5, not 10.


Rigid tonsil tip suction catheter __5___




Nasal airway in one of the following sizes: 16fr, 18fr, 20fr, 22fr, or 24fr (internal diameters 3.5mm to 6.0mm) a_NasAir16_24_Num _____

Nasal airway in one of the following sizes: 26fr, 28fr, 30fr, 32fr, or 34fr (internal diameters 6.5mm to 8.5mm) a_NasAir26_34_Num _____

Either a size 0 or size 1 (50mm or 60mm) oral airway a_OralAir0_1_Num _____



Pulse oximeter with pediatric probes a_PulseOxPed_Num Note: Pulse oximeter may be independent or integrated with a monitor/defibrillator or other device _____

Pulse oximeter with adult probes a_PulseOxAd_Num Note: Pulse oximeter may be independent or integrated with a monitor/defibrillator or other device _____

OB kit a_OBKit_Num _____

Bulb suction for infants a_Bulb_Num Note: Bulb suction may be carried either separately or as part of the OB Kit _____

Either a thermal absorbent blanket and head cover or appropriate heat-reflective material a_Blanket_Num Note: May be carried either separately or as part of the OB Kit _____

Small rigid cervical immobilization device a_CervDevS_Num _____

Medium rigid cervical immobilization device a_CervDevM_Num _____

Large rigid cervical immobilization device a_CervDevL_Num _____

Child size lower extremity (femur) traction device a_LoExDevCh_Num Note: This could be a device that is adjustable based on patient size _____

Adult size lower extremity (femur) traction device a_LoExDevAd_Num Note: This could be a device that is adjustable based on patient size _____

Small extremity immobilization device a_ExImDevS_Num Note: This could be a device that is adjustable based on patient size _____

Medium extremity immobilization device a_ExImDevM_Num Note: This could be a device that is adjustable based on patient size _____

Large extremity immobilization device a_ExImDevL_Num Note: This could be a device that is adjustable based on patient size _____

Sphygmomanometer with a pediatric cuff a_SphygPed_Num _____

Sphygmomanometer with an adult cuff a_SphygAd_Num _____




Length/weight based tape or appropriate reference material for pediatric equipment sizing and drug dosing a_PedTape_Num _____

Size 0 Miller laryngoscope blade a_Miller0_Num _____



Either a size 3 or size 4 Miller laryngoscope blade a_Miller3_4_Num _____

Size 2 curved laryngoscope blade a_Curved2_Num _____

Either a size 3 or 4 curved laryngoscope blade a_Curved3_4_Num _____

Pediatric size stylette a_StylettePed_Num _____

Adult size stylette a_StyletteAd_Num _____

Meconium Aspirator Adaptor a_MecAsp_Num _____

Pediatric size Magill forceps a_ForcepsPed_Num _____

Adult size Magill forceps a_ForcepsAd_Num _____

End-tidal CO2 detection capability for pediatric patients either: quantitative capnometry or colorimetric a_CO2detCh_Num _____

End-tidal CO2 detection capability for adult patients either: quantitative capnometry or colorimetric a_CO2detAd_Num _____

4 different sizes of intravenous catheters from 14 gauge to 24 gauge a_IVCath14_24_Num _____

Either a size 22 or size 24 gauge intravenous catheter a_IVCath22_24_Num _____

Child size intraosseous needle a_IOCh_Num _____

Adult size intraosseous needle a_IOAd_Num _____

1cc size syringe a_Syringe1_Num _____

Syringe in one of the following sizes: 3cc, 5cc, or 10cc a_Syringe3_10_Num _____

Defibrillator with the appropriate paddles and/or pads to defibrillate children a_DefibPed_Num _____

Defibrillator with the appropriate paddles and/or pads to defibrillate adults a_DefibAd_Num _____

Transcutaneous cardiac pacemaker with pediatric pads/cables a_PacingPed_Num Note: Includes both independent and monitor/defibrillator incorporated pacing units _____

Transcutaneous cardiac pacemaker with adult pads/cables a_PacingAd_Num Note: Includes both independent and monitor/defibrillator incorporated pacing units _____



ThispagelistsETtubesandsizes.Thequestionsonthispageareaskingforinformationthatisdifferentthanthepreviouspages.Pleasereadthestatementbelowregardingtheitemsonthispage.

For the following questions, please indicate the number of ALS transporting ground vehicles that carry at least 2 of each size of either CUFFED or UNCUFFED endotracheal tubes.


At least 2 size 2.5mm endotracheal tubes a_ETTube2_5_Num _____

At least 2 size 3.0mm endotracheal tubes a_ETTube3_Num _____











26. How many of your ALS transporting ground vehicles carry ALL of the equipment items

listed on the previous pages? (Note that your answer cannot be greater than the smallest number previously provided for any of the ALS equipment items. See list below for a review of the equipment items.) _____ aCarryAll

Suction catheter – rigid tonsil tip Suction catheter in one of the following sizes: 6fr,

8fr, or 10fr Suction catheter in one of the following sizes: 12fr,

14fr, or 16fr Nasal canula – child size Nasal canula – adult size Non-rebreather mask – child size Non-rebreather mask – adult size Hand operated self-expanding bag (bag-valve mask) –

child size (450-750 ml) Hand operated self-expanding bag (bag-valve mask) –

adult size (>1000 ml) Mask for bag-valve mask – neonate size Mask for bag-valve mask – infant size Mask for bag-valve mask – child size Mask for bag-valve mask – adult size Nasal airway in one of the following sizes: 16fr,

18fr, 20fr, 22fr, or 24fr (internal diameters 3.5mm to 6.0mm)

Nasal airway in one of the following sizes: 26fr, 28fr, 30fr, 32fr, or 34fr (internal diameters 6.5mm to 8.5mm)




Pulse oximeter with pediatric probes Pulse oximeter with adult probes OB kit Bulb suction for infants Thermal absorbent blanket with head cover or

appropriate heat-reflective material Rigid cervical immobilization device – small Rigid cervical immobilization device – medium Rigid cervical immobilization device – large Lower extremity (femur) traction device – child size Lower extremity (femur) traction device – adult size Extremity immobilization device – small Extremity immobilization device – medium Extremity immobilization device – large Sphygmomanometer with a pediatric cuff Sphygmomanometer with an adult cuff Length/weight-based tape or appropriate reference

material for pediatric equipment sizing and drug dosing

Laryngoscope blade – Miller size 0 Laryngoscope blade – Miller size 1

Laryngoscope blade – Miller size 2 Laryngoscope blade – Miller either a size 3 or size 4 Laryngoscope blade – curved size 2 Laryngoscope blade – curved either a size 3 or size 4 Stylette for endotracheal tube – pediatric size Stylette for endotracheal tube – adult size Meconium aspirator adaptor Magill forceps – pediatric size Magill forceps – adult size End-tidal CO2 detection capability for pediatric

patients either: quantitative capnometry or colorimetric

End-tidal CO2 detection capability for adult patients either: quantitative capnometry or colorimetric

Intravenous catheters – 4 different sizes from 14 gauge to 24 gauge

Intravenous catheter – either a size 22 or size 24 gauge

Intraosseous needle – child size Intraosseous needle – adult size Syringe – 1cc Syringe in one of the following sizes: 3cc, 5cc, or

10cc Defibrillator with the appropriate paddles and/or

pads to defibrillate children Defibrillator with the appropriate paddles and/or

pads to defibrillate adults Transcutaneous cardiac pacemaker with pediatric

pads/cables Transcutaneous cardiac pacemaker with adult

pads/cables Endotracheal tubes (2 each) – 2.5mm Endotracheal tubes (2 each) – 3.0mm Endotracheal tubes (2 each) – 3.5mm Endotracheal tubes (2 each) – 4.0mm Endotracheal tubes (2 each) – 4.5mm Endotracheal tubes (2 each) – 5.0mm Endotracheal tubes (2 each) – 5.5mm Endotracheal tubes (2 each) – 6.0mm Endotracheal tubes (2 each) – 7.0mm Endotracheal tubes (2 each) – 8.0mm



27. If you have additional thoughts about equipment on your transporting ground vehicles or the survey itself, please share them here. equipComments _____________________________________________________________________ _____________________________________________________________________ _____________________________________________________________________

Thank you again for completing the survey! We appreciate your time.


Workshop “Identifying Opportunities to Improve Performance Measure Results” Variable Names: Inter-facility Transfer Guidelines/Agreements

Variable Names: Inter-facility Transfer Guidelines/Agreements Survey

Variables generated from the survey software that appear in the dataset:

ResponseID – unique identifying ID number assigned to each response by the online survey software Started – The date and time the online survey was accessed and the response was started LastEdit– The date and time the online survey was completed State– The state that the respondent selected on www.emscsurveys.org origName – The hospital name that the respondent selected on www.emscsurveys.org. The value of the variable origName may or may not be the same as the value for the variable hospital because the respondent may have updated their hospital name in the hospital variable. Group – The county (or region) that the respondent selected on www.emscsurveys.org Values for the variables origName and Group will only appear in datasets of states that listed their hospitals on www.emscsurveys.org. For states not listing their hospitals on www.emscsurveys.org, these two columns will simply be blank.

The remaining pages of this document give all of the survey questions with their variable names and the coding for each multiple choice response



Inter-facility Transfer Guidelines/Agreements Survey

Before you get started, please tell us about your hospital in case we need to contact you for any follow up information…

BackgroundInformation:

1. Name of your Hospital: ______________________________________ hospital

2. Address: __________________________________________________ address

3. City: ______________________________________________________ city

4. Zip Code: ___________________________________________________ zip

5. Name of person completing survey: _______________________________ name

6. Job title of person completing survey: _____________________________ jobTitle

7. Phone Number: ______________________ [format: (xxx) xxx-xxxx] phone

8. Email of person completing survey: ________________________________ (format: name@place. xxx) emailAddress

Next, please tell us about your hospital’s inter‐facility transfer guidelines…

Inter‐facilityTransferGuidelines: 9) Does your hospital or medical facility have written inter-facility guideline(s) that outline

procedural and administrative policies with other hospitals for the transfer of patients of all ages including children in need of care not available at your hospital? (Select one) guidelines

NOTE: Compliance with EMTALA does not constitute having inter-facility transfer guidelines. Guidelines may be a separate document or part of an inter-facility transfer agreement document.

Yes, we have written guidelines/protocols Y Go to 10 No, we do not have written guidelines/protocols N Skip to 11 We currently do not have written guidelines/protocols, but are in the process of developing

them. inDev 9a) If you are in the process of developing guidelines, when do you anticipate the

guidelines/protocols to be ready: Month/Year (mm/yyyy): _________ Skip to 11

guidelinesDT



10) You answered that your facility has written inter-facility transfer guidelines. Please indicate

whether the guidelines /protocols include information specifically for the transfer of patients for

each item below:

a. Defined process for initiation of transfer, including the roles and

responsibilities of the referring facility and referral center (including

responsibilities for requesting transfer and communication)

component _roles_y_n

Yes Y No N

b. Process for selecting the appropriate care facility

component _facility_y_n

Yes Y No N

c. Process for selecting the appropriately staffed transport service to

match the patient’s acuity level (level of care required by patient,

equipment needed in transport, etc.) component _staff_y_n

Yes Y No N

d. Process for patient transfer (including obtaining informed consent)

component _transfer_y_n

Yes Y No N

e. Plan for transfer of patient medical record

component _record_y_n

Yes Y No N

f. Plan for transfer of copy of signed transport consent

component _consent_y_n

Yes Y No N

g. Plan for transfer of personal belongings of the patient

component _belongings_y_n

Yes Y No N

h. Plan for provision of directions and referral institution information

to family component _directions_y_n

Yes Y No N



Please tell us now about your hospital’s inter‐facility transfer agreements…

Inter‐facilityTransferAgreements:

11) Does your hospital or medical facility have written inter-facility agreement(s) with other

hospitals for the transfer of patients of all ages including children in need of care not available at your hospital? (Select one) agreements

NOTE: Compliance with EMTALA does not constitute having inter-facility transfer agreements. Agreements may be a separate document or part of an inter-facility transfer guideline document.

Yes, we have a written agreement(s) Y Go to 12 No, we do not have written agreement(s) N Go to 12 We currently do not have written agreement(s), but are in the process of developing them.

inDev

11a) If you are in the process of developing agreements, when do you anticipate the agreement(s) to

be ready: Month/Year (mm/yyyy): __________________________ agreementsDT

AdditionalInformation:

12) If you have any additional thoughts related to inter-facility transfer guidelines/protocols or

agreements or about the survey itself, please share them here: comments

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Thank you again for completing the survey!

We appreciate your time and help.


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