MATTHEW CONSTANTINE DIRECTOR EMERGENCY MEDICAL …...KMC 30 1 24 KVH 3 28 0 MER 31 0 30 MSW 31 0 30...
Transcript of MATTHEW CONSTANTINE DIRECTOR EMERGENCY MEDICAL …...KMC 30 1 24 KVH 3 28 0 MER 31 0 30 MSW 31 0 30...
EMERGENCY MEDICAL SERVICESSYSTEM COLLABORATIVE
MEETINGThursday
April 5, 2018
MATTHEW CONSTANTINEDIRECTOR
INTRODUCTIONS
MATTHEW CONSTANTINEDIRECTOR
ReddiNetBed Availability / MCI Response
MCI Response
February
Notice Resp
BHH 4 0
BMH 4 4
DRMC 2 1
KMC 4 4
KVH 3 1
MER 4 4
MSW 4 4
RRH 3 3
SJCH 4 4
Tehach 3 3
March
Notice Resp
BHH 3 3
BMH 3 1
DRMC 2 2
KMC 3 3
KVH 1 1
MER 3 3
MSW 3 3
RRH 1 1
SJCH 3 2
Tehach 1 1
0
2
4
6
8
10
12
BHH BMH DRMC KMC KVH MER MSW RRH SJCH Tehach
40.00% 80.00% 66.67% 100.00% 60.00% 100.00% 100.00% 100.00% 90.00% 100.00%
4 8 4 10 3 10 10 5 9 5
10 10 6 10 5 10 10 5 10 5
Year To Date
Alerts
Responses
Patient Distribution
I D M Total
BHH 0 0 0 0 0.00%
BMH 0 0 5 5 14.29%
DRMC 0 0 2 2 5.71%
KMC 2 0 9 11 31.43%
KVH 0 0 0 0 0.00%
MER 2 0 2 4 11.43%
MSW 0 0 0 0 0.00%
RRH 0 2 8 10 28.57%
SJCH 1 0 2 3 8.57%
Tehach 0 0 0 0 0.00%
Total 35
Pt Dist
Bed Availability
February
Number of
Days
B.A.
Reported
Number of
Days
B.A. not
reported
Number of
Days B.A.
reported >1
BHH 28 0 20
BMH 28 0 28
DRMC 27 1 19
KMC 28 0 27
KVH 4 24 1
MER 28 0 28
MSW 28 0 27
RRH 28 0 27
SJH 28 0 27
THD 11 17 0
Bed Availability Reporting
March
Number of
Days
B.A.
Reported
Number of
Days
B.A. not
reported
Number of
Days B.A.
reported >1
BHH 31 0 22
BMH 31 0 30
DRMC 27 4 20
KMC 30 1 24
KVH 3 28 0
MER 31 0 30
MSW 31 0 30
RRH 31 0 29
SJH 31 0 29
THD 10 21 0
Bed Availability Reporting
8689
8285
10
89 89 89 88
44
60
86
54
73
1
86
82 8284
10
0
10
20
30
40
50
60
70
80
90
100
BHH BMH DRMC KMC KVH MER MSW RRH SJH THD
2018
Number of Days B.A. Reported Number of days B.A. reported >1
Patient Offload to Triage
• Public Comment Period ended March 5th.
• One comment was received
Our triage and acceptance protocols are designed to
expedite the transfer of care from the ambulance to our ED
staff. Our APOD times demonstrate our ability to manage
this process. Our new ED when completed isolates the
“Ambulance Entrance” from the “Public Entrance”
significantly. While this policy would not work at our facility,
we do not want to inhibit its adoption and implementation
elsewhere.
Effective Date
• Effective date is Monday, April 9th, at 12:01hrs.
APOTMarch 2018
APOT-1: March 2018Rank Hospital Number of Transports APOT-1 (Minutes)
1 Ridgecrest Regional 218 7.7
2 Kern Valley Healthcare District 142 13.4
3 Delano Regional Medical Center 250 22
5 Tehachapi Hospital 107 34.1
6 Mercy Hospital 500 38.4
6 Kern Medical 763 46.3
7 Mercy Southwest Hospital 548 46.9
8 (9) Adventist Health 1564 49.8 (93.5)
9 Bakersfield Memorial 1365 78.6
10 Bakersfield Heart Hospital 248 81.4
APOT-1 Bakersfield Hospitals: June 2017-March 2018
0
20
40
60
80
100
120
140
June July August September October November December January February March
AP
OT-
1 (
min
ute
s)
Month
Adventist Health Bakersfield Bakersfield Heart Hospital Bakersfield Memorial Hospital
Kern Medical Mercy Hospital Mercy Southwest Hospital
APOT-1 Outlying Area Hospitals: June 2017- March 2018
0
5
10
15
20
25
30
35
40
45
June July August September October November December January February March
AP
OT-
1(m
inu
tes)
Month
Delano Regional Medical Center Kern Valley Healthcare District Ridgecrest Regional Tehachapi Hospital
APOT-1 and Transport Volume
March 2018, Weekly
Bakersfield Hospitals
0
100
200
300
400
500
600
700
800
900
1000
1100
1200
0
20
40
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120
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Week 1 Week 2 Week 3 Week 4
Tota
l Vo
lum
e o
f Tr
ansp
ort
s
Ap
ot-
1 T
ime
(M
inu
tes)
Week (March 2018)
Adventist Health Bakersfield Bakersfield Heart Hospital Bakersfield Memorial Hospital
Kern Medical Mercy Hospital Mercy Southwest Hospital
Outlying Area Hospitals
0
20
40
60
80
100
120
140
160
180
200
0
10
20
30
40
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60
Week 1 Week 2 Week 3 Week 4
Tota
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nsp
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Vo
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AP
OT-
1 (
Min
ute
s)
March 2018
Delano Regional Medical Center Kern Valley Healthcare District Ridgecrest Regional Tehachapi Hospital
APOT-2Individual Hospital Data
APOT-2: March 2018Hospital 2.1 (N, %)
(<=20 min)2.2 (N, %)(21-60 min)
2.3 (N, %)(61-120 min)
2.4 (N, %)(121-180 min)
2.5 (N, %)(>180 min)
Total Numberof Transports
Bakersfield Memorial Hospital 390 (28.6) 759 (55.6) 161 (11.7) 3 (2.4) 23 (1.7) 1367
Adventist Health Bakersfield 628 (40.2) 853 (54.5) 70 (4.5) 12 (0.77) 0 (0) 1564
Bakersfield Heart Hospital 87 (35.1) 127 (51.2) 18 (7.3) 9 (3.6) 7 (2.8) 248
Mercy Hospital 265 (54) 220 (44.8) 6 (1.2) 0 (0) 0 (0) 548
Kern Medical 285 (37.4) 447 (58.6) 29 (3.8) 2 (0.3) 0 (0) 763
Mercy Southwest Hospital 242 (44.2) 286 (52.2) 19 (3.5) 1 (0.2) 0 (0) 500
Kern Valley Healthcare District 135 (95.1) 5 (3.5) 2 (1.4) 0 (0) 0 (0) 142
Tehachapi Hospital 73 (68.2) 32 (30) 2 (1.9) 0 (0) 0 (0) 107
Delano Regional Medical Center 220 (88.4) 28 (11.2) 1 (0.4) 0 (0) 0 (0) 249
Ridgecrest Regional 216 (99.1) 2 (0.9) 0 (0) 0 (0) 0 (0) 218
Adventist
0
500
1000
1500
2000
2500
0
10
20
30
40
50
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90
100
June July Aug Sept Oct Nov Dec Jan Feb March
Tota
l Tra
nsp
ort
Vo
lum
e
Pe
rce
nt
of
Tota
l Tra
nsp
ort
s (%
)
Month
2.1 2.2 2.3 2.4 2.5
Bakersfield Memorial
0
200
400
600
800
1000
1200
1400
1600
1800
2000
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
100.0
June July Aug Sept Oct Nov Dec Jan Feb March
Tota
l Tra
nsp
ort
Vo
lum
e
Pe
rce
nt
of
Tota
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nsp
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s
Month
2.1 2.2 2.3 2.4 2.5
Bakersfield Heart Hospital
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50
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150
200
250
300
350
400
0.0
10.0
20.0
30.0
40.0
50.0
60.0
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90.0
100.0
July Aug Sept Oct Nov Dec Jan Feb March
Tota
l Tra
nsp
ort
Vo
lum
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Pe
rce
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of
Tota
l Tra
nsp
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s
Month
2.1 2.2 2.3 2.4 2.5
Proportion of Kern County ED Visits Reporting ILI with Fever: 2017-2018
0.0
2.0
4.0
6.0
8.0
10.0
12.0
September October November December January February March
Pe
rce
nt
Ill
Month
Data prepared by Jyoti Kaur, MPH
Kern County: Total Number of Acute Care Interactions, Oct 2017-March 2018
36540
32316
32707
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15000
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Extra Slides
Transport Volume By Hospital
Week 1 Week 2
349, 30%
55, 5%
321, 28%
168, 14%
134, 11%
139, 12%
Adventist HealthBakersfield
Bakersfield HeartHospital
BakersfieldMemorial Hospital
Kern Medical
Mercy Hospital
Mercy SouthwestHospital
384, 32%
67, 6%310, 26%
185, 16%
126, 11%
107, 9%
Adventist HealthBakersfield
Bakersfield HeartHospital
BakersfieldMemorial Hospital
Kern Medical
Mercy Hospital
Mercy SouthwestHospital
Transport Volume by Hospital, Cont.
Week 3 Week 4
328, 31%
41, 4%
312, 29%
187, 18%
89, 8%
111, 10%Adventist HealthBakersfield
Bakersfield HeartHospital
BakersfieldMemorial Hospital
Kern Medical
Mercy Hospital
Mercy SouthwestHospital
367, 33%
60, 6%
277, 25%
155, 14%
111, 10%
133, 12%
Adventist HealthBakersfield
Bakersfield HeartHospital
BakersfieldMemorial Hospital
Kern Medical
Mercy Hospital
Mercy SouthwestHospital
Transport Volume by Hospital
Week 1 Week 2
51, 31%
40, 24%
55, 33%
19, 12%
Delano RegionalMedical Center
Kern ValleyHealthcare District
Ridgecrest Regional
Tehachapi Hospital
64, 37%
33, 19%
51, 30%
24, 14%
Delano RegionalMedical Center
Kern ValleyHealthcare District
RidgecrestRegional
Tehachapi Hospital
Transport Volume by Hospital, Cont.
Week 3 Week 4
50, 32%
28, 18%
54, 34%
25, 16%
Delano RegionalMedical Center
Kern ValleyHealthcare District
Ridgecrest Regional
Tehachapi Hospital
62, 40%
21, 14%
41, 27%
29, 19%
Delano RegionalMedical Center
Kern ValleyHealthcare District
RidgecrestRegional
Tehachapi Hospital
ALS to BLS November 2017- February 2018
November percentage
November 2017
December Percentage
December 2017
January Percentage
January 2018
February Percentage
February 2018
EMD QI
• Emailed the QI group first meeting will be April 19th
11:00 – 12:00.
•We will start looking at EMD cards starting with Bravo cards.
•Discuss on ways to improve the EMD process/QI
EMT RegulationsEffective July 2018
EMT Regulations
• Effective July 1, 2017 Blood glucose testing, Epinephrine and Naloxone are in the EMT’s basic scope of practice.
• EMT regulations required EMT course content include Tactical Casualty Care, Naloxone Epinephrine and assessing a blood glucose with a glucometer.
• The Epinephrine and Naloxone must be a minimum of 2 hours. The Tactical Casualty Care must be a minimum of 4 hours.
• Training programs must submit evidence of compliance within 12 months. Training programs and provider will be getting a letter for evidence of compliance and will need to submit for approval.
HP-CPR
• HP-CPR Protocol changes are through 30 day public comment period with no comments received.
• Implementation will be tomorrow April 9th 2018, at 12:01am.
• All providers should be ready to implement if they have not already done so.
Pediatric Determination of Death
• Recent studies and current best practices suggest that on scene resuscitation efforts provide a far higher ROSC and survival rate than resuscitation efforts while transporting for both Adult and Pediatric populations.
• On scene resuscitation is more effective for patients and is far safer for providers, patients, family and the general public.
• If the scene becomes unstable then transport is encouraged, it is up to provider discretion with base consult as to whether resuscitation should be continued during transport.
Determination of Death Pediatric Change
• Currently all patients under 18 years are immediately transported if no signs of obvious death.
• Proposed change is to work pediatric patients on scene for 30 minutes as we do with adults currently. Standard exception for social issues and unsafe scene will remain.
• Base contact for termination of efforts for all patients < 15 shall be required.
Mandatory Paramedic Update Training
Mandatory Paramedic Update Training
MONDAY THE 21ST AND FRIDAY THE 25TH WILL BE MORNING SESSIONS ONLY, 4 HOURS EACH SESSION.
TUESDAY, WEDNESDAY, AND THURSDAY THE 22ND,23RD & 24TH WILL BE MORNING AND AFTENOON SESSIONS 4 HOURS EACH SESSION.
AGENDA
Time Presenter Topic
0805-0810 1305-1310 Jeff Fariss Welcome/Local Accreditation
0810-0820 1310-1320 Kimberly Tollison IGel
0820-0835 1320-1335 Kimberly Tollison Core Measures
0835-0850 1335-1350 Nick Lidgett Paramedic Handoff/Transport directly to the
waiting room/Wellbeing Notification of Death
Online Program
0850-0905 1350-1405 Nick Lidgett Chem Pack
0905-0935 1405-1435 George Baker Protocol Changes/New Protocol Format. EMT
Epi Administration/ D-10
Administration/Intubation
0935-0950 1435-1450 Charles Brockett PCR Review/Documentation
0950-1000 1450 -1500 Break Break
1000-1025 1500-1525 Jeff/Dr. STEMI Center Presentation
1030 1055 1530-1555 George/Dr. Pediatric Center Presentation
1100-1125 1600-1625 Charles Brockett/Dr. Trauma Center Presentation
1130-1155 1630-1655 Kim/DR. Stroke Center Presentation
ANNOUNCEMENTS
MATTHEW CONSTANTINEDIRECTOR
THANK YOU FOR COMING
MATTHEW CONSTANTINEDIRECTOR