Oahu EMS Update. Rick Bruno MD DOH District Medical Director, Oahu Vice President HEPA

Transcription

1 Oahu EMS Update Rick Bruno MD DOH District Medical Director, Oahu Vice President HEPA

2 Oahu EMS Contacts HEMS quality report/complaints procedure: Immediate assistance: (808) ; Offline quality issues: For other questions:

3 Oahu EMS Topics EMS data for 2014 YTD Transportation guideline revisions New Medical Directives M&M conference Stresses on system Topics for 2015 Discussion

4 Ambulance Volume ~ 4,300 transports/month

5 Destination Facilities

6 Pre Closing of Hawaii Medical Center

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8 Metro Destination (Charlie)

9 Central Oahu (Aiea unit)

10 West Oahu (Nanakuli)

11 Central Oahu (Wahiawa unit)

12 Summary (2011 vs. 2014) System Volume: stable Destination Facilities: Town facilities stable, slightly up QMC West above HMCW Pali Momi up Kaiser, WCCHC to historic norms WGH and TAMC down Better able to stay in geographic area

13 OAHU REROUTE DATA (2014)

14 Inclusive of data from all facilities (Central, Metro & Windward) Down >30% since June

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17 Windward Oahu No significant reroute issue!!! Total 2014 YTD < 40 hrs

18 Turnaround Time All units meet mean time of 20 minutes All facilities meet mean time of 20 minutes Drilled down on % > 20minutes by facility

19 Fallouts from Turnaround Times

20 Oahu Data Summary Volume stable Reroute down 30+++% Units more able to stay in geographic area Turn around times meet standard Across units Across facilities Some outliers on tails

21 Oahu Pre-Hospital Transportation Guidelines Update

22 Transportation Guidelines Rules by which ambulances bring you patients Present are from 2010 In process of updating: Completed hospital capabilities survey Rough presented at October M&M Await input from stake holders Issue early 2015

23 Relevant Transport Updates Many housekeeping items Communication requirements Integrated 2014 Trauma triage guidelines Inter-facility transfers Reroute language

24 MICT Communications EMS/Facility Communications: Many different policies in past, varying success Regional variation At present MICT Communicate: After Standing Order utilized At medic discretion 2014 Revisions: Nurse Communication Physician Communication Special Consideration (Trauma, OB, Accommodation)

25 Inter-Facility Transport Inter-facility Transfers by 911 Covered under SO A-22 Different from AMR requirements* 2014 Revisions: Role of Base station physician Only MD who can order transfer Only MD that MICT can take orders from Drop off and Pick ups outside ED Must have appropriate hospital person accompany in facility

26 Reroute Updated Guidelines Goal is to balance: Hospital requirement to manage at capacity times EMS system needs 2014 Revisions: Ambulance reroute is a courtesy by EMS Closing/opening facility is hospital decision Define roles of Hospital & EMS in times of capacity Working with EMS & HAH Future changes to parallel IT updates and other changes in Dispatch

27 Hospital Resource Capabilities List for EMS of hospital resources 2014 Revisions: General Updates, mostly house keeping Added Stroke Team Updated PTCA STEMI receiving sites Updated EKG receiving sites

28 Other Updates

29 New Medical Directives for 2014 Suspended: 2012 Transport Directive: Reroute in Central Oahu Dual communication with Kapiolani on Pediatrics Added: Communication of special needs Blood transfusion protocol Refusal after hypoglycemia and no transport

30 New Base Stations May 2014 Queens Medical Center West Oahu Kahuku Medical Center Now has CT Scanner

31 M&M Conference Meet every other month Each facility has MD and Admin reps EMS agencies (HEMS, AMR, Fed Fire, HFD) Purpose is to review quality issues by Base Station Physicians and stakeholders Offline medical oversight of our EMS system Case review Focus on common system issues Share information

32 Current EMS Issues on Oahu Central/West reroute Dialysis No dialysis capacity past H1/H2 merge Lots of Dialysis patients central/west Oahu Role of WCCHC in our system Level III Trauma sites Pali Momi Castle

33 Focus for 2015 Updated Transportation Guidelines Central/West reroute Changes in the Communication Center IT enhancement with WebEOC integration into CAD, fleet eyes, Optima Predict Data driven dispatch and management of system New EMS electronic medical record

34 Discussion

35 Oahu EMS Contacts HEMS quality report/complaints procedure: Immediate assistance: (808) ; Offline quality issues: For other questions: