Newfoundland)and)Labrador)Ambulance)Program)Review) Department)of)Health)and)Community)Services) Government)of)Newfoundland)and)Labrador)
|
|
|
- Beatrix Rodgers
- 8 years ago
- Views:
Transcription
1 ConsultantFinalReport 21August2013 NewfoundlandandLabradorAmbulanceProgramReview DepartmentofHealthandCommunityServices GovernmentofNewfoundlandandLabrador FITCH&ASSOCIATES,LLC 2901WilliamsburgTerrace#G PlatteCity Missouri JaneHelleur&AssociatesInc. P.O.Box21041 St.John s NewfoundlandandLabrador A1A5B2 NewfoundlandandLabrador Page1 Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013 CONSULTANTFINALREPORT
2 ConsultantFinalReport TheFirmsagreethatconfidentialinformationabouttheClientoritsrelatedentitieswill notbereleased,exceptasrequiredbyacourtofcompetentjurisdiction,withoutthe priorapprovaloftheclient,unlessthatinformationisotherwisereleasedaspublic information.theclientagreesthatitshallnotreleasenorallowitsemployeesoragents toreleaseanyofthefirms proprietarymaterialsprovided,orutilizedduringthe process,withoutwrittenpermission. NewfoundlandandLabrador Pagei Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
3 ConsultantFinalReport EXECUTIVESUMMARY InDecember2012,Fitch&Associates,inpartnershipwithJaneHelleur&Associates (collectively,the Consultants beganacomprehensivereviewofthe NewfoundlandandLabradorProvincialAmbulanceProgramonbehalfofthe provincialgovernment sdepartmentofhealthandcommunityservices.the objectivesofthereviewincludedanalysisandrecommendationsforprogram improvements. Thereviewwasshapedbythefollowingtenant: MostEmergencyManagementService(EMSsystemsfunction accordingtodefinitionsthathavebeensetbythesystemsthemselves, orbythesystems serviceproviders.however,bydefiningand evaluatingemergencyambulanceservicefromthepatient spointof view,thefocusisonthepatientfirst:beforeanyotherinterests.in thisway,onecancomparevariousproviderservicemodelsandresults objectively,accordingtohowtheybestservethepatient,ratherthan howtheybestservetheprovider. MedicaltransportationserviceinNewfoundlandandLabradoriscomplex.Itfaces numerouschallenges,someofwhichareuniquetothegeographyoftheprovince includingalargelandmass,harshweatherandawidelydispersedservicepopulation. Theseelementsputemergencymedicalservicesandambulancetransportationin NewfoundlandSLabradortothetesteveryday. Yet,EMSisnotabouttheenvironment.Itisaboutpeople.Itisaboutthecriticallyill orinjuredpatientsandthosewhocareforthem.emsisaboutensuringatransport systemthatsafelymovespatientstohealthcarefacilitiesandservesasaneffective andefficientlinktotertiaryandspecialtyclinicalservices.itissupportedbyems personnelwhoarecommittedtohighstandardsofcare. LikemanyambulanceservicesinNorthAmerica,NewfoundlandandLabrador s AmbulanceProgrambeganasagrassroots,humanitarianefforttoaddresstheneeds oftheillorinjuredwhorequiredcareandtransporttomedicalfacilitiesinruralareas oftheprovince.thecommunityambulancesserviceswerestartedbyvolunteers withlimitedmedicaltraining.overthepastdecade,theprovincialgovernmenthas NewfoundlandandLabrador Pageii Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
4 ConsultantFinalReport investedheavilytoincreasethesizeandprofessionalismoftheprogram.for example,theroadambulanceprogrambudgethasincreasedinsizeby350%from $14millionin2001S02toalmost$50millionin2011S12. In2011S12,theNewfoundlandSLabradorAmbulanceProgramcompletednearly66,000 transportsthroughitsroadambulanceprograms,whichutilize: 61hospital,privateandcommunitybasedambulanceservices,operating171 ambulances; 3governmentownedandoneleasedairambulanceconfiguredaircraft stationedontheislandandinlabrador; 6utilityhelicoptersthatcanprovidedaytimemedevacresponse;and 800ambulanceprofessionals. Duringthereviewprocess,theConsultantsheardopinionsthat: EMSisnotbeingoperatedasefficientlyandeffectivelyasitcouldbe; Demographicshiftsarehavingasignificantimpactondemandforservice; and Provincialcostsforambulanceservicesareescalating. Despitetheincreasedinvestment,theNewfoundlandandLabradorAmbulance ProgramhasnotreacheditsfullpotentialasahighSperformanceemergency ambulanceservicethatconsistentlyandpredictablydeliversclinicalexcellence, responsestimereliability,economicefficiencyandpatient/customersatisfaction.high performanceemergencyambulanceservicesexhibitthefollowingfivehallmarks: Hallmark1 Holdingtheemergencyambulanceserviceaccountable. Hallmark2 Establishinganindependentoversightentity. Hallmark3 Accountingforallcosts. Hallmark4 Requiringsystemfeaturesthatensureeconomicefficiency. Hallmark5 EnsuringlongStermhighperformanceservice. NewfoundlandandLabrador Pageiii Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
5 ConsultantFinalReport Currently,theprovince sfundingmodelresultsinthepaymentofhighlevelsof ambulanceavailabilitywhentherearelowperiodsofambulanceservicedemand.in otherwords,theprovinceispayingforambulanceswhentheyarenotneeded.the privateandcommunityoperatorsarealsofunded,inpart,byamodelthatrecognizes volumeandpaysformileage.thisfundingmodelprovidesanincentiveforthe Program scoststoincrease. TheConsultantsalsofoundthattheNewfoundlandandLabradorAmbulance Programisnotanorganizedsystemasthereisnocentralcoordinationorlegislatively enabledauthority.further,thecurrentpoorqualityofavailabletransportdata hobblessystemimprovementorredesign. Thesurveys,interviewsanddiscussionsheldrevealedaserviceindustrydoingits best,despiteahostofchallenges. Operatorsexpressedconcernoverwidespreadworkforceshortages,unsuccessful recruitmenteffortsandlowemployeeretention.somereportedsituationswhere otherambulanceoperators,otherprovincesandevenotherindustrieshireaway staffthroughhigherpay.unscheduledandnonsemergencylateday,eveningor weekendtransfersarehinderingtheoperators abilitytoservelocalcommunities. Latenightcallsalsoplacestaffinharm sway,especiallyiftheyexperiencefatigue anddecliningweatherconditionsastheytravelacrosstheprovince. Theemergencymedicalresponders,primarycareparamedicsandadvancedcare paramedicsspokeproudlyandpassionatelyabouttheirwork.despitetheirlovefor theirprofessions,theyvoicedconcernswiththeindustry.intheprivateambulance sectorspecifically,theyidentifiedpaydisparity,longhoursandpoorqualityoflife issues.professionalsvoicedconcernswithfearofreprisal,orworse,lossof employmentforspeakingupaboutproblemsorissues. TheNewfoundlandandLabradorAmbulanceProgramisnotsufferingfromalackof determinationorcommitment.acrosstheprovinceareindividuals,groupsand communitieswithakeenfocusonsystemimprovement,innovationandsolutionsto theseissues,manyofwhichweincludeinourfindingsandrecommendations.infact, thegenesisofourrecommendationscamefromstakeholdersthemselves. Thefollowingrepresentthestrategicrecommendationstoenablethechanges requiredtooperateanefficient,effective,sustainableandqualityambulancesystem NewfoundlandandLabrador Pageiv Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
6 ConsultantFinalReport foraprovincepatientcentricmodel.alloftheserecommendationsshouldbe implementedwithinafivesyeartimehorizon,beginningnow. ImmediateRecommendations:(tobecompletedwithinthefirst18L24months" 1. Transitiontheambulance levelofeffort contractstoperformancesbased contracts.thiswillprovideforhigherlevelsofaccountabilitybyestablishing performancemetricsthataretobereportedbyallambulanceoperators.the assignmentofauditorstoassessandreportonconsistentcomplianceisan importantcomponentofthisrecommendation. 2. Clarifyambulanceoperatorroles,responsibilitiesandrightsinrelationto serviceareaexclusivity.thisisfundamentaltotheimplementationofa CentralizedMedicalDispatchCentre(CMDC. 3. CommenceimplementationofAmbulanceDispatchandManagementSystem (ADAMSwithintheRegionalHealthAuthorities. 4. EnactEmergencyMedicalServices(EMSlegislationtogoverntheambulance servicesintheprovince.thelegislationwouldprovidethedepartmentof HealthandCommunityServiceswiththeauthorityto: a. Licenseandregulateambulanceoperators; b. Establishmedicaloversightforambulanceprofessionals; c. Establishstandardsforambulancesandequipment;and d. Registerambulancevehicles. 5. BuildandoperationalizeaCentralizedMedicalDispatchCentre(CMDC. a. BegintodevelopaCMDCwithatargettobeoperationalwithin18months. Thisincludesensuringthetechnologyandtoolsexisttoelectronically captureprovinceswideservicedeliveryoutputsandperformancedatafor measuring,monitoringandqualityimprovement;and b. Intandemwiththerecentlyapproved911centre,theCDMCshouldworkin tandemwithfireandemergencyservicestoprovidefortheseamless receiptandcoordinationofemergencyrequests,effectivemedicaland operationalcontrol,realtimeperformancemonitoringandharddatafor NewfoundlandandLabrador Pagev Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
7 ConsultantFinalReport theprovince semssystemdesignandcontinuousoperational improvements. 6. EstablishEMSNewfoundlandandLabradorwithdirectaccountabilitytothe DeputyMinisterofDepartmentofHealthandCommunityServices.EMS NewfoundlandandLabradorshould: a. Assumeaccountabilityandresponsibilityforallaspectsofroadandair ambulanceservicesdeliveredbyoperatorsandagentsexceptforthe registrationandlicensureofemsprofessionals; b. Assureaccountabilityforthesystem sperformanceresultsincludinginthe areasofclinicalexcellence,responsestimereliability,economicefficiency andpatientsatisfaction; c. DefineprovincialqualitybenchmarksforthedeliveryoftheEMS NewfoundlandSLabradorsystem;and d. ReplacetheexistingPMOofficeandincorporateanOfficeofMedical Director(OMDwithinthenewgovernancestructure. MediumTermRecommendations(tobecompletedwithin36L42months 7. ReviewoptionsforselfSregulationofEMSpersonnelthroughthe NewfoundlandSLabradorCouncilofHealthProfessionalsandtheexisting HealthProfessionsAct. 8. DesignandbeginimplementationofatieredEMSresponseincludingarobust MedicalFirstResponderprogram.Inthedesignofsuchacapability,the uniqueattributesanddemographicsoftheprovince scommunitiesmustbea drivingfactorindeterminingthelevelofemspersonnelrequiredata communityandlocalareabasis. 9. Establishandimplementaplantoaddresshumanresourceissuesraisedby stakeholderstoincluderecruitment,retention,pay,benefits,qualityofwork life,trainingprogramaccessandaccreditation. LongerTermRecommendation(tobecompletedwithin48 60months 10. FinalizethedesignoftheNewfoundlandandLabradorEMSsystemandbegin implementation.thekeydataandperformanceresultsfromthe NewfoundlandandLabrador Pagevi Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
8 ConsultantFinalReport recommendationslistedabovewillhavebeencompiledforapplication validatingthefinalemssystemdesign. Noneoftherecommendationsshouldbeimplementedwithoutanunrelenting commitmenttothefundamentalreasonforthesignificantinvestmentoftime,talent andresources:thepatient.itisthepatientwhowillexperiencethemostgain. However,asignificantlyimprovedEMSwillbenefittheentireprovinceasitmoves towardahighperformanceemsservice. " NewfoundlandandLabrador Pagevii Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
9 ConsultantFinalReport ACRONYMS ACP AdvancedCareParamedics ADAMS AmbulanceDispatch&ManagementSystem ALS AdvancedLifeSupport AVL AutomatedVehicleLocation CAD ComputerSAidedDispatch CCAC CommunityCareAccessCentre CCP CriticalCareParamedic CCT CriticalCareTransport CMDC CentralizedMedicalDispatchCentre CME ContinuingMedicalEducation CAN CollegeoftheNorthAtlantic CPR CardioSPulmonaryResuscitation ECP ExtendedCareParamedic EHIS EmergencyHealthInformationSystem EHS EmergencyHealthService EMD EmergencyMedicalDispatch EMR EmergencyMedicalResponders epcr ElectronicPatientCareRecord GAS GovernmentAirServiceDivision GIS GeographicalInformationSystem GPS GlobalPositioningSystem HEMS HelicopterEmergencyMedicalServices IDR InformationDataRequest IFR InstrumentFlightRules MFS MedicalFlightService MPDS MedicalPriorityDispatchSystem OHS OccupationalHealth&Safety PCP PrimaryCareParamedics PCR PatientCareRecord(Report PMO ProvincialMedicalOversight PMT ParamedicineandMedicalTransport PSAP PublicSafetyAnswerPoint RHA RegionalHealthAuthority VOIP VoiceOverInternetProtocol NewfoundlandandLabrador Pageviii Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
10 ConsultantFinalReport TableofContents 1. INTRODUCTION BackgroundofProvincialAmbulanceProgram OrganizationsandTheirRole RoadAmbulanceServiceEvolution FixedWingAmbulanceServiceEvolution RotaryWingAmbulanceServiceEvolution AmbulanceFundingModels ProjectMethodology DescriptionofStakeholderConsultation DataCollectionMethodsandLimitations DataLimitations FINDINGS:STAKEHOLDERCONSULTATIONS PublicSurveyResults PrivateOperatorRoundtables CommunityOperatorRoundtables HospitalcBasedOperatorRoundtables AmbulanceProfessionalSurveyandTownHallResults TownHallMeetingAttendanceBarriers FINDINGS:CURRENTOPERATINGENVIRONMENT AmbulanceVolumeandCallTypes DemandandServiceDelivery ManagementofRoutineandReturnTransfers InterfacilityTransports:HubandSpoke ProgramFundingMethodsandAccountability ServiceAreaExclusivity EMSCoordinationandDispatch QualityStandards:IssuesandChallenges DataCaptureforQualityImprovement VehicleStandards AmbulanceProfessionals EMSProfessionals,TrainingandWorkforceSupply ProfessionalRegistration EMSSalaries MedicalAirServices ProvincialMedicalOversight EMSGovernanceandLegislation TOWARDSAHIGHPERFORMANCEEMSSYSTEM HallmarksofaHighPerformanceEMSSystem StaffingaHighPerformanceEMSSystem TieredSystemResponse MedicalFirstResponders AnAllSALSSystem AlternativeModelsforPreSHospitalCommunityCare EnablingTechnologyandProcessesforaHighPerformanceEMS AutomaticVehicleLocation(AVLandGlobalPositioningSystems(GPS ComputerSAidedDispatch(CADtoMobileDataTerminals CallProcessesandStandards ElectronicPatientCareRecords(ePCR EMSGovernanceandLeadership...60 NewfoundlandandLabrador Pageix Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
11 ConsultantFinalReport Governance StructureandComponentsofEMSNewfoundlandSLabrador FinancesandFunding RECOMMENDATIONSANDIMPLEMENTATIONTARGETS SUMMARY...68 ListofTables Table1:AmbulanceOperatorsperRHAandNumberofAmbulancesperRHA...7 Table2:AmbulanceProfessionalsperCategory,April Table3:TypesofFunding,WhoReceivesFundingandtheIntendedPurpose...10 Table4:AmbulanceOperatorIDRResponseRate...14 Table5:GroundAmbulanceVolumeforFY2011/ Table6:NewfoundlandLabradorAmbulanceProgramCostsforFY2011L Table7:Patient(UserFees,Fiscal2011/12(Millions...32 Table8:OperatorTrips,KilometersFunds(Fiscal2011/ Table9:MileageRatesPaidperAttendantTypeasofJanuary1, Table10:EMSLegislationinCanadianProvinces...48 Table11:AnnualCommunityAmbulanceTransports,FY2011/ ListofFigures Figure1:RHA,Populationand#ofPatientTransportsbyRHA...5 Figure2:GroundAmbulanceCallsbyTypeforFY2011/ Figure3:AmbulanceVolumebyMonth(2011L Figure4:AmbulanceDailyAverage(2011L Figure5:AmbulanceAverageWeekday(2011L Figure6:AmbulanceAverageHourlyforFY2011L Figure7:TenYearTrend:RoadAmbulanceProgramCosts2002L Figure8:TypicalCADDesign...38 Figure9:StructureandComponentsofEMSNewfoundlandLLabrador...62 ListofAnnexes AnnexA:ProjectTimeline AnnexB:PublicSurveyTemplate AnnexC:AmbulanceProfessionalSurveyTemplate. 76 AnnexD:PublicSurveyNarrative AnnexE:PublicSurveyTabularResults AnnexF:AmbulanceProfessionalSurveyNarrative...93 AnnexG:AmbulanceProfessionalTabularResults AnnexH:ManitobaExample HubandSpoke AnnexI:CallProcessing&DispatchStandards AnnexJ:AmbulanceAge&MileageComparison 143 AnnexK:AmbulanceProfessionalSalaries AnnexL:Community/MedicalFirstResponderModel WORKSCITED.150 NewfoundlandandLabrador Pagex Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
12 ConsultantFinalReport 1. INTRODUCTION MedicaltransportationserviceinNewfoundlandandLabradorisacomplexand highlyvisiblehealthcareprogram.thechallengeistoprovideappropriate,safeand timelytransportandeffectiveclinicalinterventionsinresponsetomedical emergenciesforcriticallyillorinjuredpatients.theprogrammustalsoensurea medicaltransportsystemeffectivelyservesasalinktotertiaryandspecialtyclinical services. ProvidingambulanceservicesinNewfoundlandandLabradorisnotwithoutitsshare ofchallenges.theprovincehasapopulationofjustover514,000peopleanda landmassofapproximately400,000squarekilometres.approximately92percentof theprovince'spopulationresidesontheislandportionoftheprovince(includingits associatedsmallerislandsandmorethanhalfofthetotalpopulationlivesonthe AvalonPeninsula.Hometoavarietyofclimatesandweather,fromahumidmarine climateontheislandtosubarcticandsubpolarclimatesinlabrador,transportation evenunderthebestofconditionsisnotalwayseasy.atitsworst,heavyfog,blizzard andhighwindconditionscanshutdowntransportationbetweencommunities. LikemanyambulanceservicesinNorthAmerica,theNewfoundlandandLabrador AmbulanceProgrambeganasagrassroots,humanitarianefforttoaddresstheneeds oftheillorinjuredwhorequiredcareandtransporttoahospitalorclinic.today, ambulanceservicecontinuestobuildonthelegacyofcommunitygoodwilland receivesstrongcommunityandgovernmentsupport.aswell,ambulanceservices benefitfromitspersonnelwhodeliveraconsistent,strongefforttosupportpatient care. InDecember2012,Fitch&Associates,inpartnershipwithJaneHelleur&Associates (collectively, TheConsultants,commencedacomprehensivereviewofthe NewfoundlandandLabradorAmbulanceProgramonbehalfoftheDepartmentof HealthandCommunityServices.TheprojecttimelineisincludedinAnnexA.Thus,the reviewincludedathoroughanalysisofthecurrentoperatingenvironmentand detailedanalysestosupportrecommendationsaimedatachievingahigh performanceemergencymedicalservices(emssystem. NewfoundlandandLabrador Page1of151 Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
13 ConsultantFinalReport WhiletheConsultants scopeofworkconsideredhowthemedicalairplanes helicoptersintegratewiththegroundambulanceprogram,thelocation,selection, fundingand/oroperationofemergencyairtransportationwerealloutsidetheproject scope. TheinformationreflectedinthisreportwascollectedfromDecember1,2012to March8,2013.Whereveravailable,threeSyearprogramdatawascollected. Benchmarksforstandardsandperformancecriteriaweredeterminedthrough industryguidesandstandards,nationalandprovincialpracticesandinternational industryguidelines. 1.1 BackgroundofNewfoundlandandLabradorAmbulanceProgram Asimportantcontextforthisreport,itisfirstnecessarytoprovidebackground informationaboutthenewfoundlandandlabradorambulanceprogram. TheprimarymandateoftheProgramistorespondtopatientsinemergency situations.however,ambulancesandaircraftarealsoutilizedfortheconveyanceof patientsrequiringspecializedmedicalattentionortestsatanothermedicalfacility. Therearethreeprograms,including: 1. TheRoadAmbulanceProgramwhichcontractswith27privateambulance operators,22communityambulanceoperatorsand12hospitalbasedservices witheachdeliveringserviceintheirrespectiveregions.throughtheroad AmbulanceProgram,approximately66,000patientsaretransferredannually. 2. TheFixedWingAmbulanceProgram,theaircraftareoperatedbythe GovernmentAirServiceDivision(GASofTransportationandWorks,with3 governmentsownedkingairsandamonthstosmonthleasedcitationjet.the medicalcomponentisoperatedbyeasternhealth sparamedicineandmedical Transportdepartment.ThroughtheFixedWingAmbulanceProgram, approximately1,200patientsaretransferredannuallythroughoutthe provinceandtooutsofsprovincefacilities. 3. Rotarywing(helicopteremergencymedicalevacuationsareprovided throughouttheprovincethroughtheuseofsixutilityconfiguredbell206and 407helicoptersleasedbyGASfromUniversalHelicoptersLimited.These helicoptersarealsousedbyseveralgovernmentdepartmentsforsearchand NewfoundlandandLabrador Page2of151 Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
14 ConsultantFinalReport rescue,firefighting,wildlifetracking,etc.in2011/12therewereapproximately 80RWmedicalflights:40weremedevacsandanother40flightswere scheduledtotransportphysiciansandpatientstoandfromremote communities.ifthebellhelicoptersarenotavailable,gaswillcalluponthe DepartmentofNationalDefenseSearchandRescue(SARorcharterCougar HelicoptersLimited OrganizationsandTheirRole ThissectionintroducestheorganizationsinvolvedintheNewfoundlandand LabradorAmbulanceProgram. Department"of"Health"and"Community"Services" TheDepartmentofHealthandCommunityServicesprovidesleadershipinhealthand communityservicesprogramsandpolicydevelopmentfortheprovince.this involvesworkinginpartnershipwithanumberofkeystakeholdersincludingregional HealthAuthorities(RHAs,communityorganizations,professionalassociations,postS secondaryeducationalinstitutions,unions,consumersandothergovernment departments. TheDepartmentofHealthandCommunityServicesprovidesfunding,leadspolicy andprogramdevelopment,monitorsandprovidessupporttotherhasforthe deliveryofambulanceprogramsintheirregion. " Regional"Health"Authorities" FourRHAsdeliverhealthprogramsandservicestothecitizensoftheirregion.These are: 1. EasternHealth 2. CentralHealth 3. WesternHealth 4. LabradorSGrenfellHealth Figure1identifiesthegeographicareasservicedbyeachRHAandidentifiesthe approximatenumberofambulancetransfersineachregion. NewfoundlandandLabrador Page3of151 Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
15 ConsultantFinalReport EachRHAhasaParamedicineandMedicalTransportstaffthatmanagestheir hospitalsbasedambulanceservicesandoverseestheoperationsoftheprivateand communitysbasedambulanceoperatorsintheirregion. TheDepartmentofHealthandCommunityServiceshasdelegatedfourProgram responsibilitiestoeasternhealth sparamedicineandmedicaltransport(pmt DivisiontoprovidethefollowingservicestoalltheRHAs: 1. RegionalServices Monitorscomplianceandperformancetoprovincial ambulancepolicesandadherencetoprovincialstandards.themedical CommunicationsCenter(MCCprovidesmedicalcommunicationsand dispatchcoordinationforprovincialairambulance,onslinemedicalcontrol, androadambulanceservicessuchasnortheastavalon911medicaldispatch, provinceswideroadambulancedispatchforrcmp,royalnewfoundland ConstabularyandtheHealthLine,aswellaslongSdistancetransport coordinationfromtertiarycarecentresinst.john s. 2. FinancialServices Processesallambulanceoperatormileage/attendant claimsforeachtransfercompletedintheprovince.privateandcommunity operatorssendtheirclaimstofinancialserviceswheretheclaimsare adjudicatedagainstthedepartmentofhealthandcommunityservices rules andregulationsandthenapprovedforpayment.batchesofapprovedclaims aresenttotherhasforpayment. 3. ProvincialMedicalOversight(PMOProgram SeethePMOSectionbelow fordetails.pmoalsoadministerstheprovincewidepurchaseofnew technology. 4. MedicalFlightTeam Ateamof12flighttrainedRegisteredNursesand AdvancedCareParamedicsflyontheprovincialfixedwingandrotarywing aircraft.recruitmentandtrainingisunderwayforasecondmedicalflight TeamtobestationedinHappyValleySGooseBaytoserviceLabradorand northernnewfoundland. NewfoundlandandLabrador Page4of151 Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
16 ConsultantFinalReport Figure"1:"RHA,"Population"and"Number"of"Patient"Transports"by"RHA" Source:DepartmentofFinanceNewfoundlandandLabradorStatisticsAgencyandParamedicineandMedical TransportAnnualReport2009S10 " Provincial"Medical"Oversight" Allparamedicinepersonnelpracticingintheprovincecarryoutstandardizedmedical diagnosisandtreatmentprotocolsthatarerequiredduringtransport,underthe licenseoftheprovincialmedicaldirectorforparamedicineandmedicaltransport. TheProvincialMedicalOversight(PMOProgramwasestablishedtosupportthe registrationandmedicaldelegationtoattendantsthroughfourfunctions: 1. ActsastheProvincialRegistrarofAmbulanceAttendantsthroughthe followingactivities: a. Reviewandapproveofeligibilitytopracticerequirements; NewfoundlandandLabrador Page5of151 Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
17 ConsultantFinalReport b. Administertheentrytopracticeexam; c. Administertheannualprotocolexams; d. Overseeandtracktheattendants ContinuingMedicalEducation courses;and e. Trackattendants clinicskillscompletionrequirements. 2. WorkswiththeMedicalDirectortoestablishandupdatetheBasicLife Support,AdvancedLifeSupportandCriticalCareTransportprotocols. 3. Provides24/7onSlinemedicalcontroltoattendantswhorequiretheadviceof aphysicianduringatransfer. 4. Qualityassurancemonitoringandcontinuousqualityimprovementofthecare providedbyattendantsthroughauditandinvestigationofpatientconcerns. Road"Ambulance"Operators" The61provincialroadambulanceserviceslicensedbythePublicUtilitiesBoardare classifiedinoneofthreecategories: 1. PrivateAmbulance 27privatebusinessesprovideroadambulanceservicesin designatedgeographicareas.dependingonthesizeoftheservicean operatormayhavebetweentwoandtenambulancesintheirfleet.therehas beenageneraltrendtowardsconsolidation,withlargeroperatorsbuyingthe licensesandassetsofsmalleroperators. 2. CommunityAmbulance 22volunteerornotSforSprofitorganizationsprovide ambulanceservicesindesignatedgeographicareas.mostcommunity ambulanceoperatorshaveoneambulanceintheirfleet. 3. HospitalAmbulance In12regionalcentres,RHAshavetheirownambulance servicesthatarestaffedbyhospitalemployees. " AmbulanceoperatorsperRHAandambulancenumbersperRHAarelistedinTable1. " " " " NewfoundlandandLabrador Page6of151 Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
18 ConsultantFinalReport " Table"1:"Ambulance"Operators"per"RHA"and"Number"of"Ambulances"per"RHA"(2012" RegionalHealth Authority Private Operators Community Operators 2012 Hospital Operators Total Numberof Ambulances Eastern Central Western LabradorSGrenfell Total Source:EasternHealth PMTDivision Currently,the61operatorsworkindependentlyfromeachotherwithintheirdefined serviceareasandeachhastheirowndispatchprocess. Therearetwoassociationsrepresentingtheprivateambulanceoperatorsandone associationrepresentingthecommunityoperators.noformalassociation representingthehospitalsbasedambulanceservicesexists.thecurrentambulance ServiceAgreementforprivateandcommunityoperatorsexpiredonMarch31,2012. Theagreementisautomaticallyrenewedforsuccessiveperiodsof180days. Emergency"Medical"Service"Professionals" Therearethreecategoriesofroadambulanceattendantsintheprovince.Their minimumtrainingrequirementsareasfollows: EmergencyMedicalResponder(EMRS2weeksclassroomtraining; PrimaryCareParamedic(PCPS8monthsclassroomtrainingwithaclinical skillscomponent;and AdvanceCareParamedic(ACPSPCPqualificationplus16monthsofadditional classroomtrainingwithanadvancedclinicalskillcomponent. Table2belowoutlinesthebreakdownofEMSstaffintheprovince. NewfoundlandandLabrador Page7of151 Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
19 ConsultantFinalReport Table"2:"Ambulance"Professionals"per"Category,"April"2012" Category NumberofAmbulanceProfessionals AdvancedCareParamedic(ACP 30 PrimaryCareParamedic(PCP 444 EmergencyMedicalResponders(EMR 336 Total 810 Source:ProvincialMedicalOversight Government"Air"Services" GovernmentAirServices(GASoperatesairassetsonbehalfoftheGovernmentof NewfoundlandandLabradorandservesfourambulancefunctions: 1. Operates(pilots,maintenance,etc.threeGovernmentownedKingAirs.Two arestationedinst.john sandoneinhappyvalleysgoosebayinlabrador. Theaircraftareusedtotransferpatientstoandfromtheprovince shealth carefacilitiesandoutsofsprovincefacilities. 2. ManagestheuseofaCitationjet(onmonthStoSmonthretainertothe DepartmentofHealthandCommunityServicesusedforrapidemergency responseofthemedicalflightteamandthejanewaychildrenhospital s NeonatalTeamfromSt.John stolabradorandforthetransportationof patientstoandfromoutsofsprovincemedicalfacilities. 3. ManagesthecharterofsixnonSdedicatedutilityBell206&407helicopters stationedaroundtheisland.whenusedformedevacsorbushrescues,the helicoptersareconvertedtocarryastretcherandmedicalattendants. 4. Overseestheselectionandmovementoffixedandrotarywingassetswhen requiredforairtransfersandmedevacsthroughacentralizeddispatch operation RoadAmbulanceServiceEvolution PriortoApril1,2005,anEmergencyHealthServicesDivisionwithintheDepartment ofhealthandcommunityserviceswasresponsiblefortheambulanceprogram.this divisionwasresponsibleforalloperationalissues,medicalcontrol,registrationof ambulancepersonnelandvehicles,policydevelopmentaswellasnegotiations NewfoundlandandLabrador Page8of151 Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
20 ConsultantFinalReport relatedtotheserviceagreementsbetweenthedepartmentandtheindividual ambulanceoperators. OnApril1,2005,responsibilityforoperationalissuesrelatedtotheroadandair ambulanceprogramwasdevolvedtotherhas.theprovincialgovernmenthas maintainedresponsibilityforcontractnegotiationswithprivateandcommunity operatorsaswellasthedevelopmentandmaintenanceofprovincialpolicies, proceduresandoperationalstandards FixedWingAmbulanceServiceEvolution Theprovincialgovernmenthasoperatedafixedwingairambulanceservicesincethe early1960s.inthelastthreeyears,theprovincialgovernmentinvestedinnew aircraftwiththepurchaseoftwonewstateoftheartkingair350sinanair ambulanceconfiguration.theprovincehasanetworkofairportsandairstrips adjacenttomedicalfacilitieswhichallowsforasystemofairtransporttomove patientstotheappropriatelevelofmedicalcare RotaryWingAmbulanceServiceEvolution Sincethelate1960stheprovincialgovernmenthascharterednonSdedicatedutility helicoptersthatprovidemedevacservices.theunderlyingmedevacprincipleisthe stabilizationofthepatientbeforeflightandthemonitoringofthepatientduringthe flighttothenearestmedicalfacility.thesehelicoptersoperateundervisualflight rules(vfrandarenotavailableforuseatnightandinperiodsofinclementweather. Inemergencysituationsrequiringinstrumentflightoperationsand/orinvolvingnight operations,thedepartmentofnationaldefense(dndsearchandrescue(sar helicopters(stationedinganderandinhappyvalleysgoosebaymayprovide assistance AmbulanceFundingModels " Road"Ambulance"Program" HospitalSbasedambulanceservicesreceiveannualglobalfundingthroughtheRHA s operatingbudgets.privateandcommunityoperatorsreceivefundingasoutlinedin Table3. " " NewfoundlandandLabrador Page9of151 Fitch&Associates,LLC AmbulanceProgramReview JaneHelleur&AssociatesInc. DepartmentofHealthandCommunityServices 21August2013
Newfoundland)and)Labrador)Ambulance)Program)Review) Department)of)Health)and)Community)Services) Government)of)Newfoundland)and)Labrador)
21August2013 NewfoundlandandLabradorAmbulanceProgramReview DepartmentofHealthandCommunityServices GovernmentofNewfoundlandandLabrador FITCH&ASSOCIATES,LLC 2901WilliamsburgTerrace#G PlatteCity Missouri
REQUEST FOR PROPOSALS
DEPARTMENT OF HEALTH AND COMMUNITY SERVICES REQUEST FOR PROPOSALS CENTRAL MEDICAL DISPATCH CENTER AND ASSOCIATED TECHNOLOGY PLANNING PROJECT September 8, 2015 1 Health and Community Services - Request
Mike Provencher, Policy Analyst, Paramedicine and Medical Transport Division.
PAGE 1/5 Concurrent Policy Name: Private / Corporate Services Medical Oversight Authorization Issuing Authority Signature/Date Original Signed July 29, 2009 Office of Administrative Responsibility Author
911 Phone System: Telecommunicator Furniture PHONE & FURNITURE TOTAL: 22,080.00. Software Expenditures
911 Phone System: cost 9-1-1 trunk line charges 8,280.00 Basic line charge only **One administrative line per call-taking position Interpretive Services Selective Routing and ALI provisioning 13,800.00
Using ECVET and EQAVET principles: some early experiences at national level
AF2015 AF2015 DOC3 DOC3 Some experiences of working together Using ECVET and EQAVET principles: some early experiences at national level June 2015 Page0 TABLE OF CONTENT Background. I II The work of the
CONSULTANT REPORT. THE GOVERNMENT OF MANITOBA Minister of Health. March 2013. Manitoba EMS System Review
March 2013 Manitoba EMS System Review THE GOVERNMENT OF MANITOBA Minister of Health Reg Toews, Project Lead Consultant Supported by Fitch & Associates CONSULTANT REPORT Manitoba EMS System Review Page
A Guide to Planning One-Call Services. Simplifying Access to Transportation Services & Information
A Guide to Planning One-Call Services Simplifying Access to Transportation Services & Information Today s Session Presentation of project process & results Discussion: What is your experience? Currently
How To Succeed At Motthaven Community High School
ADDITIONAL WAYS TO GRADUATE QUICK REFERENCE GUIDE YOUR OPTIONS: Stay at your school. Depending on your age and school history (credit accumulation and Regents examinations) staying in or returning to your
ใบงานท ๕ เร อง เคร องม อทางภ ม ศาสตร รอบต วเรา และล กษณะสาค ญ
ใบงานท ๕ เร อง เคร องม อทางภ ม ศาสตร รอบต วเรา และล กษณะสาค ญ ต วช ว ด : ส งท น กเร ยนพ งร และปฏ บ ต ได มฐ. ส ๕.๑ (๑) จ ดประสงค การเร ยนร. ศ กษากระบวนการทางภ ม ศาสตร โดยการเล อกใช เคร องม อทางภ ม ศาสตร
By:!Geoffrey!Smith! Major!Research!Project!for!the!Ted!Rogers!School!of!Management s! MBA!in!the!Management!of!Technology!and!Innovation!Program!
Measuring*the*Performance*of*Toronto s* Business'Incubators By:GeoffreySmith MajorResearchProjectfortheTedRogersSchoolofManagement s MBAintheManagementofTechnologyandInnovationProgram August19 th,2013
Thinking about bringing your EMS Billing In-House?
Thinking about bringing your EMS Billing In-House? Presented by: Stacey Bickford, Product Manager Summary NAAC CEU Approved! Assumptions Outsourcing Your Billing Example Outsourcing Costs Bringing Billing
FY17 PSAP GRANT PROGRAM APPLICATION
FY17 PSAP GRANT PROGRAM APPLICATION VIRGINIA INFORMATION TECHNOLOGIES AGENCY Integrated Services Division FY17 PSAP GRANT PROGRAM APPLICATION HOW TO APPLY/DEADLINE The grant application is available and
Littering Behavior in America
LitteringBehaviorinAmerica ResultsofaNationalStudy PreparedforKeepAmericaBeautiful January,2009 910W.SanMarcosBlvd.,Ste.108SanMarcos,CA92078 www.takeactionresearch.com 2009KeepAmericaBeautiful TABLEOFCONTENTS
CONSENT CALENDAR AGENDA ITEM NO. 7 BOARD OF DIRECTORS MEETING November 20, 2014
CONSENT CALENDAR AGENDA ITEM NO. 7 BOARD OF DIRECTORS MEETING November 20, 2014 TO: FROM: SUBJECT: Board of Directors, Orange County Fire Authority Brian Stephens, Assistant Chief Support Services Department
หน วยการเร ยนร ท 1 เร อง การใช เคร องม อทางภ ม ศาสตร รายว ชาท น ามาบ รณาการ ศ ลปะ, เศรษฐศาสตร 1. มาตรฐานการเร ยนร ประจ าหน วย ส 5.1 ม.1/1 ส 5.1 ม.
หน วยการเร ยนร ท 1 เร อง การใช เคร องม อทางภ ม ศาสตร รายว ชาท น ามาบ รณาการ ศ ลปะ, เศรษฐศาสตร 1. มาตรฐานการเร ยนร ประจ าหน วย ส 5.1 ม.1/1 ส 5.1 ม.1/2 2. ต วช ว ดช นป ท เก ยวข อง ส 5.1 ข อ 1 เล อกใช เคร
Foster Care/Texas State Adoption Frequently Asked Questions
FosterCare/TexasStateAdoption FrequentlyAskedQuestions Q:WhyshouldIbecomepartoftheInternationalFamilyServicesfamily? A:Therearealotofreallygreatagenciesthatyoucanworkwith.Wefeelthatourbestassetisthat whenyouworkwithus,wetreatyoulikefamily.weknowthatwhenyoubringachildintoyourhome
Colorado Springs - Fire Department and Traffic Management Center
Colorado Springs - Fire Department and Traffic Management Center City of Colorado Springs This project is being utilized by the City to improve the delivery of public safety services. It is a combination
REQUEST FOR PROPOSALS. EMS BILLING AND COLLECTION SERVICES and ELECTRONIC PATIENT CARE REPORTING (epcr)
REQUEST FOR PROPOSALS EMS BILLING AND COLLECTION SERVICES and ELECTRONIC PATIENT CARE REPORTING (epcr) Page i Table of Contents 1.0 Background... 2 2.0 Proposal Submission... 2 3.0 Scope of Work... 2 3.1
How To Classify A Community
Public Protection Classification Summary Report Alachua Co FD FLORIDA Prepared by Insurance Services Office, Inc. 4B Eves Drive, Suite 200 P.O. Box 961 Marlton, New Jersey 08053-3112 (856) 985-5600 July
County of Brant Ambulance
CCTU New Business I received a copy of the Ministry Press release on the implementation of the Critical Care Paramedic Initiative proposed for the province and the Hamilton Region. The HHS has not been
CONSULTANT REPORT EMS ASSESSMENT. Schertz EMS Schertz, Texas. March 11, 2013. Prepared by:
March 11, 2013 EMS ASSESSMENT Schertz EMS Schertz, Texas Prepared by: FITCH & ASSOCIATES, LLC 2901 Williamsburg Terrace #G Platte City Missouri 64079 816.431.2600 www.fitchassoc.com CONSULTANT REPORT Schertz
BOARD OF SUPERVISORS HEALTH COMMITTEE PRESENTATION. BOARD OF SUPERVISORS HEALTH COMMITTEE PRESENTATION January 28, 2013 ALAMEDA COUNTY EMS
BOARD OF SUPERVISORS HEALTH COMMITTEE PRESENTATION January 28, 2013 EMS SYSTEM OVERVIEW EMS SYSTEM OVERVIEW Response system consists of dispatch, first responder agencies, transporting ambulance providers,
CE Activity List - Credits Already Assigned EMACCS Submit Approved Activies Form
CE Activity List - Credits Already Assigned EMACCS Submit Approved Activies Form Please note: This list is provided as a reference for commonly submitted continuing education activities. You may submit
Security and Emergency Services Community of Interest 2151 Emergency Dispatching Career Road Map
Security and Emergency Services Community of Interest 2151 Emergency Dispatching Career Road Map Prepared by: Booz Allen Hamilton Career Progression within the 2151 Emergency Dispatching Occupational Series
McLellan s+brook+asbestos+disposal+facility+
McLellan sbrookasbestosdisposalfacility ArchaeologicalResourceImpactAssessment DavisMacIntyre&AssociatesLimited 1 09JohnStewartDrive,Dartmouth,NSB2W4J7 McLellan sbrookasbestosdisposalfacility ArchaeologicalResourceImpactAssessment
cover next page > cover next page > Cover
cover Cover cover next page > title : Applying the Rasch Model : Fundamental Measurement in the Human Sciences author : Bond, Trevor G.; Fox, Christine M. publisher : Lawrence Erlbaum Associates, Inc.
Threat!and!Vulnerability!Assessments!
ThreatandVulnerabilityAssessments https://www.cybersecdefense.com @cybersecdefense 13720JetportCommerceParkway STE13 Ft.Myers,FL33913 COPYRIGHT 2015,CybersecurityDefenseSolutions,LLC ALLRIGHTSRESERVED
Newfoundland and Labrador Medical Flight Service: Fixed Wing Aircraft, Staffing and Scheduled Multi-load Air Shuttles
22 December 2014 Newfoundland and Labrador Medical Flight Service: Scheduled Multi-load Air Shuttles Department of Health and Community Services Government of Newfoundland and Labrador FITCH & ASSOCIATES,
Session Initiation Protocol Gateway Call Flows and Compliance Information
Session Initiation Protocol Gateway Call Flows and Compliance Information Corporate Headquarters Cisco Systems, Inc. 170 West Tasman Drive San Jose, CA 95134-1706 USA http://www.cisco.com Tel: 408 526-4000
Statements in bold are directly from the statute IC 36-8-16.7-38.
Statements in bold are directly from the statute IC 36-8-16.7-38. Permitted uses of distribution by PSAPs; annual reports to board by PSAPs; state board of accounts annual audit of PSAP expenditures; review
Electric Power from Competitive Sources
Ultra-Systems Technology Pty Ltd Fuel & Power Experts Electric Power from Competitive Sources prepared for Report No: c1056 June, 1999 ELECTRIC POWER FROM COMPETITIVE SOURCES EXECUTIVE SUMMARY CONTENTS
EMERGENCY HEALTH SERVICES PATIENT CARE REPORTING MINIMUM DATA SET
Health Information Data Standard HEALTH INFORMATION STANDARDS COMMITTEE FOR ALBERTA EMERGENCY HEALTH SERVICES PATIENT CARE REPORTING MINIMUM DATA SET Status: Approved - Amendment Version 1.2 Status Date:
AUGUSTA, MAINE. Emergency Medical Dispatcher Certification and License Renewal Information Revised July 30, 2014
STATE OF OF MAINE DEPARTMENT OF OF PUBLIC SAFETY MAINE EMERGENCY MEDICAL SERVICES 15216 STATE EDISON HOUSE DRIVE STATION AUGUSTA, MAINE 04330 04333 PAUL R. LEPAGE GOVERNOR JOHN E. MORRIS COMMISSIONER JAY
CIVIL AVIATION DEPARTMENT MINISTRY OF TRANSPORT AND CIVIL AVIATION REP OF MALDIVES FLIGHT ATTENDANT TRAINING STANDARD TABLE OF CONTENTS
TABLE OF CONTENTS TABLE OF CONTENTS...TOC - i RECORD OF REVISIONS... ROR - v LIST OF EFFECTIVE PAGES...LEP - vi INTRODUCTION SYLLABUS SYL-i Introduction...1 Program Overview...1 Applicability...3 Flight
SHARED EMS SERVICE OPTIONS PHASE II REPORT RESOLVING THE CHALLENGES A COMMUNITY SOLUTUION FOR DEERFIELD, SUNDERLAND AND WHATELY
SHARED EMS SERVICE OPTIONS PHASE II REPORT RESOLVING THE CHALLENGES A COMMUNITY SOLUTUION FOR DEERFIELD, SUNDERLAND AND WHATELY Bruce Baxter and Associates Haverhill, Massachusetts November 7, 2012 1 Executive
2008 / 2009. Focused. Professionalism Accountability Responsiveness Teamwork Wellness. Focused 2008 / 2009. British Columbia Ambulance Service
Focused 2008 / 2009 o n d e l i v e r i n g c a r e Focused 2008 / 2009 British Columbia Ambulance Service 1 Table of Contents Overview Provincial Profile Regional Profile Vision, Mission and Goals Services
Calling 9-1-1: What You Need to Know. Cathy Clark October 2011
Calling 9-1-1: What You Need to Know Cathy Clark October 2011 9-1-1 Regulations 2 9-1-1 is common across North America, but not Europe where 9-9-9 is often used In Canada, there is no specific legislation
Module Two: EMS Systems. Wisconsin EMS Medical Director s Course
: EMS Systems Wisconsin EMS Medical Director s Course Objectives List the components of EMS systems Outline organizational and design options for EMS systems Outline system staffing and response configurations
Lesson 2: Technology Applications Major Transit Technologies Grouped by Function
Technology Tool Accounting Software Automatic Passenger Counters (APC) Automated Scheduling and Routing Software Automated Vehicle Location Systems (AVL) Communications Computer-Assisted Software for Demand
Agreement between the County of Monterey and American Medical Response West Agreement No.: A-11610 Page i BOARD OF SUPERVISORS RESOLUTION - ORIGINAL
Page i BOARD OF SUPERVISORS RESOLUTION - ORIGINAL Page ii Page iii Page iv BOARD OF SUPERVISORS ORDER AMENDMENT 1 Page v Page vi BOARD OF SUPERVISORS ORDER AMENDMENT 2 Page vii Page viii Page ix Page x
RescueNet Dispatch. Next-Generation Computer-Aided Dispatch
RescueNet Dispatch Next-Generation Computer-Aided Dispatch RescueNet Dispatch makes call taking and dispatching for emergent and non-emergent ambulance organizations more efficient, economical, and organized.
Paramedic Re-Registration Log Book & Information Guide
Appendix: A PDN: 6012.03 Last Updated: August 20, 2013 Subject: Paramedic Re-Registration Log Book & Page 1 of 15 Paramedic Re-Registration Log Book & $ Re-Registration is due ABIENNIALLY@ on the 1 st
Connecticut s Compliance. Enhanced 9-1-1
The Status of Connecticut s Compliance with Enhanced 9-1-1 By Jennifer Herz Introduction Enhanced 911 (E 911) is a program regulated by the Federal Communications Commission (FCC). The goal of this program
IAC Ch 132, p.1. 641 132.1 (147A) Definitions. For the purpose of these rules, the following definitions shall apply:
IAC Ch 132, p.1 641 132.1 (147A) Definitions. For the purpose of these rules, the following definitions shall apply: Ambulance means any privately or publicly owned ground vehicle specifically designed,
A report by the University of Vermont Transportation Research Center. Vermont Statewide Travel Demand Model - A Preliminary Evaluation
A report by the University of Vermont Transportation Research Center Vermont Statewide Travel Demand Model - A Preliminary Evaluation Report # 10-007 May 2010 VermontStatewideTravelDemandModel APreliminaryEvaluation
WINTER WEIGHT TRAINING PROGRAM FOR CYCLING
Body2Bike WinterWeightTrainingProgramforCycling WINTERWEIGHTTRAININGPROGRAMFORCYCLING BASICPRINCIPLES First4 6weeks: Technique: Thisisyourhighestpriority,neversacrificetechniqueforweight.Beginwithlongerrepsofbetween12and16
Government Information Technology Agency State-wide Technology Contracting Issues
A REPORT TO THE ARIZONA LEGISLATURE Performance Audit Division Performance Audit Government Information Technology Agency State-wide Technology Contracting Issues JANUARY 2003 REPORT NO. 03 01 Debra K.
IDA Corporation. Company Overview. Applications LOCATION U.S.A. CONTACT INFORMATION. History. Mission Statement. Product and Service Offerings
IDA Corporation History The Way for 2-Way Company IDA has over 30 years of industry leadership in providing integrated 2- way radio remote control systems and custom GPS/AVL solutions. Using radio and
Emergency Medical Services System in Greene County Assessment of EMS Operations and Options for Improving Service
Emergency Medical Services System in Greene County Assessment of EMS Operations and Options for Improving Service September, 2014 Prepared for: Greene County Ambulance Task Force Greene County Rural Health
IMPORTANT 9-1-1 INFORMATION
IMPORTANT 9-1-1 INFORMATION Telsist wants to ensure that our customers are aware of important differences in the way the 9-1-1 services operate with a VoIP phone when compared with traditional telephone
Community Referrals by EMS. An Extension of Service
Community Referrals by EMS An Extension of Service Paramedics Often the first point of contact to the healthcare continuum Strong patient advocacy skills First hand knowledge of the patient s living conditions
Central 911SMS & Central All-Text For Emergency Mobile Text Communication For People Who Cannot Use Voice Calls
Central 911SMS & Central All-Text For Emergency Mobile Text Communication For People Who Cannot Use Voice Calls (Version 2.3 7-1-2011) The quick, affordable, universal, no training approach to providing
SIERRA-SACRAMENTO VALLEY EMS AGENCY PROGRAM POLICY REFERENCE NO. 450
SIERRA-SACRAMENTO VALLEY EMS AGENCY PROGRAM POLICY REFERENCE NO. 450 PURPOSE: To establish minimum standards for the integration of EMS aircraft and flight personnel into the EMS prehospital patient transport
Rural General Practitioner Anaesthesia Locum Program (RGPALP) Policy. Ministry of Health
Policy Ministry of Health Revised June 2014 Page: 2 of 10 Section: 1 Description, Administration, and Funding Effective: June 2014 1.1 Description The helps eligible rural general practitioners who provide
Ambulance Control. Procedure. Call Taking / Address Verification / Dispatch. National Ambulance Service (NAS)
Ambulance Control Procedure Call Taking / Address Verification / Dispatch National Ambulance Service (NAS) Document reference number Revision number NASCC032 Document developed by 2 Document approved by
Fleet Management System for BPOs & Call Centers
Ideation Technology Solutions Ideation Technology Solutions Private Limited www.ideationts.com DA 10, First Floor, Sector I Salt Lake, Kolkata 700064 Phone: +91 33 23584010 India TABLE OF CONTENTS 1. PROPOSED
Food Deserts in the Inland Empire Locating space for urban gardens in Ontario, California
FoodDesertsintheInland Empire LocatingspaceforurbangardensinOntario, California AshleyMcCoy PomonaCollege,EnvironmentalAnalysis Readers:CharMiller,MariaTucker December2010 TableofContents Acknowledgements...2
DISPATCHING. get the right information at the right time to the right people EVERY CALL
DISPATCHING get the right information at the right time to the right people EVERY CALL? TM What are we all about? We re about reliability, delivering products you can trust, services that help communications
Integrated Command and Control Center Solutions for Public Safety
Integrated Command and Control Center Solutions for Public Safety TETRA - P25 - LTE - CAD We live in a rapidly changing world, and the time has come for critical communications systems to either evolve
Guide to Senior Services in Pike County. Pike County Ambulance Service 640 W. Washington Phone: 217-285-4334 Pittsfield, Illinois 62363
Emergency Services: Guide to Senior Services in Pike County Pike County Ambulance Service 640 W. Washington Phone: 217-285-4334 American Red Cross 117 S. Memorial Phone: 217-285-2813 Provides food, clothing,
cover cover next page >
cover cover next page > title : Chocolate and Cocoa : Health and Nutrition author : Knight, Ian. publisher : Blackwell Publishing Ltd. isbn10 asin : print isbn13 : 9780632054152 ebook isbn13 : 9780632061921
Public Safety Answering Point Consolidation
Report for Public Safety Answering Point Consolidation Prepared for Ohio Department of Administrative Services November 2013 ARCHITECTURE ENGINEERING COMMUNICATIONS TECHNOLOGY AVIATION CIVIL CONSTRUCTION
Public Transport Planning and Regulation: An Introduction
VII. Service Monitoring Public Transport Planning and Regulation: An Introduction VII-1 Planning and Analysis Building Blocks Schedule Building Cost Analysis and Financial Planning Measures & Standards
British Columbia Ambulance Service. Helping Save Lives. Annual Report 09/10
British Columbia Ambulance Service Helping Save Lives Annual Report 09/10 Table of Contents Table of Contents Table of Contents Message from the Chief Operating Officer...3 About Us...4 Top Stories from
How it works: Step 1
How it works: Step 1 99% of CAD systems can do this without modification Email is sent to a unique email address for your agency Example: 1234-nDhWorjDjw@alert.active911.com How it works: Step 2 Message
NG9-1- 1 Deployments in U.S.A.
NG9-1- 1 Deployments in U.S.A. Presented to EENA 112 Commi
Emergency Medical Services Ambulance Transport Provider Agreement. County of Alameda and Paramedics Plus, LLC
Emergency Medical Services Ambulance Transport Provider Agreement County of Alameda and Paramedics Plus, LLC June 2010 TABLE OF CONTENTS DEFINITIONS AND ACRONYMS... VII RECITALS OF AUTHORITY... 1 SCOPE
Montgomery County Computer Aided Dispatch Roadmap Study
Montgomery County Computer Aided Dispatch Roadmap Study March 23, 2009 Prepared for Montgomery County Government Department of Technology Services Rockville, MD 20850 Prepared by Tetra Tech, Inc. 10306
2.5 Long Distance Ambulance Transports
2.5 Long Distance Ambulance Transports Data provided by the Southern Health Board (SHB) in the RoI indicated a significant number of long distance journeys in 2001 among a total of 40,232 patient transports
WEBINAR Best Practices for Rural Traffic Safety Webinar Series CrashHelp: An Innovative Tool to Assist in Rural EMS Response
WEBINAR Best Practices for Rural Traffic Safety Webinar Series CrashHelp: An Innovative Tool to Assist in Rural EMS Response March 1, 2012, 3:00-4:00 p.m. Eastern Sponsored by the University of Minnesota
AACP Public Health SIG Newsletter Issue 3 December 2010 SIG Officers 2010 2011 SIG Committees and Chairs
AACPPublicHealthSIGNewsletter Issue3December2010 AACPPublicHealthSIG Fall2010Newsletter TableofContents Page1 2:GuidelinesandResourcesinPublicHealthforAcademicPharmacy Page3:SIGCollaborationwithinAPHA
SECURITY AND EMERGENCY VEHICLE MANAGEMENT
SECURITY AND EMERGENCY VEHICLE MANAGEMENT Index Purpose Description Relevance for Large Scale Events Options Technologies Impacts Integration potential Implementation Best Cases and Examples 1 of 10 Purpose
POLICIES AND PROCEDURES MANUAL
Sunnybrook Regional Base Hospital Program POLICIES AND PROCEDURES MANUAL MAY 23, 2014 VERSION 1.0.0 2 P age Table of Contents PREAMBLE... 4 SECTION 1... 5 AVAILABILITY OF THE SUNNYBROOK REGIONAL BASE HOSPITAL
Public Safety Communications 1 Union Avenue 203-946-6321 / 9-1-1
Public Safety Communications 1 Union Avenue 203-946-6321 / 9-1-1 Acting Department Head: George Peet, Deputy Director 203-627-3064 Additional Point Person: Same Positions: GF- 57 SF- 20 General Fund Budget:
Emergency Medical Services Division. Emergency Medical Services Dispatch Policies and Procedures
Division Dispatch Policies and Procedures November 12, 2015 Edward Hill EMS Director Kristopher Lyon, M.D. Medical Director TABLE OF CONTENTS I. GENERAL PROVISIONS... 2 II. DEFINITIONS... 3 III. MEDICAL
2 www.aircriticalcare.com
Every patient has a right to the best medical care possible. Unfortunately for some individuals, the access to these facilities is not nearby. Some patients may require long distance medical transportation
Information Technology. April 19, 2012
Information Technology April 19, 2012 1 Overview Mission Statement Department Goals Key Performance Indicators 2011 Annual Customer Survey Scope of IT Services How Do We Improve IT Services Must Address
BY WAY OF EXAMPLE, BUT NOT LIMITATION, THE FOLLOWING COSTS ARE 911 FUND ELIGIBLE (as approved by the North Carolina 911 Board on 2/08/2008):
BY WAY OF EXAMPLE, BUT NOT LIMITATION, THE FOLLOWING COSTS ARE 911 FUND ELIGIBLE (as approved by the North Carolina 911 Board on 2/08/2008): IF YOU HAVE QUESTIONS ABOUT EXPENDITURES NOT LISTED, PLEASE
STATE OF THE STATE 9-1-1 OFFICE
State of California Office of the Chief Information Officer Public Safety Communications Division 911 Emergency Communications Office DAPHNE RHOE Office Chief STATE OF THE STATE 9-1-1 OFFICE 2009 CALNENA
Livestock Gross Margin Insurance for Dairy Farms What is it? Do I need it? What will it cost? A guide for Ohio dairy producers.
Cameron Thraen Thraen.1@osu.edu March 11, 2011 Livestock Gross Margin Insurance for Dairy Farms What is it? Do I need it? What will it cost? A guide for Ohio dairy producers. Prepared for the Risk Management
Los Angeles Regional Interoperable Communications System
Los Angeles Regional Interoperable Communications System Public Safety Broadband Network Update Technical/Operations Committee Meeting March 4, 2014 Agenda Approval of September 27, 2012 Minutes New Business
Review of Operations of Ground Emergency Medical Services in Alberta
Review of Operations of Ground Emergency Medical Services in Alberta In Accordance with Section 15 (1) of the Health Quality Council of Alberta Act January 2013 Promoting and improving patient safety and
MONTANA PUBLIC SAFETY SERVICES OFFICE
MONTANA PUBLIC SAFETY SERVICES OFFICE STATEWIDE E9-1-1 and WIRELESS DEPLOYMENT PLAN - 1 - Project Summary Enhanced 9-1-1 Assessment of Existing Problems The 9-1-1 Program is responsible for administering
JusticeConnect AVL for Windows SETUP GUIDE
JusticeConnect AVL for Windows SETUP GUIDE 1 Table of Contents JusticeConnect AVL Procure Software... 3 JusticeConnect AVL Deploy Software... 3 JusticeConnect AVL First Time Setup... 4 JusticeConnect AVL
NG9-1-1 Explained. John Chiaramonte, PMP, ENP. April 14, 2011
NG9-1-1 Explained John Chiaramonte, PMP, ENP April 14, 2011 Today s 9-1-1 Progress since the first-ever 9-1-1 call in 1968 (Haleyville, Alabama) Late 1960 s 1970 s 9-1-1 is established across the U.S.,
OETS. Update. December 2010
OETS Update December 2010 If Your PSAP is Getting 9-1-1 Calls from 500 Miles Away, You May Be a Regional PSAP In spite of all of the efforts to maintain your PSAP as the sole provider of 9-1-1 service
GIS System Development Project
Application of Southern California Gas Company for authority to update its gas revenue requirement and base rates effective on January 1, 2012. (U904G) Application No. 10-12- Exhibit No.: (SCG-13-CWP)
Review of Operations of Ground Emergency Medical Services in Alberta
Review of Operations of Ground Emergency Medical Services in Alberta In Accordance with Section 15 (1) of the Health Quality Council of Alberta Act January 2013 Promoting and improving patient safety and
Benefits. Benefit Plan Orientation
Benefits Benefit Plan Orientation Benefit Plan Orientation BENEFIT PLANS RETIREMENT PLAN GROUP LIFE INSURANCE PLAN DISABILITY INCOME PLAN ENHANCED DENTAL & EXTENDED HEALTH PLAN Retirement Plan SHEPP Saskatchewan
MONOC s Paramedic Services;
MONOC s Paramedic Services; How We Determine What to Charge and Why it Seems so Much? A State Mandated, Unique Two-Tier System There are two levels of EMS (emergency medical services) in New Jersey. They
Patrice Randle, City Auditor Craig Terrell, Assistant City Auditor Roshan Jayawardene, Internal Auditor. Ambulance Services Audit September 2012
Patrice Randle, City Auditor Craig Terrell, Assistant City Auditor Roshan Jayawardene, Internal Auditor Ambulance Services Audit September 2012 Ambulance Services Audit Table of Contents Page Executive
RECORDING & LOGGING CAPABILITIES of 112 PSAP s in TURKEY
RECORDING & LOGGING CAPABILITIES of 112 PSAP s in TURKEY Talip Küçükkılıç, M.Sc. Senior Expert Engineer, aselsan tkucukkilic@aselsan.com.tr +90 312 592 1462 1 ASELSAN Brief Information OUTLINE ASELSAN
Emergency Medical Dispatch Task Force. February 18, 2016
Emergency Medical Dispatch Task Force February 18, 2016 Agenda Welcome Introductions Purpose / Objectives Task Force Scope Task Force Operations Work Groups Deliverables Next Steps Adjourn Santa Clara
Fire Suppression Rating Schedule
Fire Suppression Rating Schedule INSURANCE SERVICES OFFICE, INC. Insurance Services Office, Inc., 2012 Page 1 FIRE SUPPRESSION RATING SCHEDULE Table of Contents Section 100 Introduction Chapter I Public
City of Los Angeles Department of Public Works Bureau of Sanitation. Pre-Qualified Sanitation On-call Consultant Services Contract
City of Los Angeles Department of Public Works Bureau of Sanitation Pre-Qualified Sanitation On-call Consultant Services Contract Task Order Solicitation for Implementation of Fleet Optimization Program
REQUEST FOR INFORMATION. Electronic Patient Care Reporting ISSUED BY: NAPA COUNTY PUBLIC HEALTH EMERGENCY MEDICAL SERVICES
REQUEST FOR INFORMATION Electronic Patient Care Reporting ISSUED BY: NAPA COUNTY PUBLIC HEALTH EMERGENCY MEDICAL SERVICES Release Date: November 24, 2014 Due Date: December 19, 2014 Send inquiries via
Emergency Medical Services Division. EMS Quality Improvement Program May 15, 2015
Emergency Medical Services Division EMS Quality Improvement Program May 15, 2015 Edward Hill EMS Director Kris Lyon, M.D. Medical Director Contents I. Authority... 2 II. Mission Statement... 2 III. Vision
THE ROLE OF GIS IN PSAP AND RESPONDER OPERATIONS
THE ROLE OF GIS IN PSAP AND RESPONDER OPERATIONS Thought Paper: The Role of GIS in PSAP and Responder Operations In the past, PSAP personnel and responders were dependent on wall maps and map books for
White Paper. Delivery Management. HME/DME Technology Series:
White Paper Effective delivery management software can result in substantial cost savings to the HME provider, while improving customer service and reducing DSO. www.cprplus.com Introduction Through the
Internet Standards - Emergency Services
Internet Standards - Emergency Services Hannes Tschofenig (Chair IETF ECRIT Working Group) Mail comments to Hannes.Tschofenig@nsn.com and/or ecrit@ietf.org. Architectural Considerations Layer 7 VoIP, Inc.