EMS World

DEC 2014

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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NEWS NETWORK moved past their "doing more with less" discussions and are exploring alternative reimbursement options. From payers to hospitals, everyone is beginning to recognize the fnancial implications of the prehospital experi- ence, in part because of the role of EMS in affecting downstream medical costs. This presents an opportunity for EMS, said Glenn Leland, MBA Pro Transport-1's chief strategy offcer. For the frst time, instead of being a commodity, EMS has some leverage. Leland offered practical suggestions for those negotiations. He said payers, such as insurance companies and the government, are too price-sensitive and often too diffcult to deal with— instead, he suggests negotiating with health facilities and nursing profes- sionals to leverage services. Because EMS provides an effcient alterna- tive and unique experience, it's well positioned to take advantage of the opportunity healthcare reform affords. However, it will take some prepara- tion. "We have to be a different kind of provider to help them adjust to change," Leland notes. Several speakers offered examples of programs that lower costs and improve patient care. In Mesa, AZ, the fre department has incorpo- rated its change in philosophy—from emergency care delivery to commu- nity care—into its name: The Mesa Fire and Medical Department is the recipient of a Round 2 CMS Innova- tion Grant to implement a program that adds two transitional response vehicles and two community care units to its 20 ALS engines and fve ALS medic units. The department's medical director, Gary Smith, MD, offered a caveat to agencies considering realigning to ft more closely with the ideals of health- care reform: If EMS agencies expect to be paid for performance, "our perfor- mance has to improve," he said. How patients are managed and the quality of care they receive must be consis- tently high. He noted that the service provided a year ago won't be good enough today. He also advocated for advanced certifcation and licenses for frefghters. Pinnacle 2015 will be held August 3–7 at the Omni Amelia Island Planta- tion Resort in Jacksonville, FL. For more information, see http://pinnacle- ems.com. Teresa McCallion, EMT, recently served as the associate editor of Integrated Healthcare Delivery . Todd Stout, president of FirstWatch (left); Jack Stout, "the father of high-performance EMS" (center); and Jay Fitch, president of Fitch & Associates (right), pictured after the opening ceremony at Pinnacle. During the ceremony, Jack was presented with the Pinnacle Lifetime Achievement Award, while son Todd received the Pinnacle Emerging Leader Award. "You don't need to get a seat at the table—you need to earn a seat at the t able." The U.S. remained relatively unscathed as West Africa's Ebola crisis stretched into November, but EMS systems shouldn't get complacent—the outbreak exposed serious vulnerabilities many need to repair. It's raised several issues, says infection-control expert Katherine West, RN, of Infection Control/Emerging Concepts in Manassas, VA. "First, we have not given enough training and attention to the proper use of PPE and transmission-based precautions," West says. "Second, we tend to fall of of asking travel histories on patients. Getting travel histories began with SARS, then bird fu, then H1N1 and MERS, and still it is not consistently being done. This needs to be on all patient assessment sheets!" The CDC recommends PPE with full body coverage for those who care for Ebola patients, with training and procedures to support its proper use and removal. Per the CDC, travel histories should focus on countries with widespread transmission. In one of those, Liberia, the rate of new infections seemed to be in decline. But Sierra Leone was seeing sharp increases, and WHO ofcials emphasize that cases can appear to fall or level of, only to surge again later. A third issue for American EMS systems is that OSHA requires compliance monitoring in its bloodborne-pathogens and tuberculosis plans, and many departments don't do it. "Compliance monitoring," says West, "is how we identify noncompliance and the need for retraining." EMS systems should continue to follow guidance from the CDC, WHO and other reputable bodies, and should, as in all areas, be guided by science over fear and emotion. ADDITIONAL RESOURCES • Latest CDC Ebola guidance—www.cdc. gov/vhf/ebola/hcp/index.html • World Health Organization Ebola page—www.who.int/csr/disease/ebola/ en/ • PPE guidance—http://www.cdc.gov/ vhf/ebola/hcp/procedures-for-ppe.html • EMS preparedness checklist— www.cdc.gov/vhf/ebola/pdf/ems- checklist-ebola-preparedness.pdf • EMS EVD screening tool— www.cdc.gov/vhf/ebola/pdf/ evd-screening-criteria.pdf • EMS World November article— www.emsworld.com/article/12010347. Ebola Update: Get Your Travel Histories 18 DECEMBER 2014 | EMSWORLD.com

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