EMS World

DEC 2018

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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10 DECEMBER 2018 | EMSWORLD.com O ver the last 11 months, we've brought you strategies to imple- ment a few of the most signifi- cant recommendations of the Promoting Innovation in EMS (PIE) proj- ect. This final installment summarizes the strategies. Project Summary The PIE project evolved from the recogni- tion by three federal agencies with over- sight responsibility for EMS—the National Highway Traffic Safety Administration (NHTSA), the Health and Human Services Office of the Assistant Secretary for Pre- paredness and Response (ASPR), and the Department of Homeland Security (DHS)—that there are common regula- tory, legislative, and financial barriers to EMS innovation faced in nearly every com- munity. While there may be federal-level policy changes that could impact these, there are also many opportunities for local and state EMS leaders and partners to help overcome them. The project team interviewed internal and external stakeholders to get diverse perspectives on impediments to the desired state of EMS in our country. This group helped identify numerous common barriers across seven different domains and devel- oped around 250 actionable recommenda- tions aimed at local and state EMS leaders. External stakeholder organizations rep- resented included the Emergency Nurses Association, Visiting Nurse Associations of America, National Association of County and City Health Officials, Cigna Health- Spring, Kaiser Permanente, Geisinger Health System, Johns Hopkins Bloom- berg School of Public Health, Mesa (Ariz.) City Council, and Institute for Healthcare Improvement. This broad representation provided keen insight into how to overcome barriers to innovation. Members of the NAEMT EMS 3.0 Com- mittee combed through the PIE recom- mendations and developed a triage/scor- ing methodology to help identify those that could be addressed first and then ranked them based on: • Feasibility—The likelihood of the recom- mendation being implemented, main- tained, and sustained; • Value—Does the recommendation posi- tion EMS to demonstrate enhanced value to our stakeholders? • Alignment—The extent to which the recommendation aligns with the EMS 3.0 mission. This process helped focus on innova- tion strategies with the greatest potential to advance the EMS profession. For our final column in this series, we wanted to sum- marize the seven main themes of the series: the ingredients for successful innovation, quality measures and data, demonstrating value for EMS, decoupling payment from transport, EMS association alignment, edu- cation and medical oversight, and enhanc- ing the business acumen of EMS providers. 1. Ingredients for Successful Innovation • Visionary leadership—Innovation begins with a visionary leader—someone who can see something new and better than the status quo. It requires a telescopic view of the horizon, with a firm understanding of the realities of the local environment. • Risk tolerance—Innovation is messy. There's a chance innovation could fail. It's often said failure is only failure if you fail to learn. While risk can be mitigated by thorough planning, execution, and small- scale rapid-cycle testing and pilots, not everything will work perfectly. Develop a tolerance for risk you're comfortable with. • Organizational readiness—Some organi- zations are known for being nimble and embracing change, others for being slow to innovate or adapt. Assessing organiza- tional readiness for innovation is crucial for transformation. It requires an honest assessment of visionary leadership and risk tolerance of the organization's internal and external stakeholders. 2. Quality Measures and EMS Data The recommendation with the highest overall priority score focused on the need for EMS to determine ways to prove value. The EMS Compass project, highlighted in the PIE document, was an excellent first step toward developing quality measures that could demonstrate the value of effec- tive EMS delivery. While that project unfortunately sunset- ted, a new initiative has been undertaken to continue the work. With seed funding from NHTSA, the new National EMS Quality Alli- ance (NEMSQA) has developed an organiza- tional structure, steering committee repre- sentation, and a project plan to identify and adopt quality measures for EMS. 3. Demonstrating the Value of EMS Data The second-highest-rated recommenda- tion related to promoting EMS data as valu- able to the rest of the healthcare system. In today's healthcare environment data, PROMOTING INNOVATION IN EMS A review of the year's PIE project content summarizes its key lessons By Matt Zavadsky, MS-HSA, NREMT, and Kevin G. Munjal, MD, MPH Innovation: What We've Learned Over the last year we've explored key recommendations of the Promoting Innovation in EMS (PIE) project. The PIE project utilized broad stakeholder involvement over four years to identify and develop guidance to overcome common barriers to innovation at the local and state levels and foster development of new, innovative models of healthcare delivery within EMS. Find earlier columns in the series under the monthly magazine issue archives at EMSWorld.com.

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