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	The Pit Crew Concept: Improving the EMS Performance Process 10,000 Links in the Chain of Survival Photo ID e-PCR: Electronic Patient Care Report EMS Needs Assessment Study Paramedic Integration Law Enforcement – 1st Responder & CPR-D Training Recruitment And Retention Champaign Service Management Training for Recruitment And Retention Public Access Defibrillation – Pad (CPR-D) Training Pad in Schools Automatic External Defibrillation Placements Camp “RTE” EMS Youth Corps Non-Urgent Medical Transportation Study EMS Volunteer Recruitment and Retention Manual EMS Handbook for Schools Not-For-Profit Incorporation On-Line Training Program Files-of-Life EMS Medical Director Course St-Rescue Rural Health Community Systems Web Site Development FREE HeartCode™ Interactive ACLS & BLS Learning System Training 10,000 Links in the Chain of Survival Sudden cardiac arrest is a killer! But more people can be saved with the new program offered by the Rural Health Community Systems, Inc. "10,000 Links in the Chain of Survival." During the next three-years RHCS and partners will train 10,000 Steuben County residents in CPR (cardiopulmonary resuscitation) - that is ten percent of the county's residents. "This is a massive undertaking," said Art Jones, RHCS Coordinator of Network Initiatives, adding "but we are ready and confident in the program's success." The chain of survival is: Call 911, Perform CPR until an AED (automated external defibrillator) is available or the EMS arrives. Immediate CPR is one of the keys to survival in a sudden cardiac arrest. To pick up the pace of CPR education, Rural Health Community Systems, Inc. partners will provide the instruction to all interested Steuben County residents. The Greater Steuben Chapter of the American Red Cross offers Certification Classes in CPR/AED at a small fee. Also one-hour awareness classes utilizing the American Heart Association's Friends and Family will be offered at no charge. It is the hope to maintain training sites in 19 locations across the county on a monthly basis. For more information, see the RHCS website at www.10000linksCPR.com. Photo ID In this day and age it is important that EMS providers be identified when on the emergency scenes, at hospitals, and attending training events. EMSTAR established a regional Photo ID program and Rural Health Community System has been taking the program to EMS providers in Steuben County. The network coordinator has been traveling the county, taking photos for the ID badges. Network partner, the Steuben County Sheriff's Department, has been processing the badges for the EMS providers. To date 155 photos have been taken for ID Badges by RHCS. Contact Art Jones at 794-0759 if you need an EMS ID badge. Art can come to your agency or you can stop in at the RHCS office on the 2nd floor of the Bath Municipal Building to have your photo taken. e-PCR: Electronic Patient Care Report What Is It? Rural Health Community Systems, Inc. and EMSTAR, the regional EMS program agency, are implementing an electronic (computer based) substitute for the traditional hand written paper Pre-hospital Care Report. Why Use It? The use of the electronic PCR System has many advantages for the individual EMS provider, the patient, the EMS agency, the receiving hospitals, and the EMS system: More extensive and detailed documentation. (The program has prompts to assure required information is entered.) Better organized and a much more readable report. (Can we be honest: many EMS providers don't have the best handwriting.) Allows for tracking of individual providers training and CME's. Allows for basic personnel information management. Improves security of patient information. Automatic submission of PCR data to the regional program agency (no more yellow copies to chase around. No more yellow copies returned for missing information. E-PCR program prompts for required information when the E-PCR is being written The database compiled is available for use by the EMS agency for internal QI audits, and other stats. It is also available for studies to improve and grow the EMS system in Steuben County. Computer System Requirement for the E-PCR Program Pentium III or equivalent AMD processor 128MB minimum RAM Windows 2000, or XP Functioning or compatible printer 28.8 KBS or faster Internet Connection (DSL or Cable preferred) Telephone connection (Optional-for faxing PCR's when necessary) EMS Needs Assessment Study The rural health network started with this EMS Assessment which has recently been abridged and reviewed by the network and sent on to the participants of the Steuben County EMS Association. The study provides a tool for continued planning and development of prehospital service delivery. Paramedic Integration An initiative of Rural Health Community Systems, this project is now an essential part of the prehospital delivery service provided by Ira Davenport Memorial Hospital and Rural/Metro Medical Services. This component is now considered “stand-alone” as it receives no concrete assistance from Rural Health Community Systems. ^top Law Enforcement – 1st Responder & CPR-D Training The entire compliment of Sheriff Deputies in Steuben County and several New York State Police in this zone have received CPR-D and/or ‘train-the-trainer’ training or better. Rural Health Community Systems is now focusing on local law enforcement officers. The New York State Troopers and Sheriff’s Department component is now considered “stand-alone” as they now have in-house instructors. Recruitment And Retention Champaign 1. An innovative Rural Health Community Systems recruitment and retention brochure has been developed and printed and distributed to the EMS Association for dissemination. One-on-one recruiting has proven to be the best means of enlisting new volunteers. It will be ‘reissued’ on a cyclical basis. 2. The first Rural Health Community Systems “Media Day” was held the spring of 2002. The coverage by all media was very attractive and appealing. It produced several inquiries from interested parties. A Video was produced and shown on the local TV news shows. 3. Rural Health Community Systems contracted with a professional to produce a 30 second and 60 second “Public Service Announcement” to be shown on our local TV stations. Our agreement with the TV stations includes an offer by STREMS to double the times it will be shown. 4. The EMS RECRUITMENT AND RETENTION “VOLUNTEER MANUAL” for use by the local squads has been published and distributed to the squads. The Manual provides a step-by-step guide for volunteers to use to get and keep solid volunteers. ^top Service Management Training for Recruitment And Retention The call for EMS Service Management courses were seen as a high need area in the EMS Assessment. A contract with JET, Inc, (Joint Education & Training) provided the Instructors and schedules. Managers are the tone setters of any organization. Supervisors are leaders. Effective leadership is an art. EMS Service Management Training uses problem-solving models; decision-making process; critical and intuitive thinking; all of which are key to successful recruitment and retention. Utilizing time effectively, managing stress, recognizing burnout and taking action steps to make changes to improve personal productivity and achieve the balance that is desired. Stress management ~ recognizes personal and organizational stressors as well as effective coping strategies. Coaching, counseling and disciplining volunteer personnel: identifying the performance deviation, gathering the data, writing the documentation, conducting work sessions, and follow-up are all covered. Customer service is about attitude. It is critical to know and understand customers and to treat them with the respect they deserve. How can a crew limit the effects of negative people, attitudes, and practices in the workplace? How can a crew develop a win-win relationship between a manager and crew members? This is a goal of any organization. How can a crew develop a shared vision and non-coercive ways to help members feel a part of their organization? Communication: Effective telephone, public relations, and interpersonal communication techniques. The secret to giving feedback is to take the feelings out of feedback. We do this by having a clear behavioral outcome in mind, using objective phrases, listening to the receiver, and jointly developing an operating agreement. Interviewing skills are essential tools used by supervisors every day in promoting, disciplining, evaluating, and routine supervision. Listening skills are essential tools for effective managers, supervisors, clerical personnel, and other employees. How can a crew positively manage change in their organization and seize opportunities? How can a crew do performance appraisals ~ promote communication between managers and staff, improve job understanding, promote more effective job performance, and develop personnel? These strategies for supervising employees across generation lines and more are taught in these important courses. Critical Incident Management Trainings, which stresses the Unified Command System, incorporates a huge board with city-like structures and vehicles on it that is used to recreate real life scenarios with individual’s role-playing parts on a functional exercise board. Instructors and facilitators play the roles of dispatchers and other players to keep the scenario rolling. The outcome is a better understanding from all parties of how each agency will work during a critical incident within their community. Public Access Defibrillation – Pad (CPR-D) Training The Rural Health Community Systems sponsored community by-stander training programs have successfully trained over 1,000 community by-standers in CPR-D. ^top Pad in Schools Rural Health Community Systems has been working with schools to help develop guidelines and plan for utilization of AED’s in rural schools. The network trained core teams of volunteers in the schools. Rural Health Community Systems offered a 50-50 formula for schools to purchase a limited number of AEDs at half the cost. Training in the Steuben County Schools has been wide-spread. This project will now focus on “Train-the Trainer” efforts in the schools. Automatic External Defibrillation Placements Rural Health Community Systems offers a 50-50 formula for businesses, industry and employers to purchase AEDs at half the cost by participating in our CPR-D Training program. To date over 100 AEDs have been placed in public access locations throughout Steuben County. ^top Camp“RTE” Beginning in 2001 and twice every summer since, Rural Health Community Systems and the American Red Cross Steuben County Chapter sponsored Camp RTE (Responding to Emergencies) for teenagers 14 to 18 years of age. Each camp was comprised of a 40-hour week long phenomenon. The camp included the ‘Responding to Emergencies’ American Red Cross course, which is 24 hours long, plus leadership and team building techniques for the remaining 16 hours. The participants toured ambulances, advanced life support vehicles, emergency helicopters and emergency departments. The objectives of “Camp RTE” are to educate, encourage, and empower youth to be a help in an emergency salutation; learn new skills; meet new people; and gain important characteristics like self-esteem, a sense of belonging, and self-awareness. EMS Youth Corps The EMS Youth Corps, designed especially for teens, teaches “Responding to Emergencies” primarily in Steuben County schools. This outreach effort has received a positive response from the education community. Combined with Camp RTE, the network offers teenager’s choices for career direction. The EMS Youth Corps incorporates a broad health, leadership, team building and safety program preparing the teenagers for preventing, and/or responding to emergencies. For the younger children the Youth Coordinator uses Andy the Ambulance to attract young people at schools and community events. Developing interest in youth is the networks long term investment in the future. ^top Non-Urgent Medical Transportation Study The Non-Urgent Medical Transport Study has been completed. The Office for the Aging provided the mailing list and guidance in developing three surveys which were sent to (1) consumers, (2) EMS Squads, and (3) Office for the Aging transport volunteers. Data from these surveys were collected, analyzed, reported and an analysis of the issue was made and published. It is clear that there is a need for non-urgent medical transportation, especially in the very north and the very south sections of Steuben County. These are also the areas where EMS squads are thin particularly during the workdays. EMS Volunteer Recruitment and Retention Manual The final edition of the EMS Volunteer Recruitment and Retention Manual is now in distribution. This Volunteer Recruitment and Retention Manuals are also being used by JET in the network training programs for EMS Volunteers. This publication is an example of an excellent instrument that could and should be a part of every EMS provider’s orientation. ^top EMS Handbook for Schools This EMS Handbook for Schools has been an invaluable tool for teachers to use in their classrooms. Many teachers are unaware of the hours of medical treatment training needed to be an EMS provider and the complex systems needed to be in place to maintain this critical safety net for the rural communities. The EMS Handbook for Schools developed and printed by the network was distributed to school district personnel throughout Steuben County. Handbooks were also distributed to local EMS Squads. The book is divided up by age levels ~ elementary, middle and high school so that Volunteer squad personnel can use the Handbook as a guide when asked to present to school children. Several hundred of these Handbooks have been distributed to school personnel throughout the county by the EMS Youth Corps Coordinator. Not-For-Profit Incorporation Rural Health Community Systems, Inc. is now incorporated as a not-for-profit. The paperwork has begun on our tax-exempt request. Ira Davenport Memorial Hospital will remain our grant applicant and fiscal manager. ^top On-Line Training Program This partnership with regional rural health networks afforded the network to purchase the equipment for our joint EMS recertification project is moving ahead, delayed by the late award of our grant funding. This regional project is highly anticipated. Files-of-Life Also a regional project, three rural health networks purchased 10,000 Files of Life for senior citizens of Steuben County. They are being distributed by the Steuben County Office for the Aging, an anchor member of TRIAD. ^top EMS Medical Director Course Te Medical Director Course was held in September 2003. The course was excellent and very informative. The verbal and written reviews of the course were very positive. The people in attendance included physicians, ER managers, EMS paramedics and STREMS personnel. The consensus was that the information provided went a long way in helping to clarify roles. Mic Gunderson of HealthAnalytics, Eric Davis, MD of URMC and Evan Mayfield of US Department of Health and Human Service , Office of Rural Health Policy and the Continuing Professional Education Department at the URMC did an excellent job. This outstanding course for EMS Medial Directors was the first one offered in New York State. The course was stimulating, gave outstanding direction, links and front-line guidelines to the principal prehospital leader. See conference notes at: http://www.healthanalytics.net/conferences/cmmoremss/default.htm St-Rescue Laerdal, developer of the Interactive Learning Equipment, or the HeartCode Interactive Learning System, which is a computer-based self-learning system for the American Heart Association ACLS and BLS (Healthcare Provider and Heartsaver AED) courses. Students (EMS Volunteers) review the reference material and have their skills evaluated by the software. Upon completion of the program, students receive an American Heart Association course completion (ACLS only) or renewal (BLS & ACLS) card. American Heart Association product 24-hour availability Convenient and economical training alternative Students complete the program at their own pace and at a time convenient for both the administrators and students Automatic recording of students' results aids the administrator in meeting reporting requirements Training based on national curriculum Each student is assigned a unique tuition key that allows one-on-one interactive education and evaluation. There is a tuition fee associated with these keys. The Rural Health Community Systems has bought a large number of keys that active members of Steuben County Volunteer EMS Corps can use for free. Laerdal understands that all training organizations have different needs and they have customized a Heartcode package to meet our needs. ^top Rural Health Community Systems Web Site Development Vijay Alagawadi has worked with the network to develop a redesigned website. FREE HeartCode™ Interactive ACLS & BLS Learning System Training Rural Health Community Systems, Inc. now offers Steuben County EMS Volunteers the use of the HeartCode Interactive Learning System. This free computer-based self-learning system provides an accessible certification and recertification track for the American Heart Association ACLS, BLS and PALS courses. Students review the Healthcare Provider and Heartsaver AED reference material and have their adult and infant life support skills evaluated by the software. Upon completion of the program, students receive an American Heart Association course completion (ACLS) or renewal (BLS, PALS & ACLS) card. The Rural Health Community Systems rural health network houses the equipment at our lead agency, Ira Davenport Memorial Hospital. It is available for training purposes 24/7 just by speaking with the Education Department or the Nursing Supervisor. For your added convenience, arrangements can be made to locate the interactive learning system to your local EMS squad headquarters for a limited period of time. American Heart Association product 24-hour availability Convenient and economical training alternative Students complete the program at their own pace and at a time convenient for both the administrators and students Automatic recording of students' results aids the administrator in meeting reporting requirements Training based on national curriculum Each EMS Volunteer is assigned a unique tuition key free, that allows one-on-one interactive education and evaluation. There is a tuition fee associated with these keys that the rural health network has paid for Steuben County Emergency Medical Services volunteers. Teamwork, communication and coordination are key elements in Advanced Cardiac Life Support (ACLS) training. Our ACLS training manikins provide a way to practice and integrate these skills on the same manikin. The students feel that the scenario they are participating in is the "real thing". The PALS program teaches a systematic, organized approach for the evaluation and management of acutely ill or injured children. Early identification and treatment of respiratory failure and shock in children improve survival, from a dismal 10 percent to an encouraging 85 percent. Whatever level of training you require our adult and pediatric training manikins will help put it all together. Rural Health Community Systems, Inc. works hard for our hard working EMS Volunteers. ^top
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