Tag: FirstWatch

Webinar | Who Was Jack Stout and Why Do His Ideas Still Resonate?

From AIMHI, FirstWatch, and the National EMS Museum | Hosted on Prodigy EMS

Who Was Jack Stout and Why Do His Ideas Still Resonate?

Thursday, June 24th | 9:00am PT (12:00pm ET)
Followed by a 30 minute session for remaining Q&A and practical tips for FirstWatch customers and interested Public Safety agencies
The late Jack Stout, an economist by training, is considered the father of high performance EMS. His public utility model, implemented in a half a dozen spots in the 70’s and 80s, transformed how communities thought about the relationship between efficiency, policy, and patient centric care in their EMS systems. Almost every EMS system in America includes elements of his design. He captured his ideas in more than a 100 articles and columns in JEMS, the Journal of Emergency Medical Services, in the 1980’s.
The National EMS Museum just announced the formation of the Jack Stout Archive, where his legacy in writing will live on. The archive received the financial support of FirstWatch and the Academy of International Mobile Healthcare Integration (AIMHI.)
In this highly interactive CTM, facilitators Mike Taigman and Rob Lawrence will be joined by Kristy Van Hoven, the Museum’s director, Todd Stout, Jack’s son and president of FirstWatch, Keith Griffiths, the founding editor of JEMS, and Jon Washko, a “Stoutian” disciple and highly respected consultant and EMS system expert. They’ll discuss the Archive and its mission. They will explore with you why Jack’s ideas are vital for today’s EMS leader and key for the design of EMS systems in the future.
Speakers:
Kristy Van Hoven
Kristy Van Hoven joined The National EMS Museum team in late 2018 and is currently serving as the Director of The National EMS Museum (NEMSM). In partnership with the Museum’s Board of Directors, she is leading the charge for NEMSM to grow into the national museum dedicated to preserving the legacy and stories of early pre-hospital care while inspiring a future generation of EMS professionals through engaging exhibitions, research, and programs. Concurrently, Kristy is pursuing a doctoral degree in which she is studying the effect museum programs and collections have on the health and wellbeing of those suffering brain trauma and how partnerships between medical professionals and museums can create a network of care for patients and practitioners beyond the clinical walls.
Todd Stout
Todd Stout, President of FirstWatch and the recipient of a JEMS EMS 10 Innovator Award, a Pinnacle Leadership Award, and the Dr. Jeff Clawson Leadership Award has extensive experience in multiple aspects of EMS, including in the field, dispatch, management and public safety communications software. He began his career as an EMS Stock boy and has spent the last two decades focusing on helping public safety and health agencies improve operational performance, clinical care and situational awareness.
Keith Griffiths
Keith Griffiths is the founding partner of the RedFlash Group, an award-winning communications and marketing firm serving the public safety market. He was the founding editor JEMS, the Journal of Emergency Medical Services, where he worked with the late Jim Page to build Jems Communications, which included the EMS Today trade show, a book division, newsletters and other periodicals. He worked as Jack Stout’s editor for nearly 10 years during the 1980’s.
Jonathan Wahsko
Jonathan Washko, MBA, FACPE, NRP, AEMD has been involved in the EMS industry for over 30 years and has held progressive leadership positions with small, medium and large EMS systems and has worked with or for government, private, for-profit and not-for-profit entities. Mr. Washko is considered the leading industry expert on EMS system design, High Performance EMS concepts, Industry Best Practices, EMS Deployment, Lean Business Processes, System Status Management, Use of Technology, IP Development, EMS Economics and EMS Finance and is often called upon by EMS systems in crisis as well as those considered at the top of their game, in order to help transform these organizations to become the best they can be. Mr. Washko frequently speaks at national conferences, is a JEMS EMS10 Innovator award recipient, sits on various industry boards and advises EMS agencies and governments on an international basis on EMS Systems improvement.
Facilitators:
Mike Taigman, MA
Mike uses more than four decades of experience to help EMS leaders and field personnel improve the care and service they provide to patients and their communities. Mike is the improvement guide for FirstWatch and a nationally recognized author and speaker. He was the facilitator for the national EMS Agenda 2050 project and teaches improvement science in the Master’s in Healthcare Administration and Interprofessional Leadership program at the University of California San Francisco. He will serve as host and facilitator for Conversations that Matter.
Rob Lawrence, MCMI
Rob has part-time roles as Director of Strategic Implementation for Pro EMS of Cambridge, Mass. and the Executive Director of the California Ambulance Association. Rob is also the Principal of Robert Lawrence Consulting. Rob served as the California COO with Paramedics Plus after nine years as the COO of the Richmond Ambulance Authority. Prior to that, he was the COO for Suffolk as part of the East of England Ambulance Service. He is a graduate of the UK’s Royal Military Academy Sandhurst, serving for 23 years as a Medical Support Officer. Rob is the Communications Committee Chair of the American Ambulance Association, a member of the EMS World Advisory Board, and an accomplished writer, broadcaster and international speaker.

 

National EMS Museum Jack Stout Archive Announced

FOR IMMEDIATE RELEASE: May 13, 2021

Media Contact:

Jenny Abercrombie
jabercrombie@firstwatch.net
951.440.6848

FirstWatch and the Academy of International Mobile Healthcare Integration (AIMHI) Partner to Fund the Jack Stout Archive at The National EMS Museum

Online Collection will Showcase the Late EMS Visionary’s Legacy

Carlsbad, Calif.—FirstWatch, a technology and quality improvement company serving public safety and healthcare organizations, has partnered with the Academy of International Mobile Healthcare Integration to preserve the written legacy of the late EMS visionary Jack Stout. The partnership will fund an online archive hosted by The National EMS Museum, making more than 100 of Stout’s articles and essays available to the public. Many of them appeared in JEMS, the Journal of Emergency Medical Services, beginning with his pivotal series introducing the concepts of high-performance EMS in the May 1980 edition.

As EMS Week approaches with the theme of, “This is EMS: Caring for our Communities,”

Keith Griffiths, the founding editor of JEMS and now a partner with the RedFlash Group, noted that

Stout is known for creating efficiency in EMS systems. However, his philosophy was very much about doing what was best for the patient and their community, according to their priorities and policies.  Griffiths worked with Stout on dozens of his articles and columns. “He was a brilliant communicator and storyteller,” he said, “taking abstract concepts and making them come alive with clear, down-to-earth prose that still resonates today.”

Known as the “Father of High-Performance EMS and System Status Management,” Stout developed his concepts in the 1970s to improve EMS systems by making them more efficient and focused on patient care. An economist by trade, he found that applying the science, concepts, and economics used in manufacturing provided the framework for standing up high-quality EMS systems that could afford to provide effective and reliable prehospital care.

Stout’s son, FirstWatch Founder and President, Todd Stout, has granted The National EMS Museum the rights to provide access to all of his father’s articles in a format that’s fully searchable. “Teaming up with AIMHI was the natural and obvious choice to enable The National EMS Museum to ensure my father’s work, which is still so timely today, is available for future generations to learn from,” he said. “We appreciate that JEMS provided a good home for his ideas for more than a decade.”

The National EMS Museum will digitally transcribe and catalog the documents as part of its digital library and research archives—part of the virtual museum program created and maintained by volunteers. Many of the articles are already available in the museum’s online Jack Stout Archive. Additional material will be added in future months.

“We’re delighted to preserve and share these historical and transformative articles,” said Kristy Van Hoven, the museum’s director.

“AIMHI is proud to partner with FirstWatch to contribute to the creation of the Jack Stout Archive,” said Chip Decker, president of AIMHI and CEO of the Richmond Ambulance Authority. “His legacy lives on as many of our member organizations were formed around the high-performance principles and practices of Jack’s work—which is increasingly valuable in today’s economically-challenged EMS landscape.”

The principles established by Stout led to the creation (by him, Jay Fitch, and others) of nationally recognized and award-winning high-performance EMS systems including the Three Rivers Ambulance Authority (TRAA) in Fort Wayne, Indiana; the Richmond Ambulance Authority (RAA) in Richmond, Virginia; Metropolitan EMS (MEMS) in Little Rock, Arkansas; the Regional EMS Authority (REMSA) in Reno, Nevada; the EMS Authority (EMSA) in Tulsa and Oklahoma City, Oklahoma; the Sunstar system in Pinellas County, Florida; and MEDIC in Charlotte, North Carolina.

On June 24, FirstWatch will host a special edition of Conversations That Matter—a series of thought-provoking discussions in EMS—to answer the question, “Who Was Jack and Why Do His Ideas Still Resonate?” Facilitators Mike Taigman and Rob Lawrence will be joined by Kristy Van Hoven, Todd Stout, Keith Griffiths, and Jon Washko, a “Stoutian” disciple and highly respected consultant and EMS system expert, to explore why Stout’s ideas remain critically relevant for today’s EMS leader and key to the design of EMS systems of the future. Register for the session now here.

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About FirstWatch

FirstWatch helps public safety and healthcare professionals serve their communities through the use of technology and the science of quality improvement. Drawing on deep experience in emergency services, the FirstWatch team develops software and personalized solutions to help organizations continuously improve at what they do. Founded in 1998, and based in Carlsbad, Calif., FirstWatch has partnered with more than 500 communities across North America to improve outcomes, efficiency, safety, and operations. Learn more at: https://firstwatch.net.

About the Academy of International Mobile Healthcare Integration (AIMHI)

The Academy of International Mobile Healthcare Integration (AIMHI) represents high performance emergency medical and mobile healthcare providers in the U.S. and abroad. AIMHI, formerly known as the Coalition of Advanced Emergency Medical Services (CAEMS), changed its name in March 2015 to better reflect its members’ dedication to promoting high performance ambulance and mobile integrated healthcare systems working diligently to performance and technological advancements. Member organizations are high performance systems that employ business practices from both the public and private sectors. By combining industry innovation with close government oversight, AIMHI affiliates are able to offer unsurpassed service excellence and cost efficiency. Learn more at: http://aimhi.mobi/.

About The National EMS Museum

The National EMS Museum is dedicated to preserving and commemorating the history of EMS in the U.S. By collecting historic equipment, books, articles and tools of the trade, the museum showcases how EMS has developed over the last 150 years. Through the study of the past, the museum strives to inspire EMS practitioners and leaders of today to develop new tools and procedures to provide better and more effective emergency care to patients and communities. Learn more at: https://emsmuseum.org/.

FirstWatch Webinar | ET3 Medical Triage Line NOFO Help

From FirstWatch Solutions

You’re invited to join us for a 30-minute webinar to help with your team’s submission for the

ET3 Notice Of Funding Opportunity (NOFO): Medical Triage Line

Tuesday, April 20th

9:00am PT / 12:00pm ET

ET3 submissions for Medical Triage Line are due May 11, 2021

FirstWatch & Priority Solutions have partnered to create ‘cut-n-paste’ text for your review / potential use designed for relevant sections of the ET3 NOFO directed at Low-Code (Emergency Communication Nurse System (ECNS) and long-time partner solution offered by FirstWatch (real-time views of ECNS, ProQA & CAD data, as well as Reporting requirements) for your review & consideration, as part of your submission.
Register Here for Webinar on April 20th

Register Now

Webinar Speakers

Rob Lawrence, MCMI

Rob has part-time roles as Director of Strategic Implementation for Pro EMS of Cambridge, Mass. and the Executive Director of the California Ambulance Association. Rob is also the Principal of Robert Lawrence Consulting. Rob served as the California COO with Paramedics Plus after nine years as the COO of the Richmond Ambulance Authority. Prior to that, he was the COO for Suffolk as part of the East of England Ambulance Service. He is a graduate of the UK’s Royal Military Academy Sandhurst, serving for 23 years as a Medical Support Officer. Rob is the Communications Committee Chair of the American Ambulance Association. Rob is an accomplished writer, broadcaster and international speaker and is a member of the EMS World Advisory Board.

Elaine Messerli-Kelly, BSN-RN

Elaine is a Subject Matter Expert specializing in nurse triage and programs aimed at navigating patients to appropriate care. Elaine and EMK Consultants have partnered with several agencies who are seeking innovative solutions to traditional care which will improve the health of their communities. She works with Priority Solutions and the International Academy of Emergency Dispatch as a Regional ECNS and ECN-Quality Instructor.

Dr. Conrad Fivaz

Dr. Fivaz chairs the Council of Standards for Emergency Nurse Triage within the International Academy of Emergency Dispatch, the body responsible for the clinical governance of the nurse triage protocols. He fulfills the role of Clinical Director for PSI. He is also a member of the IAED CBRN committee.

He held a position as associate editor of the peer-reviewed journal, Annals of Emergency Dispatch and Response and authored numerous original research papers. He co-authored the clinical triage protocols used in the ECNS system and implemented the system in many countries on 4 continents over a 20-year period.

He qualified as Family Physician in South Africa where his interest and experience in clinical triage medicine started when he worked as emergency physician in a busy tertiary University Hospital’s Emergency Department and flight doctor for the “Flight for Life” helicopter service while completing his Masters degree in Family Medicine. He worked as a Family Physician in the UK before relocating with his family to the US.

FirstWatch Resilience Dialogue Webinars

From FirstWatch

Monthly Interactive Session
Friday, March 12th, 2021 | 9:00am PT / Noon ET
Resilience involves the ability to handle stress, bounce back, and move forward in life. The challenges of the last year highlight the need for individual, organizational, and collective resilience. We’ve learned a lot about how to build resilience and improve your ability to deal with all kinds of stress. These dialogues are open forums to explore resilience, all the things that cause stress in our lives, relationships, and more. Please join us for these monthly interactive sessions where everyone, including family members, is welcome. They will be held the second Friday of the month at 9am Pacific time.

EMS1 & FirstWatch Webinar | Public Sector EMS Grants

Grant me the Money!

Finding, completing, and winning grant funding in the public sector
Thursday, February 25th, 2021 | 10:30am PT
Followed by a 30 minute session on practical tools for FirstWatch customers and interested Public Safety agencies

More than $600 billion in nationwide grants is available to public safety agencies and local government each year—
but it can be difficult to navigate through the grant process. Few agencies have grants experts on staff, or the time to research opportunities and develop grant applications.

February’s “Conversations That Matter” will consult the professionals on where grant sources are, the methodology for completing applications, the key elements and evidence needed to write a successful grant, and the timetable for grant production.

Hosts Mike Taigman and Rob Lawrence will be joined by grants experts from Lexipol, the company behind EMS1, FireRescue1 and Police1. They have been helping public safety find and secure grants for more than 20 years.

In true CTM style, we’re sure our attendees will have tips to contribute as well.

Register Free on Prodigy

FirstWatch | The Promise, Potential, and Possible Pitfalls of ET3

Firstwatch Webinar on January 22 at Noon ET | Powered by Prodigy EMS

The ET3 program starts in earnest on January 1, 2021. This program has been a long time in the making, which COVID only prolonged.

In this installment of Conversations That Matter, guest facilitator Rob Lawrence explores the path to going live with ET3 with Matt Zavadsky (MedStar Mobile Healthcare, Fort Worth, Texas) and Hanan Cohen (Empress EMS, New York). You’ll learn about what they hope to achieve with their ET3 programs, how they’re measuring quality and success, and the potential for program expansion. They’ll also share their views on whether the new administration in Washington might support continuation or expansion of Treatment in Place and other initiatives that have been implemented as a result of the pandemic.

Register

Guest Host – Rob Lawrence, MCMI

Rob has part-time roles as Director of Strategic Implementation for Pro EMS of Cambridge, Mass. and the Executive Director of the California Ambulance Association. Rob is also the Principal of Robert Lawrence Consulting. Rob served as the California COO with Paramedics Plus after nine years as the COO of the Richmond Ambulance Authority. Prior to that, he was the COO for Suffolk as part of the East of England Ambulance Service. He is a graduate of the UK’s Royal Military Academy Sandhurst, serving for 23 years as a Medical Support Officer. Rob is the Communications Committee Chair of the American Ambulance Association, a member of the EMS World Advisory Board, and an accomplished writer, broadcaster and international speaker.

Matt Zavadsky, MS-HSA, NREMT

Matt Zavadsky is the Chief Strategic Integration Officer at MedStar Mobile Healthcare. Matt has 41 years of EMS experience and has helped guide the implementation and financial sustainability of numerous innovative programs with healthcare partners. Matt is also the President of the National Association of EMTs and chairs their EMS 3.0 committee. He is the co-author of the book “Mobile Integrated Healthcare – Approach to Implementation” published by Jones & Bartlett Publishing. He has a Master’s Degree in Healthcare Administration, with a Graduate Certificate in Healthcare Data Management and is a member of the EMS World Advisory Board.

Hanan Cohen

Hanan is the Director of Business Development and Community Paramedicine at Empress EMS. He is a paramedic and community paramedic with 30 years experience in EMS and Hospital Administration. His major focus is on new program design to provide collaborative community health programs with hospitals in Westchester County, New York, and New York City. Through his efforts, Empress EMS launched community paramedic programs for two local hospitals in White Plains and the Bronx. These treat in place programs primarily focus on reducing readmission of high-risk patients with chronic disease to the hospital and preventing the use of the emergency room for non-emergency issues.
Register

Webinar Dec 3 | Patient-Centered QI and System Design

From Firstwatch, Prodigy EMS, and the Center for Patient Safety

Conversations that Matter:
Patient-Centered QI and System Design
December 3, 2020 | Noon ET | Learn More & Register►

Most EMS systems claim to put the patient first, yet they still work 24-hour shifts, drive ambulances designed so that patients face the rear, and have QI systems that are not connected to the rest of the healthcare system.

Join us for this installment of Conversations that Matter, when facilitator Mike Taigman will explore how to create a more patient- and people-centered EMS organization with Jeff Jarvis, MD, MS, EMT-P, medical director for Williamson County EMS and Marble Falls Area EMS; former paramedic and hospital executive Bill Atkinson, PhD, EMT-P; and Brian LaCroix, EMS coordinator with the Center for Patient Safety. This session is sure to expand your knowledge and may just challenge your beliefs in the process.

Register on Prodigy EMS

Host – Mike Taigman, MA

Mike Taigman uses more than four decades of experience to help EMS leaders and field personnel improve the care and service they provide to patients and their communities. Mike is the improvement guide for FirstWatch and a nationally recognized author and speaker. He was the facilitator for the national EMS Agenda 2050 project and teaches improvement science in the Master’s in Healthcare Administration and Interprofessional Leadership program at the University of California San Francisco. He will serve as host and facilitator for Conversations that Matter.

Jeff Jarvis, MD, MS, EMT-P

Jeff Jarvis, MD, MS, EMT-P, is the medical director for Williamson County EMS and Marble Falls Area EMS. He is a practicing emergency physician at Baylor Scott & White Hospital in Round Rock, Texas. His experience in EMS and the broader health care field spans over 30 years, beginning as a volunteer firefighter and EMT. He has served as a paramedic in three states, the Texas State EMS training coordinator and department chair of EMS Technology at Temple College. Dr. Jarvis served as a member of the EMS Agenda 2050 Technical Expert Panel and represents the American College of Emergency Physicians on the National EMS Quality Alliance Steering Committee.

Bill Atkinson, PhD, EMT-P

Bill Atkinson, PhD, EMT-P, is president of Guidon Healthcare Consulting in Raleigh, North Carolina. He began his career in healthcare leadership as one of the first EMTs and then paramedics in the state of North Carolina. Dr. Atkinson went on to a lengthy career in healthcare management, running hospitals in South Carolina, Texas and Colorado before returning home to serve as president and CEO of New Hanover Regional Medical Center and, from 2003 until his retirement in 2013, WakeMed Health and Hospitals.

Brian LaCroix

Brian LaCroix serves as EMS coordinator with the Center for Patient Safety. He recently retired as president and EMS chief of Allina Health EMS in St. Paul, Minnesota, where had started as a field provider in 1997. LaCroix also served as the president of the National EMS Management Association, is a fellow in the American College of Paramedic Executives and holds a paramedic degree and a bachelor’s degree in business administration. HE also consults with organizations to recruit senior EMS leaders, develop individuals and grow leadership teams and has worked on extended international EMS projects in Nicaragua, France and Croatia.

Center for Patient Safety

The Center for Patient Safety (CPS) provides expert support and resources across the healthcare continuum in our mission to reduce preventable harm.

For paramedicine providers CPS helps agencies cultivate a Culture of Patient Safety, manages a robust Patient Safety Organization for providers, offers education and support of mental and well-being of providers.

The Center is honored to be supporting the important dialogue of “Conversations that Matter!”

In Memory of Jack Stout

Updated July 20 to include a link to  Jack Stout’s obituary.

It is with heavy hearts that the American Ambulance Association shares news of the peaceful passing of EMS legend Jack Stout. Our thoughts are with the Stout family as well as Jack’s many friends and mobile healthcare colleagues. Thank you, Jack, for your leadership and vision which live on in your son, Todd, as well as in the life-saving actions of EMS professionals around the world. Rest in peace.

Read Jack Stout’s obituary in the Falls City Journal.

COVID-19 Update II for EMS

First Case of 2019 Novel Coronavirus in the United States

The New England Journal of Medicine has rapidly published a peer-reviewed paper on the Snohomish County WA ‘Patient 1’. This was the first reported case of COVID 19 in the US. This seminal document, which given the magnitude of the case and its initial findings is released in full here

The work by Michelle L. Holshue, M.P.H., Chas DeBolt, M.P.H., Scott Lindquist, M.D., Kathy H. Lofy, et al for the Washington State 2019-nCoV Case Investigation Team was turned round in just over 5 weeks and below is an ‘Executive summary’ ( as extracted from the paper) but the full paper and range of results should be read in full.

Patient Presentation

On January 19, 2020, a 35-year-old man presented to an urgent care clinic in Snohomish County, Washington, with a 4-day history of cough and subjective fever. On checking into the clinic, the patient put on a mask in the waiting room. After waiting approximately 20 minutes, he was taken into an examination room and underwent evaluation by a provider. He disclosed that he had returned to Washington State on January 15 after traveling to visit family in Wuhan, China. The patient stated that he had seen a health alert from the U.S. Centers for Disease Control and Prevention (CDC) about the novel coronavirus outbreak in China and, because of his symptoms and recent travel, decided to see a health care provider.

On admission, the patient reported persistent dry cough and a 2-day history of nausea and vomiting; he reported that he had no shortness of breath or chest pain. Vital signs were within normal ranges. On physical examination, the patient was found to have dry mucous membranes. The remainder of the examination was generally unremarkable. After admission, the patient received supportive care, including 2 liters of normal saline and ondansetron for nausea.

Viral Presence

Both upper respiratory specimens obtained on illness day 7 remained positive for 2019-nCoV, including persistent high levels in a nasopharyngeal swab specimen (Ct values, 23 to 24).

Stool obtained on illness day 7 was also positive for 2019-nCoV (Ct values, 36 to 38).

Nasopharyngeal and oropharyngeal specimens obtained on illness days 11 and 12 showed a trend toward decreasing levels of virus

Day 8: Condition Improves

On hospital day 8 (illness day 12), the patient’s clinical condition improved. Supplemental oxygen was discontinued, and his oxygen saturation values improved to 94 to 96% while he was breathing ambient air. The previous bilateral lower-lobe rales were no longer present. His appetite improved, and he was asymptomatic aside from intermittent dry cough and rhinorrhea. As of January 30, 2020, the patient remains hospitalized. He is afebrile, and all symptoms have resolved with the exception of his cough, which is decreasing in severity.

History Taking

This case report highlights the importance of clinicians eliciting a recent history of travel or exposure to sick contacts in any patient presenting for medical care with acute illness symptoms, in order to ensure appropriate identification and prompt isolation of patients who may be at risk for 2019-nCoV infection and to help reduce further transmission. Finally, this report highlights the need to determine the full spectrum and natural history of clinical disease, pathogenesis, and duration of viral shedding associated with 2019-nCoV infection to inform clinical management and public health decision making.

Conclusion

There is little doubt that this paper is about to become a globally sited document as we continue to deal with COVID 19. As far as EMS and our first response to it goes, the paper reinforces the key actions currently being taken

 

Sample COVID-19 Policies for Mobile Healthcare Providers

Thank you to the following organizations for sharing their policies as examples.

Global Medical Response maintains a COVID-19 page to provide information to all members of the GMR community—clinicians and non-clinicians.

Updates from GMR Chief Medical Officer, Dr. Ed Racht

GMR Procedures

General Information for Caregivers

Compliance

HIPAA Reminder

FirstWatch Solutions

The intention of the COVID-19 Process/Policy Template is to provide agencies, medical directors, or others who want to utilize it, an outline/template on which to build an agency-specific policy/protocol to address COVID-19. This includes suggestions for development and/or oversight committees, outside partners and stakeholders, as well as preparation and process for EMS workers who provide best practice care for patients as well as providing for the protection of pre-hospital providers and medical director(s). Its application is totally up to the user.

This document is meant to be a living document that can be revised as circumstances or guidance changes. It can also be a discussion piece for those who choose to develop a different type of policy but may want to use some of the components of the document as a starting point.

Agency Guidance

CDC Interim Guidance for Emergency Medical Services (EMS) Systems and 911 Public Safety Answering Points (PSAPs) for COVID-19 in the United States
NEW March 6, 2020: CMS COVID-19 FAQs for Healthcare Providers (PDF Download)

March 5, 2020: CMS issued a second Healthcare Common Procedure Coding System (HCPCS) code for certain COVID-19 laboratory tests, in addition to three fact sheets about coverage and benefits for medical services related to COVID-19 for CMS programs.  https://www.cms.gov/newsroom/press-releases/cms-develops-additional-code-coronavirus-lab-tests

March 4, 2020: CMS issued a call to action to healthcare providers nationwide and offered important guidance to help State Survey Agencies and Accrediting Organizations prioritize their inspections of healthcare. https://www.cms.gov/newsroom/press-releases/cms-announces-actions-address-spread-coronavirus

February 13, 2020: CMS issued a new HCPCS code for providers and laboratories to test patients for COVID-19.  https://www.cms.gov/newsroom/press-releases/public-health-news-alert-cms-develops-new-code-coronavirus-lab-test

February 6, 2020: CMS gave CLIA-certified laboratories information about how they can test for SARS-CoV-2. https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/notification-surveyors-authorization-emergency-use-cdc-2019-novel-coronavirus-2019-ncov-real-time-rt

February 6, 2020: CMS issued a memo to help the nation’s healthcare facilities take critical steps to prepare for COVID-19.  https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/information-healthcare-facilities-concerning-2019-novel-coronavirus-illness-2019-ncov

COVID-19 Coronavirus EMS Advisory 1

This guidance is written to offer American Ambulance Association members the situational background and a list of resources and websites with which to draw guidance and further updates on the latest situation with COVID-19, colloquially referred to as “Coronavirus.” Key information for this update has been drawn from the NHTSA EMS Focus series webinar What EMS, 911 and Other Public Safety Personnel Need to Know About COVID-19, which took place on February 24, 2020. The on-demand recording is available below.

General Information

Background

The COVID-19 Coronavirus Disease was first reported in Wuhan China in December 2019. CDC identifies that it was caused by the virus SARS – CoV-2. Early on, many patients were reported to have a link to a large seafood and live animal market. Later, patients did not have exposure to animal markets which indicates person-to-person transmission. Travel-related exportation of cases into the US was first reported January 21, 2020. For reference the first North American EMS experience of  COVID-19 patient transport, including key lessons learned, can be found in the EMS 1 article Transporting Patient 1.

Spread and Identification

Global investigations are now ongoing to better understand the spread. Based on what is known about other coronaviruses, it is presumed to spread primarily through person-to-person contact and may occur when respiratory droplets are produced when an infected person costs or sneezes. Spread could also occur when touching a surface or object that has the virus on it and when touching the mouth, nose, or eyes. Again, research is still ongoing, and advice and guidance will inevitably follow.

For the cases that have been identified so far, those patients with COVID19 have reportedly had mild to severe respiratory illness with symptoms including fever and shortness of breath. Symptoms have typically appeared 2 to 14 days after exposure. Both the WHO and CDC advise that patients that have been to China and develop the symptoms should call their doctors.

COVID-19 Prevention and Treatment

To date, 30 international locations, in addition to the US, have reported confirmed cases of   COVID-19 infection. Inside the US, two instances of person-to-person spread of the virus have been detected. In both cases, these occurred after close and prolonged contact with a traveler who had recently returned from Wuhan, China.

The CDC activated its Emergency Operations Center (EOC) on January 21 and is coordinating closely with state and local partners to assist with identifying cases early; conducting case investigations; and learning about the virology, transmission, and clinical spectrum for this disease. The CDC is continuing to develop and refine guidance for multiple audiences, including the first responder and public safety communities.

As at the date of publication there is still no specific antiviral treatment licensed for   COVID-19, although the WHO and its affiliates are working to develop this.

The following are recommended preventative measures for  COVID-19 and many other respiratory illnesses:

  • Wash your hands often with soap and water for at least 20 seconds.
  • Use an alcohol-based hand sanitizer with at least 60% if soap and water are not readily available.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Avoid contact with people who are sick.
  • Stay home when you are sick.
  • Cover your cough or sneeze with a tissue, then throw it away.
  • Clean and disinfect frequently touched objects and surfaces.

Interim Guidance for EMS and 911

The Centers for Disease Control (CDC) has issued its Interim Guidance for Emergency Medical Services (EMS) Systems and 911 Public Safety Answering Points (PSAPs) for COVID-19 in the United States.

The guidance identifies EMS as vital in responding to and providing emergency treatment for the ill. The nature of our mobile healthcare service delivery presents unique challenges in the working environment. It also identifies that coordination between PSAPs and EMS is critical.

Key points are summarized below:

Recommendations for 911 PSAP Locations

The link between PSAPs and EMS is essential. With the advent of COVID19 there is a need to modify caller queries to question callers and determine the possibility that the call concerns a person who may have signs or symptoms and risk factors for COVID19.

The International Academy of Emergency Dispatch (IAED) recommends that agencies using its Medical Priority Dispatch System (MPDS) should use its Emerging Infectious Disease Surveillance (EIDS) Tool within the Sick Person and Breathing Problem protocols. For those that are not MPDS users, IAED is offering its EIDS surveillance Tool for Coronavirus, SRI, MERS and Ebola-free of charge under a limited use agreement.

Recommended Personal Protective Equipment (PPE)

The CDC recommends that while involved in the direct care of patients the following PPE should be worn:

  • Single pair of disposable examination gloves
  • Disposable isolation gown
  • Respiratory protection (N95 or higher)
  • Eye Protection (goggles or disposable face shield)

EMS Transport of a Patient Under Investigation (PUI) or Patient with Confirmed COVID19

  • Notify receiving healthcare facility so appropriate precautions can be put in place
  • Discourage family and contacts from riding in transport vehicle
  • Isolate the vehicle driver from the patient compartment by closing the windows between compartments and ensuring that the vehicle ventilation system is set to the non-recirculated mode
  • Document patient care

Cleaning EMS Transport Vehicles After Transporting PUI or Patient

  • Don PPE for cleaning with disposable gown and gloves, facemask, and goggles or face shield if splashes are anticipated
  • Routine cleaning and infection procedures should follow organizational standard operating procedures
  • Use protect use products with EPA-approved emergent viral pathogens claims

Once transport is complete, organizations should notify state or local public health authorities for follow up. Additionally agencies should (if not done already) develop policies for assessing exposure risk and management of EMS personnel, report any potential exposure to the chain of command, and watch for fever or respiratory symptoms amongst staff.

Employers Responsibilities

While not specific to COVID-19, agencies should:

  • Assess current practices and policies for infection control
  • Job- or task-specific education and training
  • PPE training and supply
  • Decontamination processes and supplies

Local EMS Considerations

  • PPE supplies
  • 911 and EMD call taking activities
  • Appropriate approach to potential patients
  • Educational resources for EMS personnel
  • Interaction with local public health/healthcare systems/emergency management
  • Interaction with local fire and law enforcement
  • Considerations for local jails

Further Reading

Conclusion

The COVID19 situation constantly evolving. Agencies should defer to their local EMS authorities, Public Health departments, and the CDC for definitive guidance. Going forward, the AAA will continue to both monitor the disease and alert issues to the membership.

2016 AMBY Best Use of Technology: Trinity EMS & Firstwatch, Opioid Epidemic Project

Congratulations to the 2016 AMBY Award Winners

Each year, the American Ambulance Association honors best practices, ingenuity, and innovation from EMS providers across the country with our AMBY Awards. 

Trinity EMS & FirstWatch Opioid Epidemic Project Awarded a 2016 AMBY for Best Use of Technology

Trinity EMS & FirstWatch | Massachusetts

amby-congrats-trinity-ems-with-firstwatchMassachusetts has seen a massive increase in opiate overdoses and deaths. In 2013 there were 918 opiate related deaths in Massachusetts. Massachusetts had 1531 deaths in the first six months of 2016. Many of the communities Trinity EMS serves are on the front lines of this issue. Their EMT’s and paramedics are helping to revive patients every day from an opiate overdose. Understanding the scope of an issue is a critical first step to solving an issue. They started using their PCR data to help frame the issue for their communities. They began tracking the demographics such as age and gender of the patients, time of day and day of the week, and location within the communities. They also monitor the volume to identify spikes in volume in individual communities and system wide. Trinity reported data monthly, one month behind to the health department, public safety partners, methadone clinics, hospitals and city governments. This data was well received. Other services contacted them for help in developing their tracking and reporting. They added FirstWatch to their program to speed up the notifications. Monthly reporting is still valuable. Instant reporting is even better. FirstWatch allows their communities to be notified within an hour of an opiate overdose. Public health and public safety now have this intelligence right away.

The goal was to gather and present data in a cross discipline format for aid with better understanding on the situation. First responders, law enforcement, public health, EMS, and district attorneys, and the press have received and used their data. Trinity wanted to show:

  • The profile of the patients we are seeing
  • The frequency of the patients
  • The location and time of the overdoses
  • The severity of the patients. (Our volume of overdoses have leveled off, the acuity of the patents is still increasing)
  • Our monthly report is a key performance indicator as to the opiate issue at the street level in our communities
  • Our needle pick up data indicated where outdoor intravenous drug use is happening
  • Many of the overdose calls to the 911 centers are not communicated as being overdoses; “fall”, “respiratory”, “unconscious” are common chief complaints at dispatch. This data would not have been collected and reported using chief complaint as a filter

When it became clear the opiate issue was becoming a wide spread crisis Trinity started working the issue. They knew their best area to provide data from was PCRs. They came up with a set of data points they thought would help. They attended many meetings and public events. During those forums dozens of additional questions and theories came forward. Trinity took and implemented all that they had data for. (Example. There was question about social benefits and opiate use. They are able to show on an ongoing basis that there is no correlation between opiate overdoses and the 1st and 15th of the month.)

Before 2015, Trinity reported opiate overdoses usually annually only when requested. Starting in 2015 they reported monthly. They wanted to provide data even quicker. Trinity had seen FirstWatch a few years before. They felt the speed and automation FirstWatch could provide was a critical improvement. The intelligence gathered with knowing in live time of opiate overdoses can’t be overstated. The automation allows that intelligence to be gathered no matter the day or time.

Trinity started working with FirstWatch in December 2015. In May 2016, Trinity put FirstWatch directly into the hands of public health, public safety and public schools. Each discipline has a HIPAA compliant login with access to data specific to their mission. They worked very closely with FirstWatch so they could understand the capabilities within the system. They brought the idea and FirstWatch brought the execution and focus. The FirstWatch platform is amazingly powerful for Trinity, to provide live access is amazing. In June 2016, Trinity participated in a Middlesex County District Attorney opiate task force meeting. Trinity had earlier in the meeting done a 20 minute presentation on the opiate crisis in our city. This provided the 70 people in attendance a fresh look at the data. Towards the end of the meeting conference to alert families and friends of addicts to watch their loved ones, and scheduled “emergency” Narcan administration training for the community. During DA Ryan’s presentation, Trinity received a FirstWatch alert for a 39 year old female opiate overdose from 30 minutes before. Three minutes later they received another alert for a 41 year old female that suffered a fatal opiate overdose. They were able to share that with the group and drive home the DA’s message.

The City Governments, Public Health, Police and Fire Departments in Trinity’s communities were eager to learn about the data they were able to collect, and their data began to become focal points at press conferences and city council meetings. News agencies began contacting Trinity to help paint the picture of the epidemic in feature stories. In sharing the mapping aspect of Firstwatch they hope that these agencies can further understand the epidemic and develop plans to combat it. Trinity has become the de facto subject matter experts of the opiate crisis.

Congratulations to Trinity EMS and FirstWatch for their selection as 2016 AMBY Winners.