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Contra Costa Health Services EMS QI Data Summary Annual Report: 2007

Contra Costa Health Services EMS QI Data Summary Annual Report: 2007. EMS QI Program (EQIP) Mission Statement.

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Contra Costa Health Services EMS QI Data Summary Annual Report: 2007

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  1. Contra Costa Health Services EMS QI Data Summary Annual Report: 2007

  2. EMS QI Program (EQIP)Mission Statement • To ensure that quality emergency medical services are available for all people in Contra Costa County and that emergency medical care is consistent with best practices and evidence based medicine.

  3. From Bricks to Road

  4. Our EMS Performance Yellow Brick Road!

  5. “Creating a Culture of Safety” • Patients • Providers • Stakeholders

  6. Who is involved? • EMS Agency • Base-Trauma Center • Emergency Dispatch • BLS/ALS First Responders • Ground Ambulance • Air Transport • Receiving Facilities

  7. Contra Costa EMS QI Program Partnership • Question: How are we doing? • Answer:

  8. What we do right! • Strong Commitment to Making Things Better • Great Environment to Solve Problems!

  9. What did QI do in 2007? • A productive year of accomplishments!

  10. Utstein Report/Cardiac Arrest Pediatric Report Documentation Trauma and Trauma Triage Patient Safety Reporting Airway Management Infrequent Skills (new) Medication Report Chest Pain/STEMI Pain Evaluation & Treatment Shortness of Breath Destination Report AMA/Patient Refusal General Activity (Dispatch) Customer Satisfaction Core EQIP Indicator Reports “Our EMS System Vital Signs”

  11. 2007 22 QI studies 2003-2006 10 QI studies QI Data Collection & Reporting Full View of EMS System Performance • Challenges Ahead • Data Warehouse • Dispatch Integration • ECG Transmission • CARES Mapping • CEMSIS Integration • Report Automation • Managing the Data Overload • Long Term: ePCR push into Facility MEDRec 2008 Zoll Integration First Responder View

  12. EMS Event (Patient Safety) Reporting2007 Summary Highlights 60%of reports come from our own EMS provider agencies Analysis:Cooperation and Accountability! 60% of our EMS events communication related Strategy:Focus is on root causes not symptoms!

  13. High Risk Communication • Patient Handoffs (CCCEMS 2006 Annual Report) • > 102,000 handoffs • Up 20% from 2005 • 2008 Goal • Improve handoff communication

  14. Paramedic EMS Patient Safety Practices 88-94% know use of weight charts/tapes improve safety but 14.5% did not always use. 3.4% reported a safety event in the last 3 years while 30 % did not. 11.5% no cross-checking during med handoffs. 29% stated Anonymous reporting would increase patient safety reporting. CCCEMS data: Sept-Dec 2007 119 surveys (27% return rate)

  15. EMS Patient Satisfaction • 4685 responses • 4.5% return rate • 4 question survey • Confidence in skills • Communication • Service • Comfort & pain control) • Positive responses 92% • Neutral 3.5% • Negative 4.5% AMR Jan-Sept 2007

  16. Ingestion Treatment AuditCharcoal Use and ALOC • Retrospective sample 2007 • Results (41 cases) • 87% Cases had charcoal given or attempted • 86% no improvement or change • 40% had GCS <15 or deteriorated after charcoal • Evaluation: Charcoal Risk > Benefit • QI outcome: Elimination of charcoal in treatment guidelines to improve patient safety

  17. Zoll 36-86% compliance MEDS Improved 17% since Jan 2007 Fax delivery 99.7% effective DocumentationDelivery and Completion QI Expectation : Draft/complete ePCR with patient delivery. Many challenges….slower progress

  18. 2007 Field Competency: SkillsHow do we maintain competency? Ranked in order of frequency AMR Data from Jan-Dec 2007, Historical studies multi agency 2003-2006

  19. Field Medication Utilization: Furosemide or Lasix

  20. Pain Assessment and Management

  21. Trauma Advanced Airway

  22. 12 Lead Field Utilization

  23. Chest Pain

  24. Field Airway Management AMR First Quarter 2007

  25. EMS for Children Performance Indicators AMR Jun-Aug 2006 (EMSC CQI Validation Study 2007)

  26. Kids Needing EMS 55 % children seen by 911 due to 3 conditions 105 pediatric patients/month (<18 yrs) 52 pediatric patients/month (<14) AMR Dec 2005-May 2007

  27. Pediatric Field Skills Success • 129 pedi-procedure attempts per month • 0.7 pedi-procedure attempts per medic per month • AMR Dec 2005-Dec 2007

  28. Goals 2008 • Improve QI information exchange • Patient Safety • Handoff communication • QI Tool Implementation • EMS Events • QI Activity Reports • Standardization • Full compliance with Title 22 QI • Improve Field Care • STEMI • Pediatrics • Pain • Skills Success

  29. On our way …..

  30. Questions?

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