EMS Best Practices

1. EMS Best Practices A vibrant approach for improving out-of-hospital care.

2. Learner Objectives • Understand what a Best Practice is • Understand why Best Practice is necessary • Describe what a Best Practice Practitioner is • Understand what a Key Performance Indicator (KPI) is • Understand and apply an EMS Best Practice to a Key Performance area of care • Understand performance parameters and goal actualization • Understand how the industry application of EMS Best Practice can universally drive profound improvement in patient outcome

3. What is Best Practice? • “Best Practices” are strategies and tactics employed by highly effective organizations that change working conditions, communications, and organizational effectiveness for the ultimate goal of achieving improvement. • “Best Clinical Practices”are simply superior methods or innovative practices that contribute to improved performance of a process involving patient care.

4. Centuries old, however still in fashion! • Big Chief “Thinks-Outside-The-Tent” canvassed his “Best Hunters” after his tribe continued to hunger & exhibit low morale • He compared arrow making techniques between his hunters • He discovered that arrow construction was critical for accuracy, speed, range and consistency

5. The arrow construction process The Big Chief requested that his “Best Hunter”, Eating-Good, explain his arrow construction process to his fellow hunters so the entire tribe would be as proficient. They learned that he always made his arrows using the feathers from the right wing of a turkey.

6. Communicating and Implementing the “Best Practice” The “Tribal Best Practice” of building arrows from the feathers of one wing of a turkey was communicated to all the tribes and warriors. It was soon discovered by another warrior that right handed warriors should use only left wing feathers and left handed warriors should use only right wing feathers for the best results. This practice led to better tribal nourishment, increased morale and a great deal of confidence in their own protection, so the story goes! Truly, you never mix left and right feathers on the same arrow.

7. Today, how do we identify EMS Best Practices? • Strategic use of information to identify our “Top Performers” in our “Key Performance” areas of care. Once these are identified, the use of interviews, surveys, and other mechanisms of "primary" research can be applied. • Beyond the primary mechanisms, we would seek “secondary” research that may include -- books, magazines, libraries, the Internet, and other public domain resources that have this information. • Unfortunately, cross-functional relationships with other EMS systems are not in place, leaving little to no information available within our industry. Thus, the “primary” mode of research is our only applicable means of learning.

8. What is an EMS Best Practice Practitioner (BP2) • A motivated person with a desire to achieve excellence in patient care; self directed. • A person armed with knowledge and a desire to immediately apply it in their daily work. • A person looking for creative ways to improve a process. Once identified, willing to share with the tribe. • Continuously engage in self-study; willing to compare themselves with other leaders in their field so they can identify, adapt, and apply significantly better practices. • Willing to accept change (Paradigm shift). Change that should transcend across an organization reaching into all levels of practice regardless of status.

9. What are the Benefits of applying EMS Best Practices? • Profound improvement in patient care. • Internal stimulation and innovative practices. • Becoming the Best. Once identified and implemented within the organization, Best Practices will help place the EMS system’s practitioners as the most admired and the keenest healthcare practitioners within the industry.

10. Key Performance Indicators (KPI) • Quick Assessment and rapid transport of the severely injured • Treatment of the Injured Brain (TBI) • Airway management • Proper drug dosing • Pain management Each of these categories of performance can be measured; they are considered a direct contributor to improved patient outcome. They will drive customer satisfaction, quality/delivery-speed of our care including the utilization of our assets. Each of these KPI have their own specific process(es) & accompanying Best Practice(s).

11. As educators and preceptors, you must have a commitment to: • Build our camp fires for smoke signaling the warriors. • Remain a key ingredient in changing our local Paradigm! • Stay a high performer, knowledgeable, motivated and a fine example of being a Best Practice Practitioner. • Continue to bring enriched experiences (stimulation) to the classroom linking human dimensions of improvement. • Continue to carry and influence our EMS Best Practices; share the knowledge, processes and our success stories.

12. What we do and how we do it will make a profound difference, ultimately, leaving a lasting impression!

14. In Closing: When we understand ourselves and how the "best" do what they do, we will adapt it into our own organization. This will be our key to achieving true success. We should be encouraging creative thinking, "getting out of the box" and sharing this information for competitive comparisons. Pinellas County should be leading and accelerating the spread of better practices within our industry. We can promote the emergence and evolution of a "learning culture" throughout the industry making our clinicians and our organization the most admired.