Massachusetts EMS Providers Face New, Mandated Data Collection Standards

Just how effective are EMS providers in Massachusetts? For the first time, the state will soon have data to help answer that question. Massachusetts is instituting data collection standards for all EMS providers as a means to evaluate and compare the effectiveness of its emergency medical services statewide. The state’s proposed system, based on the National EMS Information System (NEMSIS), is similar to data collection systems already in place in most states across the country. On June 13 the Massachusetts Department of Public Health hosted a conference to discuss this mandate and its implications for EMS providers.
 
The real value of any data collected is the knowledge revealed in its analysis. The potential for Massachusetts and its EMS providers to uncover opportunities for improving practices that enhance patient care while simultaneously reducing costs to deliver this care could be significant.
 
As the June 13 conference title “Leveraging IT and EMS Data Improvements to Enhance Performance, Operations and Collections” suggests, for EMS providers this new data collection initiative is more than a scorecard to measure EMS performance. The proposed Massachusetts Ambulance Trip Record Information System (MATRIS) will allow more than 460 data points to be collected directly from ambulances and fire trucks. Conference sessions provided a review of MATRIS and how to choose a system to report and manage this data, as well as practices to analyze and use data collected to improve operational procedures and efficiency, and reimbursement and billing functions.
 
Massachusetts Department of Public Health’s June 13 conference attracted EMS providers from across the state, and was led by Abdullah Rehayem, Director, Office of Emergency Medical Services, and Kathy Foell, Director, Heart Disease and Stroke Prevention and Control Program. Speakers included chiefs of several fire departments and public and private EMS providers within Massachusetts, as well as Skip Kirkwood, Chief of Wake County EMS in North Carolina. Attendees also visited exhibits of conference sponsors.
 
The state plans to begin the pilot phase of this data collection program this Fall.
 
Professional Ambulance (Pro EMS) Chief Executive William Mergendahl is a member of the Massachusetts EMS Data Work Group, the committee that organized the conference for the state. Mergendahl, who was a speaker at the conference, also invited and sponsored the appearance of Wake County EMS’s Kirkwood at the event.
 
Resources:
To learn more about potential EMS Agency Reports under the NEMSIS system, see http://www.nemsis.org/nemsisReporting/emsAgencyReporting.html.
 
To view a copy of the Administrative Requirements Manual entitled “Statewide EMS Minimum Data Set” published by the Massachusetts Department of Public Health, see http://www.mass.gov/Eeohhs2/docs/dph/emergency_services/ar/5_403.pdf. This version is effective 8/19/08. Please contact the DPH directly for any updated information.
 

A New Model for Measuring and Benchmarking EMS Performance

When measuring the performance of an EMS system, it’s not enough to say you got there first.
 
The survival of a patient doesn’t depend on how quickly an ALS unit arrives at the scene of an emergency call. What does matter is how quickly basic chest compressions or defibrillation attempts are started.
 
The same goes for the resuscitation rates of victims of cardiac arrest. Typically, resuscitation rates are used as a primary measure of performance for most EMS systems. Yet these calls only represent 1 percent to 2 percent of all EMS responses, which means most systems don’t know how well they’re handling the other 98 percent of their calls.
 
And while response-time intervals for advanced life support units and resuscitation rates for victims of cardiac arrest are the primary measures of EMS system performance today, exactly what these terms mean remains unclear. How long is a “response interval?” Does time being measured start when a call comes into dispatch, when a unit arrives at the location, or when treatment of the patient begins? And if cardiac arrest survival is to the point of hospital admission, should a system claim success if a patient doesn’t survive beyond the emergency room? Without standard definitions, the value of any measurement data is questionable.
 
Clearly, a new model for measuring and benchmarking EMS performance – one based on scientific evidence with uniform definitions and reporting standards – is needed.
 
The 2007 U.S. Metropolitan Municipalities’ EMS Medical Directors’ Consortium has developed such a model for large suburban and urban EMS systems. The model is based on recent data and the research behind it has been presented in an article entitled “Evidence-Based Performance Measures For Emergency Medical Services Systems: A Model for Expanded EMS Benchmarking.” The article is a statement developed by the 2007 Consortium U.S. Metropolitan Municipalities’ EMS Medical Directors, published December 12, 2007, from the section of EMF Homeland Security & Disaster Medicine, The University of Texas Southwestern Medical Center, Dallas.
 
The article proposes that the measurement of EMS system performance extend beyond the traditional focus of benchmarking cardiac arrest survival rates and response-time intervals. The new model aims to allow EMS providers to more accurately report a meaningful measurement of their performance, to set guidelines for determining which measures are best for benchmarking, and to identify, quantify and encourage the implementation of best practices in urban and suburban EMS systems.
 
Although the article asserts that evidence-based research for pre-hospital emergency medicine is limited, results from large-scale scientific research suggest specific hands-on treatment plans for several conditions including ST-segment elevation myocardial infarction, pulmonary edema, bronchospasm, seizure, and trauma patients.
 
While there are performance measures that could be used by EMS systems for internal quality assurance, the Consortium does not consider these factors appropriate for benchmarking. The proposed model considers only those medical situations for which specific treatment plans have been scientifically documented to achieve positive results, and only those that EMS systems respond to with some frequency. The goal is for the new model to create focused efforts of performance improvement and serve as a new prototype for performance measurements and benchmarking among EMS systems.
 
Resources:
To obtain a copy of the article on performance measures written by the EMS Medical Directors’ Consortium, see http://www.informaworld.com/smpp/content~content=a791816011~db=all~jumptype=rss.
 
To learn more about the EMS Performance Measures Project, which seeks to create a set of 20 to 30 EMS system performance indicators and attributes, see http://www.nasemsd.org/Projects/PerformanceMeasures/. This project is being coordinated by the National Association of State EMS Officials (NASEMSO) in partnership with the National Association of EMS Physicians (NAEMSP), and supported by the National Highway Traffic Safety Administration (NHTSA) and the Health Resources and Services Administration (HRSA).
 

“If you can’t measure it, you can’t manage it.”

That’s one of the key messages that came out of a groundbreaking EMS conference in June, when the Massachusetts Department of Public Health outlined plans to begin collecting EMS data in this state – and told members of our industry to get ready for the change.
 
It’s the message that was sent by the recently published “Evidence Based Performance Measures” paper, which discusses the need for a new model of measuring and benchmarking EMS performance. You can find a link to the actual paper in our newsletter below.
 
And it’s the message we pound home here at Pro EMS. But — and I’m sure all of you in the industry would agree – that message alone isn’t complete.
 
Ultimately, it’s not just about measuring and managing EMS. It’s about continuously looking for ways to improve. It’s about providing quality service. It’s about bringing the latest technology out of the hospital and into the field. It’s ultimately all about providing best-in-class patient care.
 
Welcome to the Pro EMS newsletter. This is our effort to contribute to this dialogue about continuous quality improvement that is sweeping our industry. Our intention is to provide you, on a quarterly basis, with useful resources, from some of the latest EMS news in our region, to information that we hope can be useful for improving your operations and patient care. We also hope you’ll enjoy learning more about Pro EMS with the links to our company’s news and events.
 
I encourage everyone to read these articles and do everything you can to begin collecting data and measuring performance. While it may seem egg-headed, bureaucratic, and to some even boring, wouldn’t it be great if we could all offer a solid projection of the lives we have impacted by providing the highest level of pre-hospital care?
 
We finally have metrics that are not solely based upon cardiac arrest — a condition that we encounter less than 1 percent of the time — but also include respiratory distress, seizures, and how we handle STEMI cases. These metrics not only prove our value as EMS providers, but will improve it.
 
Thank you all for your work and dedication to EMS.
 
–Merg
 
Bill Mergendahl, JD, EMT-P
Chief Executive Officer
Pro EMS
 

State-of-the-Art NeoNatal Patient Simulator Added To Training Program

Pro EMS Center For MEDICS Adds State-of-the-Art NeoNatal Patient Simulator to Its Training Program
 
Pro EMS is the only ambulance provider in the Northeast and New York regions to offer the “SimNewB” Manikin, developed by Laerdal and the American Academy of Pediatrics, as part of its Neonatal Resuscitation Program
 
Cambridge, Mass., August 2008 – Professional Ambulance Service (Pro EMS), one of the premiere providers of emergency medical services in Massachusetts, is pleased to announce that its training program has added a SimNewB™ newborn patient simulator, the newest, most advanced clinical training device available in the U.S. for neonatal care.
 
Pro EMS is the only ambulance provider in the Northeast and New York regions to offer a SimNewB patient simulator, which has realistic newborn traits and provides lifelike clinical feedback that enables specialized training for infant resuscitation and other lifesaving neonatal medical procedures such as pneumothorax decompression and umbilical vein catherization. Pro EMS plans to use SimNewB in a new Neonatal Resuscitation Program program to be held at its Center for MEDICS. The two-day classes will be run in conjunction with the American Academy of Pediatrics and will focus on the advanced level resuscitation of a newborn baby.
 
The Pro EMS Center For MEDICS simulation lab for emergency medical services is the first fully functioning one in the Northeast and includes emergency room and apartment settings for its patient care scenarios, computer systems that record every step a trainee takes in treating these manikin patients, and a video screen for trainees and instructors to watch and evaluate the handling of each patient care scenario. EMTs, paramedics, emergency room doctors and nurses across Massachusetts come to the Center For MEDICS for the latest in emergency medical training. In addition to the SimNewB, the state-of-the-art lab also boasts lifelike adult and child patient simulators that can speak and demonstrate symptoms of illness and trauma.
 
“Special training is needed to learn how to treat babies in a trauma situation. The medical techniques for neonatal procedures are different than those for an adult or even a child patient, and since few traumas involve infants the opportunities are rare for these skills to be practiced and perfected,” said Chris Kerley, director of The Pro EMS Center For MEDICS.
 
With SimNewB, Kerley can devise numerous medical scenarios involving patient situations ranging from a vigorous to a compromised newborn, and then remotely control the manikin’s lifelike responses throughout each training session. Special software communicates with the manikin during the simulation to register and time stamp events such as when chest compressions are started and stopped, when the blood pressure is checked, and when ventilations are started and stopped. Kerley and his staff plan to use SimNewB to train paramedics, doctors and nurses on special airway management skills and considerations that are specific to newborns.
 
The SimNewB was developed in collaboration with the American Academy of Pediatrics to meet the training requirements of the Neonatal Resuscitation Program (NRP) course. There are only three SimNewB manikins in Northeast hospitals and only fifteen in hospitals nationwide.
 
The Center For MEDICS trains staff from Professional Ambulance and the Cambridge Fire and Police Departments, as well as staff from other fire and police departments and doctors and nurses from area hospitals. The simulation center’s programs include training on emergency medical procedures that are difficult to practice anywhere else because the equipment is not widely available. As for neonatal training, the addition of SimNewB makes The Pro EMS Center For MEDICS emergency medical program the only one in Massachusetts to provide a lifelike simulator for its students.
 
About Professional Ambulance Service
Professional Ambulance Service (Pro EMS) provides emergency medical services to the City of Cambridge, Massachusetts in conjunction with the Cambridge Fire, Police, Emergency Communications and Public Health Departments. Additionally, Pro EMS provides emergency medical services to Harvard University and the Massachusetts Institute of Technology. Professional Ambulance has proudly served the citizens, students, and visitors of Cambridge for over 35 years. For more information, visit www.proems.com.
 
About Laerdal Medical
Laerdal Medical, one of the world’s leading providers of Healthcare Solutions, is dedicated to helping save lives with products and services for Airway Management, Immobilization, Basic Life Support, Advanced Life Support, Patient Care, Self-Directed Learning, and Medical Education. Laerdal serves all healthcare providers and educators, from the lay rescuer to the medical professional. For more information, visit http://www.laerdal.com/.
 
PRESS CONTACT:
 
Christine Dunn
Savoir Media Co.
Telephone: (617) 484-1660
Email: cdunn@savoirmedia.com
####
 

Host 100 Students for Emergency Medicine, CPR Certification Program

PROFESSIONAL AMBULANCE SERVICE TO HOST 100 MIDDLE SCHOOL STUDENTS FOR EMERGENCY MEDICINE, CPR CERTIFICATION PROGRAM
 
One-Day Training is Part of LeadAmerica 10-Day Career Discovery Conference
Cambridge, Mass., July 2008 – Professional Ambulance Service (PRO EMS), one of the premiere providers of emergency medical services in Massachusetts, will host about 100 middle and junior high school students on July 31st for a unique educational program on pre-hospital emergency medicine.
 
The one-day program is part of the LeadAmerica Career Discovery Conference “Discover Medicine, Science & Robotics” that is being held July 28 – Aug. 6 at Bentley College. The CPR certification classes will take place at the PRO EMS Center for MEDICS in Cambridge, the first fully functioning simulation lab for emergency medical services in the Northeast. In addition to CPR, the students will also study EMT skills and participate in realistic patient care scenarios using high-fidelity, interactive manikins.
 
The LeadAmerica students will start their one-day excursion at PRO EMS in a mass CPR certification class. They will be split into smaller groups that will then rotate among stations offering specific medical instruction and simulation experiences.
 
At one station, students will learn about the anatomy and physiology of the heart and the cardiac conduction system, and will have the chance to perform EKG tracings of their classmate’s heart waves. In another area, students will study anatomy and physiology of the airway and respiratory tract. They will learn how to place an endotracheal tube and perform an intubation on a high fidelity, life-like manikin.
 
The purpose of the LeadAmerica conference is to allow the students to explore various careers. The PRO EMS program provides the opportunity to experience the health-care field. Students can see what it’s like to be an EMT – from reviewing the required equipment and supplies in an ambulance to responding to a simulated accident scene where they must extract a manikin-patient from a motor vehicle.
 
The culmination of the program is a patient-care scenario in the PRO EMS Center for MEDICS Simulation Lab. The PRO EMS Center for MEDICS boasts lifelike human patient simulators that can speak and demonstrate symptoms of illness and trauma; computer systems that record every step a student takes in treating a manikin “patient;” and large video screens so that students can review and analyze their performance. Here, students will apply the skills they have learned to perform a patient examination and assessment in the Center’s simulated hospital emergency room setting, with the situation evolving as the patient goes into a cardiac arrest. The students, along with Center for MEDICS instructors, will then review a video of their performance and corresponding data from control computers that monitor and record the manikin/patient life-support functions during the scenario.
 
“This program not only allows students to participate in a realistic medical emergency with an interactive and clinically life-like patient, but also enables them to watch, and analyze, themselves in action after they perform the scenario,” said Jay Starzynski, Operations Supervisor at PRO EMS.
 
Starzynski and Christopher Kerley, Director for PRO EMS Center for MEDICS, worked with LeadAmerica to design this training program. They are available to design similar programs customized for other student or health-care provider groups.
 
PRO EMS recently hosted about 300 high school students from the LeadAmerica “Medicine & Healthcare” conference for a similar two-day program that also included instruction and practice on intravenous therapy.
 
About Professional Ambulance Service
Professional Ambulance Service (PRO EMS) provides emergency medical services to the City of Cambridge, Massachusetts in conjunction with the Cambridge Fire, Police, Emergency Communications and Public Health Departments. Additionally, PRO EMS provides emergency medical services to Harvard University and the Massachusetts Institute of Technology. Professional Ambulance has proudly served the citizens, students, and visitors of Cambridge for over 35 years. For more information, visit www.proems.com.
 
About LeadAmerica
LeadAmerica is the nation’s premier youth leadership organization. With a commitment to providing quality leadership education, LeadAmerica empowers teenage leaders and instills in them ethical and principled leadership values, attitudes and skills. Each of its high school conferences is college-accredited and its programs are approved activities of the National Association of Secondary School Principals. LeadAmerica sponsors the Congressional Student Leadership Conference for high school students, the National Junior Leaders Conference for middle and junior high school students, Ambassadors Abroad international study programs in China, Australia and Europe, and Washington Summer Scholars, a college-level academic program held in partnership with American University. Further information on LeadAmerica and its youth leadership programs can be found at http://www.lead-america.org or by calling 1.866.FYI.LEAD (394.5323).
 
PRESS CONTACT:
Christine Dunn
Savoir Media Co.
Telephone: (617) 484-1660
Email: cdunn@savoirmedia.com
####
 

Scholarship Awarded to Cambridge Rindge and Latin Student

PROFESSIONAL AMBULANCE SERVICE SCHOLARSHIP AWARDED TO CAMBRIDGE RINDGE AND LATIN STUDENT
 
$1,000 scholarship to be put towards college expenses for a student pursuing a health care career
 
 
Cambridge, Mass., May 2008 – Professional Ambulance Service, one of the premiere providers of emergency medical services in Massachusetts, together with The Cambridge Rindge and Latin School Scholarship Committee, selected Miss Noor Abu-Ribieh to receive the Professional Ambulance Service Scholarship for the 2007-2008 academic year. Professional Ambulance Service established this scholarship more than ten years ago to help a Cambridge Rindge and Latin School student who intends to pursue a career in health care. The $1,000 award can be used for any college-related expense.
 
“This scholarship is one of the many ways in which Professional Ambulance Service supports the city of Cambridge,” said Brian Kelley, Operations Supervisor and field paramedic for Professional Ambulance Service and member of The Cambridge Rindge & Latin School’s Healthcare Careers Board of Advisors. Professional Ambulance Service is an important training resource for the school’s Health Assisting Program, with staff like Kelley teaching CPR and First Aid Certification courses at the school as well as providing field trip opportunities for career exploration.
 
Miss Noor Abu-Ruybieh, the recipient of this year’s Professional Ambulance Service scholarship, is an honors student who is enrolled in both Advanced Placement college preparatory courses as well as Cambridge Rindge and Latin School’s rigorous Health Assisting Program, which combines classroom studies with a hands-on field placement internship in a community-based health care facility. Abu-Ruybieh also works as a nurse’s aide at Mt. Auburn Hospital, and wants to become a physician.
 
For the 2007-2008 academic year, Cambridge Rindge and Latin received 39 scholarship applications from eligible students. The scholarship winner was chosen by The Cambridge Rindge and Latin School Scholarship Committee. Selection criteria include academic performance, letters of recommendation, and answers to short essay questions.
 
Miss Abu-Ruybieh will be one of many scholarship winners honored at The Cambridge Rindge and Latin School Scholarship Night on Thursday, May 22, 2008 at 7:00 p.m. Ceremonies will be held in the school auditorium at 459 Broadway in Cambridge, Massachusetts.
 
About Professional Ambulance Service
Professional Ambulance Service provides emergency medical services to the City of Cambridge, Massachusetts in conjunction with the Cambridge Fire, Police, Emergency Communications and Public Health Departments. Additionally, PRO EMS provides emergency medical services to Harvard University and the Massachusetts Institute of Technology. Professional Ambulance has proudly served the citizens, students, and visitors of Cambridge for over 35 years. For more information, visit www.proems.com or call 617.492.2700
 
PRESS CONTACTS:
 
Christine Dunn
Savoir Media Co.
Telephone: (617) 484-1660
Email: cdunn@savoirmedia.com
####
 

Staff To Be Honored

PROFESSIONAL AMBULANCE SERVICE STAFF TO BE HONORED WITH METROPOLITAN BOSTON EMS COUNCIL REGION IV AWARDS
 
Pro EMS Operations Supervisor Brian Kelley Awarded EMS Supervisor of the Year, and Director of Pro EMS Center for MEDICS Chris Kerley Awarded EMS Educator of the Year
 

Cambridge, Mass., October 17, 2008 – Professional Ambulance Service, one of the premiere providers of emergency medical services in Massachusetts, announces two of its staff has won a prestigious Metropolitan Boston EMS Council (MBEMSC) Regional EMS Award. The MBEMSC awards are given to recognize the accomplishments of emergency medical services (EMS) providers who have made significant contributions within Region IV, the sixty-two cities and towns comprising the Metropolitan Boston area.
 
Brian Kelley, Operations Supervisor at Professional Ambulance, has been selected Region IV EMS Supervisor of the Year; and Chris Kerley, Director of the Pro EMS Center for MEDICS, has won Region IV EMS Educator of the Year. Both Kelley and Kerley will be honored at the eighth annual MBEMSC Region IV EMS awards dinner on October 23, 2008, at the American Legion Post 440 in Newton, Mass.
 
The MBEMSC Regional EMS Awards were created to bring recognition to those individuals striving to improve the delivery of pre-hospital care within their service area. There are fourteen award categories, with one individual recognized in each category. The Supervisor of the Year award is presented to a medically trained EMS Supervisor within Region IV who performs meritorious service above and beyond the expectations of the profession. The Educator of the Year award is given to an EMS instructor who is dedicated to quality instruction and promoting the best in pre-hospital care or has made an outstanding contribution to EMS education within Region IV.
 
“It is an honor to have Brian and Chris recognized for their dedication and service to our community, and for their efforts to continually improve the delivery of pre-hospital care in the field of EMS,” said Bill Mergendahl, CEO of Professional Ambulance Service (Pro EMS) and the Pro EMS Center for MEDICS.
 
Brian Kelley, Region IV EMS Supervisor of the Year, has served with Professional Ambulance Service for nearly 11 years, currently as Operations Supervisor. Brian has been a constant advocate for excellence, working tirelessly to improve patient care and safety. As Community Education Coordinator for Pro EMS, Brian has been responsible for the training of thousands of laypersons to save lives. Chris Kerley, Region IV EMS Educator of the Year, leads the Pro EMS Center for MEDICS, a training center adjacent to Pro EMS that is home to the first fully functioning simulation lab for emergency medical services in the Northeast. Originally from Ireland, Chris has had a diverse international career in emergency medicine and also served as the clinical coordinator for EMS instruction at Northeastern University. Kerley is an innovative teacher devoted to education and learning who has worked with thousands of EMS providers within the Region IV EMS System.
 
Other members from the Cambridge EMS system who will be receiving MBEMSC Regional IV EMS Awards are Nick DiIeso, COO of Mt. Auburn Hospital, who will be awarded EMS Leader of the Year; Dr. Luis Lobon, EMS Medical Control Physician from Cambridge Health Alliance, who will be awarded EMS Physician of the Year; and Leanne Schofield, RN at Mt. Auburn Hospital, who will be honored as EMS Nurse of the Year.
 
The Metropolitan Boston Emergency Medical Services Council, Inc. (MBEMSC) is the agency designated by the DPH to coordinate the delivery of emergency medical services within the sixty-two cities and towns comprising the Metropolitan Boston Area. The Region IV area, which extends north as far as Wilmington and Littleton, west as far as Marlborough and Hopkinton, and south as far as Wrentham and Hanover, serves as residence to over 2 million people, and accounts for close to 1 million emergency department visits in the Region’s hospitals each year. There are 70 licensed ambulance services and 25 acute care hospitals in the Region IV area.
 

About Professional Ambulance Service
Professional Ambulance Service provides emergency medical services to the City of Cambridge, Massachusetts in conjunction with the Cambridge Fire, Police, Emergency Communications and Public Health Departments. Additionally, Pro EMS provides emergency medical services to Harvard University and the Massachusetts Institute of Technology. Professional Ambulance has proudly served the citizens, students, and visitors of Cambridge for over 35 years. For more information, visit www.proems.com or call 617.492.2700

 
PRESS CONTACTS:
 
Christine Dunn
Savoir Media Co.
Telephone: (617) 484-1660
Email: cdunn@savoirmedia.com
####