MATTHEW CONSTANTINE DIRECTOR EMERGENCY MEDICAL …...KMC 30 1 24 KVH 3 28 0 MER 31 0 30 MSW 31 0 30 RRH 31 0 29 SJH 31 0 29 THD 10 21 0 Bed Availability Reporting. 86 89 82 85 10 89

EMERGENCY MEDICAL SERVICESSYSTEM COLLABORATIVE

MEETINGThursday

April 5, 2018

MATTHEW CONSTANTINEDIRECTOR

INTRODUCTIONS


ReddiNetBed Availability / MCI Response

MCI Response

February

Notice Resp

BHH 4 0

BMH 4 4

DRMC 2 1

KMC 4 4

KVH 3 1

MER 4 4

MSW 4 4

RRH 3 3

SJCH 4 4

Tehach 3 3

March

Notice Resp

BHH 3 3

BMH 3 1

DRMC 2 2

KMC 3 3

KVH 1 1

MER 3 3

MSW 3 3

RRH 1 1

SJCH 3 2

Tehach 1 1

0

2

4

6

8

10

12

BHH BMH DRMC KMC KVH MER MSW RRH SJCH Tehach

40.00% 80.00% 66.67% 100.00% 60.00% 100.00% 100.00% 100.00% 90.00% 100.00%

4 8 4 10 3 10 10 5 9 5

10 10 6 10 5 10 10 5 10 5

Year To Date

Alerts

Responses

Patient Distribution

I D M Total

BHH 0 0 0 0 0.00%

BMH 0 0 5 5 14.29%

DRMC 0 0 2 2 5.71%

KMC 2 0 9 11 31.43%

KVH 0 0 0 0 0.00%

MER 2 0 2 4 11.43%

MSW 0 0 0 0 0.00%

RRH 0 2 8 10 28.57%

SJCH 1 0 2 3 8.57%

Tehach 0 0 0 0 0.00%

Total 35

Pt Dist

Bed Availability

February

Number of

Days

B.A.

Reported

Number of

Days

B.A. not

reported

Number of

Days B.A.

reported >1

BHH 28 0 20

BMH 28 0 28

DRMC 27 1 19

KMC 28 0 27

KVH 4 24 1

MER 28 0 28

MSW 28 0 27

RRH 28 0 27

SJH 28 0 27

THD 11 17 0

Bed Availability Reporting

March

Number of

Days

B.A.

Reported

Number of

Days

B.A. not

reported

Number of

Days B.A.

reported >1

BHH 31 0 22

BMH 31 0 30

DRMC 27 4 20

KMC 30 1 24

KVH 3 28 0

MER 31 0 30

MSW 31 0 30

RRH 31 0 29

SJH 31 0 29

THD 10 21 0

Bed Availability Reporting

8689

8285

10

89 89 89 88

44

60

86

54

73

1

86

82 8284

10

0

10

20

30

40

50

60

70

80

90

100

BHH BMH DRMC KMC KVH MER MSW RRH SJH THD

2018

Number of Days B.A. Reported Number of days B.A. reported >1

Patient Offload to Triage

• Public Comment Period ended March 5th.

• One comment was received

Our triage and acceptance protocols are designed to

expedite the transfer of care from the ambulance to our ED

staff. Our APOD times demonstrate our ability to manage

this process. Our new ED when completed isolates the

“Ambulance Entrance” from the “Public Entrance”

significantly. While this policy would not work at our facility,

we do not want to inhibit its adoption and implementation

elsewhere.

Effective Date

• Effective date is Monday, April 9th, at 12:01hrs.

APOTMarch 2018

APOT-1: March 2018Rank Hospital Number of Transports APOT-1 (Minutes)

1 Ridgecrest Regional 218 7.7

2 Kern Valley Healthcare District 142 13.4

3 Delano Regional Medical Center 250 22

5 Tehachapi Hospital 107 34.1

6 Mercy Hospital 500 38.4

6 Kern Medical 763 46.3

7 Mercy Southwest Hospital 548 46.9

8 (9) Adventist Health 1564 49.8 (93.5)

9 Bakersfield Memorial 1365 78.6

10 Bakersfield Heart Hospital 248 81.4

APOT-1 Bakersfield Hospitals: June 2017-March 2018

0

20

40

60

80

100

120

140

June July August September October November December January February March

AP

OT-

1 (

min

ute

s)

Month

Adventist Health Bakersfield Bakersfield Heart Hospital Bakersfield Memorial Hospital

Kern Medical Mercy Hospital Mercy Southwest Hospital

APOT-1 Outlying Area Hospitals: June 2017- March 2018

0

5

10

15

20

25

30

35

40

45

June July August September October November December January February March

AP

OT-

1(m

inu

tes)

Month

Delano Regional Medical Center Kern Valley Healthcare District Ridgecrest Regional Tehachapi Hospital

APOT-1 and Transport Volume

March 2018, Weekly

Bakersfield Hospitals

0

100

200

300

400

500

600

700

800

900

1000

1100

1200

0

20

40

60

80

100

120

140

160

Week 1 Week 2 Week 3 Week 4

Tota

l Vo

lum

e o

f Tr

ansp

ort

s

Ap

ot-

1 T

ime

(M

inu

tes)

Week (March 2018)

Adventist Health Bakersfield Bakersfield Heart Hospital Bakersfield Memorial Hospital

Kern Medical Mercy Hospital Mercy Southwest Hospital

Outlying Area Hospitals

0

20

40

60

80

100

120

140

160

180

200

0

10

20

30

40

50

60

Week 1 Week 2 Week 3 Week 4

Tota

l Tra

nsp

ort

Vo

lum

e

AP

OT-

1 (

Min

ute

s)

March 2018

Delano Regional Medical Center Kern Valley Healthcare District Ridgecrest Regional Tehachapi Hospital

APOT-2Individual Hospital Data

APOT-2: March 2018Hospital 2.1 (N, %)

(<=20 min)2.2 (N, %)(21-60 min)

2.3 (N, %)(61-120 min)

2.4 (N, %)(121-180 min)

2.5 (N, %)(>180 min)

Total Numberof Transports

Bakersfield Memorial Hospital 390 (28.6) 759 (55.6) 161 (11.7) 3 (2.4) 23 (1.7) 1367

Adventist Health Bakersfield 628 (40.2) 853 (54.5) 70 (4.5) 12 (0.77) 0 (0) 1564

Bakersfield Heart Hospital 87 (35.1) 127 (51.2) 18 (7.3) 9 (3.6) 7 (2.8) 248

Mercy Hospital 265 (54) 220 (44.8) 6 (1.2) 0 (0) 0 (0) 548

Kern Medical 285 (37.4) 447 (58.6) 29 (3.8) 2 (0.3) 0 (0) 763

Mercy Southwest Hospital 242 (44.2) 286 (52.2) 19 (3.5) 1 (0.2) 0 (0) 500

Kern Valley Healthcare District 135 (95.1) 5 (3.5) 2 (1.4) 0 (0) 0 (0) 142

Tehachapi Hospital 73 (68.2) 32 (30) 2 (1.9) 0 (0) 0 (0) 107

Delano Regional Medical Center 220 (88.4) 28 (11.2) 1 (0.4) 0 (0) 0 (0) 249

Ridgecrest Regional 216 (99.1) 2 (0.9) 0 (0) 0 (0) 0 (0) 218

Adventist

0

500

1000

1500

2000

2500

0

10

20

30

40

50

60

70

80

90

100

June July Aug Sept Oct Nov Dec Jan Feb March

Tota

l Tra

nsp

ort

Vo

lum

e

Pe

rce

nt

of

Tota

l Tra

nsp

ort

s (%

)

Month

2.1 2.2 2.3 2.4 2.5

Bakersfield Memorial

0

200

400

600

800

1000

1200

1400

1600

1800

2000

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

June July Aug Sept Oct Nov Dec Jan Feb March

Tota

l Tra

nsp

ort

Vo

lum

e

Pe

rce

nt

of

Tota

l Tra

nsp

ort

s

Month

2.1 2.2 2.3 2.4 2.5

Bakersfield Heart Hospital

0

50

100

150

200

250

300

350

400

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

July Aug Sept Oct Nov Dec Jan Feb March

Tota

l Tra

nsp

ort

Vo

lum

e

Pe

rce

nt

of

Tota

l Tra

nsp

ort

s

Month

2.1 2.2 2.3 2.4 2.5

Proportion of Kern County ED Visits Reporting ILI with Fever: 2017-2018

0.0

2.0

4.0

6.0

8.0

10.0

12.0

September October November December January February March

Pe

rce

nt

Ill

Month

Data prepared by Jyoti Kaur, MPH

Kern County: Total Number of Acute Care Interactions, Oct 2017-March 2018

36540

32316

32707

0

5000

10000

15000

20000

25000

30000

35000

40000

October November December January February March

Tota

l Nu

mb

er

Month

Extra Slides

Transport Volume By Hospital

Week 1 Week 2

349, 30%

55, 5%

321, 28%

168, 14%

134, 11%

139, 12%

Adventist HealthBakersfield

Bakersfield HeartHospital

BakersfieldMemorial Hospital

Kern Medical

Mercy Hospital

Mercy SouthwestHospital

384, 32%

67, 6%310, 26%

185, 16%

126, 11%

107, 9%




Kern Medical

Mercy Hospital


Transport Volume by Hospital, Cont.

Week 3 Week 4

328, 31%

41, 4%

312, 29%

187, 18%

89, 8%

111, 10%Adventist HealthBakersfield



Kern Medical

Mercy Hospital


367, 33%

60, 6%

277, 25%

155, 14%

111, 10%

133, 12%




Kern Medical

Mercy Hospital


Transport Volume by Hospital

Week 1 Week 2

51, 31%

40, 24%

55, 33%

19, 12%

Delano RegionalMedical Center

Kern ValleyHealthcare District

Ridgecrest Regional

Tehachapi Hospital

64, 37%

33, 19%

51, 30%

24, 14%



RidgecrestRegional

Tehachapi Hospital

Transport Volume by Hospital, Cont.

Week 3 Week 4

50, 32%

28, 18%

54, 34%

25, 16%



Ridgecrest Regional

Tehachapi Hospital

62, 40%

21, 14%

41, 27%

29, 19%



RidgecrestRegional

Tehachapi Hospital

ALS to BLS November 2017- February 2018

November percentage

November 2017

December Percentage

December 2017

January Percentage

January 2018

February Percentage

February 2018

EMD QI

• Emailed the QI group first meeting will be April 19th

11:00 – 12:00.

•We will start looking at EMD cards starting with Bravo cards.

•Discuss on ways to improve the EMD process/QI

EMT RegulationsEffective July 2018

EMT Regulations

• Effective July 1, 2017 Blood glucose testing, Epinephrine and Naloxone are in the EMT’s basic scope of practice.

• EMT regulations required EMT course content include Tactical Casualty Care, Naloxone Epinephrine and assessing a blood glucose with a glucometer.

• The Epinephrine and Naloxone must be a minimum of 2 hours. The Tactical Casualty Care must be a minimum of 4 hours.

• Training programs must submit evidence of compliance within 12 months. Training programs and provider will be getting a letter for evidence of compliance and will need to submit for approval.

HP-CPR

• HP-CPR Protocol changes are through 30 day public comment period with no comments received.

• Implementation will be tomorrow April 9th 2018, at 12:01am.

• All providers should be ready to implement if they have not already done so.

Pediatric Determination of Death

• Recent studies and current best practices suggest that on scene resuscitation efforts provide a far higher ROSC and survival rate than resuscitation efforts while transporting for both Adult and Pediatric populations.

• On scene resuscitation is more effective for patients and is far safer for providers, patients, family and the general public.

• If the scene becomes unstable then transport is encouraged, it is up to provider discretion with base consult as to whether resuscitation should be continued during transport.

Determination of Death Pediatric Change

• Currently all patients under 18 years are immediately transported if no signs of obvious death.

• Proposed change is to work pediatric patients on scene for 30 minutes as we do with adults currently. Standard exception for social issues and unsafe scene will remain.

• Base contact for termination of efforts for all patients < 15 shall be required.

Mandatory Paramedic Update Training

Mandatory Paramedic Update Training

MONDAY THE 21ST AND FRIDAY THE 25TH WILL BE MORNING SESSIONS ONLY, 4 HOURS EACH SESSION.

TUESDAY, WEDNESDAY, AND THURSDAY THE 22ND,23RD & 24TH WILL BE MORNING AND AFTENOON SESSIONS 4 HOURS EACH SESSION.

AGENDA

Time Presenter Topic

0805-0810 1305-1310 Jeff Fariss Welcome/Local Accreditation

0810-0820 1310-1320 Kimberly Tollison IGel

0820-0835 1320-1335 Kimberly Tollison Core Measures

0835-0850 1335-1350 Nick Lidgett Paramedic Handoff/Transport directly to the

waiting room/Wellbeing Notification of Death

Online Program

0850-0905 1350-1405 Nick Lidgett Chem Pack

0905-0935 1405-1435 George Baker Protocol Changes/New Protocol Format. EMT

Epi Administration/ D-10

Administration/Intubation

0935-0950 1435-1450 Charles Brockett PCR Review/Documentation

0950-1000 1450 -1500 Break Break

1000-1025 1500-1525 Jeff/Dr. STEMI Center Presentation

1030 1055 1530-1555 George/Dr. Pediatric Center Presentation

1100-1125 1600-1625 Charles Brockett/Dr. Trauma Center Presentation

1130-1155 1630-1655 Kim/DR. Stroke Center Presentation

ANNOUNCEMENTS


THANK YOU FOR COMING


Documents

MATTHEW CONSTANTINE DIRECTOR EMERGENCY MEDICAL …...KMC 30 1 24 KVH 3 28 0 MER 31 0 30 MSW 31 0 30 RRH 31 0 29 SJH 31 0 29 THD 10 21 0 Bed Availability Reporting. 86 89 82 85 10 89