En la última Exposición
Mundial de la EMS - 2014, Rob Lawrence* un gran conocedor del campo del Pre
Hospitalario, nos comparte sus consejos prácticos para seguir brindado la ayuda
a quién lo necesite.-
At EMS World Expo 2014, I was challenged
to deliver a session on what high-performing EMS systems Should be doing to
stay on top of Their game. I
focused on key elements of business practice, organizational performance and
clinical excellence required for any high-performing system, EMS or otherwise. I drew my inspiration from the
practices of my own organization and Those of the Coalition of Advanced
Emergency Medical Systems (mark in this country), but the tips are scalable and
useful to all. In summary, my top
10 tips are as Follows:
1.
Embrace Economic Efficiency
From an economic sense, the mission of
EMS-and any healthcare organization for that matter-is to "convert the
amount of available budget money into high-quality healthcare in order to
produce excellent clinical outcomes." The days of well-padded budgets are
a thing of the past. Municipal
coffers are shrinking for the public sector and Reimbursements collection rates
are down for private EMS, and charitable giving and the donation of free time
is fast disappearing in the volunteer sector. In
other words, no matter the type or style of your organization, it must be run
as a business, with an eye on the bottom line and a realization That EVERYTHING
costs something.
2. Manage Data
In This day and age it's Difficult to
believe some think EMS organizaciones They Have little or no management
information. The current
situation is quite the Contrary and personal data mines are bottomless. Information is freely available, from
call volume to patient condition to mean times between failures of vehicle
components. When Collected,
collated and Analyzed, esta información Becomes a valuable intelligence That
product can be ACTED upon to improve increase the next cycle of response, care
and administration.
3.
Analyze Demand
System status management (SSM) is the
science of Being in the right place with the right resource at the right time
to meet the patients' needs. Some
say it's the practice of Placing ambulances on street corners, but the crucial thing
we must remember is the patient is Having the emergency so we must be poised to
answer-With minimal delay and maximum impact. SSM
Takes the intelligence products of demand analysis of Both time and space, and
matches to deploy manpower and availability to respond as close to the patient
as possible. This achieves a
minimal response time for the patient, and you reduce time spent running under
emergency conditions for the crew-not to mention distracted pedestrians!
4.
Engage Your Medical Manager
So far all the planning and data
crunching has-been devoted to the first 10 minutes, or approximately one-sixth
episode of the patient response. It's
ironic That some organizaciones set great store by, and are Judged on, Their
response times alone. It's not
"high-performing" if you are good at racing to the scene, only to be
incapable of delivering the goods on arrival clinical. A well-trained workforce That Has
Sufficient preception, mentoring and training, and is clinically current, is an
absolute requisite for success. To
Achieve esta, the Involvement and active engagement of the operational Medical
Director (OMD) must Occur-often.
5.
Run a Lean System
EMS is not only response, treatment and
transport;the back office and support functions are the "power behind the
punch" of service delivery. The
creation of lean, efficient and measurable systems is the key to success. An example of this is a
high-functioning fleet service. If
your vehicles fail on the way to calls, then a so does the mission. Keeping your organization well
serviced and maintained is an arterial function and performance Could
hemorrhage if you can not get to where you need to go. The swift conversion of treatment to
bill to income también está an essential function.Remembering the economic
requirement That We turn the amount of available funds into quality healthcare
requires the generation of Said funds to keep the EMS turning circle of life. While Those in support functions are
not delivering life-saving and patient care, They keep the organization alive
and healthy.
6.
Develop a Culture of Safety
The Culture of Safety is, surprisingly,
still a new concept to some quarters of US EMS. Nationally This is apparent by the
stream of line-of-duty Deaths (LODD) and devastating That vehicle accidents
result in well-publicized photos of ambulances splayed like bananas after
Impacts With Both moving and static objects. An
environment of cultured safety seeks to Establish the root cause of These
issues then a put techniques, practices, philosophy and Procedures in place to
create a safe environment for all.
7.
Make Friends with Public Health
When I go out to speak, I ask the
audience Often If They know-who is the director Their public health.Many do
not, Which is shameful. EMS
enjoys Its role in public safety and STI .Recognizes place in the house of
medicine, but fails to Realize it is an essential member of the public health
camp. Prevention is better than
cure every time, so understanding the aims and objectives To of the public
health system is essential. The
current Ebola crises have reinforced the point that we are solidly joined to
public health and we must interact Often and well.
8.
Advocate for Innovation and Research
To continue to push the boundaries of
the EMS world, we require evidence-based practice, and outcomes data to trump
industry anecdote and tradition. To
progress we can not simply hide behind the mantra of "We have always done
it That Way." Organizations Should Consider researching, Collaborating,
capturing and presenting studies and good practices. It Does not Have to Be patient massive
major projects or studies, but Perhaps a series of "small cycle
testing" that Relies on a "plan, do, study, act" (PDSA) cycle. Large Occur can change from small
tests. Writing up in Original,
Complete with supporting evidence, can effect change not only in the
Researchers' organizaciones, but in the wider industry.
9.
Get Out in the Community
The evolution of community-based
programs Almost here is anthropological in nature.Community paramedicine, or
mobile integrated healthcare, is Evolving and forming según Local environmental
and political conditions. No two
programs are the same, Which is technically good, as They are shaped to meet
the needs of the population They serve. The
bottom line for many of These programs to be Successful and Attain longevity is
to be actuarially sound and generate income to be self-sustaining.
Sadly many programs to date unavailable
operated on a loss-leading footing and, UNLESS via sustainable income is
forthcoming legislative Changes, Could some fade as Quickly As They INITIALLY
shone. That Said, some
community-based activity is part of the normal daily Already EMS practice and
Rightly Could be classed as "paramedic in the community" activity.
WHO Understanding your users are frequent
service, and managing Their whole system use case and creating conferences, is
a great community activity. Fostering
relationships with other vouchers home care organizations: such as behavioral
health, social services, faith-based groups and Both the primary and secondary
care the industries May lead to the creation of cost-effective and sustainable
programs.This level of liaison Also Assists in the breaking of barriers and
removal of care silos.
10.
Ensure Your Voice Is Heard
Internally, "if no one is
following, then a you are not leading." Externally, if you do not
broadcast your message, then a no one will hear it! A key communication strategy Should be
a major corporate activity.Some say it Takes 10 good news stories to trump one
bad story. Having an active
communication That Involves providing your average local plan With positive
stories (to get your 10 good ones in the bank) is a good investment in time. Good news stories inform the public as
to the quality of your agency and instill a sense of pride Within the service. In the social media age it is now easy
to place relativamente news. A
photograph and a descriptive paragraph can be crafted Quickly and posted on
your organization's social media sites or sent to the editor of a national
trade magazine for Both national and international coverage.
A
Bonus Tip: Know the Four Words that Count Most
Organizations EMS usually we are one
degree of separation away from politics. Public-Sector
Organizations are Governed by councils or boards of supervisors; Have private-industry companies
Shareholders and executive boards. If our EMS Lead Those Who
organizaciones are not politically aware and astute at navigating the rocky
waters of achievement and funding, then a las organizaciones-regardless of how
good or efficient whos They are-can be overturned by four political words:
"All those in please . "If You Have an Inability to Influence Those
Who govern, then a be prepared to be outvoted or worse-Voted off the island.
*Rob Lawrence es el jefe de
operaciones de la Richmond Ambulancia Autoridad
- RAA. Antes de venir a los EE.UU. en 2008 para trabajar en AAR,
ocupó la misma posición en el condado de Suffolk al Este de Inglaterra en el servicio
de ambulancias. Se graduó en la Real Academia Militar de Sandhurst y sirvió
en la Royal Army Medical Corps. Rob es además miembro de la EMS World
Editorial Advisory Boad.
