06 febrero, 2015


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.

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