2
Clinical QI and Personnel
EMS Redesign Committee
Meeting Minutes
3/7/07
Attendance
Eric Weiss EMS Medical Director
Brad Setterlund SSFFD EMS Coordinator
David Buettner UCSF Student
Jennifer Arkoosh AMR
Michael Mendenhall AMR Operations Manager
Jamie Norton San Mateo County Fire Department
John Kammeyer Central County Fire Dept.
Matt Powers JPA North
Brad Nozik AMR CES Specialist
Yolanda Musquez AMR Paramedic
Cindy Alfsen AMR EMT
Diane Imlach AMR Paramedic
Leisa Ann Steele Life Flight
Rob Consani Woodside Fire Department
Bill Euchner San Mateo County Fire Department
Jason Fox Redwood City Fire Department
Ruby Siero-Tanti AMR Paramedic
Ken Anderson SSFFD BLS Supervisor
Emil Picchi JPA South
Sue Anderson Public Safety Communications
Mark Ladas JPA-Central
Sandi Reiter AMR
Larry Olson JPA Administrator
Welcome and Introductions
Barbara and Jan welcomed the group.
The group did self-introductions
Roles
Cindy: Facilitator
Jamie: Time keeper
Scribes: Jan and Jason
Introduction To The System
Barbara provided a review of the development of the exclusive operating area (EOA) for San Mateo County. She explained what the position of San Francisco fire department in relation the Division 2.5 of the California Health And Safety Code section 1797.201. This helped to clarify what it means when a city has “201 rights”. That city is still a part of the EMS system and follows policy, procedure and protocol however they are not a part of the exclusive operating areas. Our mission will not be to redesign the EOA. It is our mission to design a portion of the EMS system that will be reflected in the Request for Proposal for the EMS Contract that will become effective in 2009.
Barbara explained that instead of having one large group work on the EMS System Redesign the project has been broken down into 9 groups each with a special emphasis. A handout was provided that shows the relation ship of each group to the Steering Committee and the Steering Committee to the EMCC, Health Director and Board of Supervisors.
San Mateo County will determine the composition of the steering committee. The role of the Steering Committee will be to review all of the recommendations and refine them for the development of the RFP. They may also make their own recommendations. The recommendations of the steering committee will then go to the EMCC and the Director of the Health Department.
General guiding principles
This will be a very open process. Any member of the San Mateo EMS system can be involved in any of the nine subject matter committees. All the meeting minutes and recommendations will be posted on the web. EMS will need to have e-mail addresses for any interested members. The e-mail address should be the one that is checked with some frequency by the committee member. Each Committee will have a mission, which will be posted on the Web Site. The web site address is: www.smhealth.org/ems/redesign
Handouts
Jan reviewed the handouts. There are copies of the pertinent sections of the RFP and the contract. The amendments of the contract are at the end of the document. The complete RFP and Contract with all amendments are available on the EMS web site under EMS system or under the “Who We Are” section of the site.
Ground Rules
The group discussed Ground Rules. The following were developed by the Transport and Response Committee and seemed complete:
· Respect
o Opinions
o Agencies
o Perspectives
· Put pages/phones on vibrate
· No PDAs
· No sidebars
· No cutting off others who are speaking
· No filibusters
· Every idea is OK to talk about
· Use the Parking Lot for Items to be referred to other Redesign Committees
· No gossip outside this group
· What this group decides will be passed up to higher group (Steering)
· We will agree by consensus
· We will strive for consensus
· How many people needed in order to have a meeting? No quorum needed. We will set next meeting at end of each meeting.
· Data versus perception. If no data is available on a particular thing, the EMS Agency will try to get it.
· Everyone has an equal voice.
:
It was stressed that any idea could be discussed at these meetings. Decisions will be made by consensus. That means that we will work toward language that most can agree with.
We will need to be done with the design process by the end of this year. Most of the 9 committee’s recommendations will need to be finalized by summary to allow time for the RFP to be drafted. The first draft of the recommendations will need to be completed in the near future.
Mission Statement
It was suggested we review the current mission statement for QLC and revise as needed for this committee. The current mission statement is:
To provide EMS professionals the tools and knowledge necessary to provide high quality evidenced-based care to patients in the San Mateo County EMS System through communication and quality improvement.
Brain Storming
The group discussed all the ideals for each section we would discuss.
Items for discussion / Item / Refer to Committee /Clinical Performance / Minimum Patient care contacts
Clinical Performance / Infrequent Skills
Clinical Performance / Required Training
Clinical Performance / Ambulance Mutual Aid (out of County Resources) / Response and Transport
Clinical Performance / Advances in Technology
Clinical Performance / Clinical Performance Measures: KPI's
Clinical Performance / Meetings: QLC
Clinical Performance / QI Plan
Clinical Performance / Patient Contact Definition
Clinical Performance / Data Points (indicators??)
Clinical Performance / Reporting Formats
Clinical Performance / Reporting Requirements
Clinical Performance / Skill maintenance
Clinical Performance / PCR Process
Clinical Performance / Documentation
Clinical Performance / Mechanism for Field Feedback
Clinical Performance / Patient Satisfaction / Performance Measures
Clinical Performance / Hospital Outcome Information / Hospitals
Clinical Performance / Timely sharing of information
Clinical Performance / New Technology "fund" (Medical Director's fund)
Clinical Performance / Hospital and Multidisciplinary Training / Hospitals
Clinical Performance / Recognition of excellence
Clinical Performance / Physician Consultation
Clinical Performance / Linguistic Access
Clinical Performance / Cultural Competency
Clinical Performance / Low Frequency/High Risk events
Clinical Performance / Feedback on QI/Incidents
Clinical Performance / Practice Standards
Clinical Performance / Compensation for Committee Participating at field/staff level / Finance??
Education Training / Standardized Training
Education Training / Multidisciplinary
Education Training / Continuing/Recurring training
Education Training / Technology for Training
Education Training / Journal Club
Education Training / Age Specific
Education Training / Joint Training
Parking Lot
These items were briefly discussed by the group and it was recommended that the topic be referred to another committee
/ Item / Committee for Referral /Parking Lot / 3 tiered system / Response and Transport
Parking Lot / Techniques for Information sharing / Data and technology
Parking Lot / Transfer of Clinical Information: Integrity/accessible / Data and technology
Parking Lot / Standby ED's (??)
Parking Lot / Standby Requirements / Response and Transport
Parking Lot / Nursing Home Interface
Parking Lot / Where fines go?? / Finance??
Parking Lot / User's tax / Finance??
Parking Lot / Grant Committee
Parking Lot / Centralized Personnel Records / Data and technology
Parking Lot / Funding for Field Supervisors / Finance??
Recommendations
The group started the recommendations with Key Personnel. This section is to be completed next meeting.
Items for discussion / Item / Refer to CommitteeKey Personnel / EMS Division
Key Personnel / Supervisors for first response (fire) and transport
Key Personnel / Minimum of 2 on duty 24/7 in county Available to respond
Key Personnel / Duties: to be determined..
Key Personnel / Qualifications
Key Personnel / Regional Training Coordinators
Key Personnel / QA/ QI Need to finish
Evaluation
The Evaluation Process was discussed for those unfamiliar with EMS committee meetings
1 2 3 3.5 4 4.5 5
8 7 8
What Went Well Opportunities
What Went Well / Opportunities for Improvement /Got a lot done / Lots of material X2
Good ideas X2 / Break into similar blocks X2
Attendance X 2 / Time Keeping
In put X 2 / Don’t reinvent what works well
Parking !!
Good Discussion X 2
Agreement/ consensus
Through
Good participation X 2
On track
Building
Next Meeting:
April 4, 2007
1000 AM – 3:00 PM
QLC will meet from 0900 am – 1000 am
Foster City Community Center
Port Room
Lunch will be provided