Recently the Tidewater EMS Council’s Stroke, STEMI and EMS Performance Improvement (PI) plans received facelifts and contents were upgraded to reflect a new structure and committee processes.
The Stroke PI plan changed the least. Aside from a new look, with formatting and appearance changes, the plan more closely aligns with current stroke treatment and transport. The wording in the plan was slightly modified such that stroke patients should be “preferentially” transported to a Primary Stroke Center, which returns some decision-making to the medical control physician and allows for a determination of current capabilities at any facility.
The regional ST Elevation Myocardial Infarction (STEMI) PI plan has been refined with assistance from the STEMI Accelerator 2 program funded by a grant from Duke University Medical Center to the AHA Eastern Region Heart Attack Coalition. The grant assisted with upgrading and improving the processes in the original STEMI plan. Regional STEMI champions, assisted by medical staff funded by the grant, reviewed the way STEMI patients were managed in the region from the onset of symptoms through treatment options in the field and at the hospitals. These champions came together and blurred hospital and agency lines with agreement to approach treatment of STEMI patients from the perspective of doing what is best for the patient. The plan now reflects these changes and they have really paid off: early EMS 12-leads have increased. ED bypass has increased. Door-to-balloon times have decreased. "False” STEMI alerts are low. Important indicators have all changed from red and yellow to green for the Tidewater region. Read more about the regional STEMI accelerator project here. Additional edits will occur during 2017 as the regional AHAC and STEMI PI subcommittee continue to refine and improve the plan.
The EMS PI plan received the most comprehensive changes. EMS PI stakeholders have been hard at work reviewing and recommending changes to the PI plan which includes the structure of the PI committees within the TEMS hierarchy. There needed to be a better structure and methods to address and handle the PI complaints and issues, and to identify new issues, along with a more consistent manner to develop and communicate PI recommendations to the EMS community. With that in mind the a revised EMS PI plan was approved by the TEMS Board of Directors with the EMS PI committee becoming the oversight committee with Trauma, Stroke, STEMI PI becoming subcommittees under the main EMS PI Committee, joined by a new Patient and Provider Safety PI subcommittee. The EMS PI plan also includes new committee and subcommittee goals and objectives. The EMS PI committee and all subcommittees meet regularly, and are open meetings, with dates listed on the TEMS online meeting and event calendar.