Transcript Division of Emergency Medical Services

County of Volusia  Department of Public Protection
Division of
Administrative Responsibilities
• Ordinance
- Certificate of Public Convenience
and Necessity (COPCN)
- Closest unit emergency medical
response
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•
System analysis
EMS Trust Fund
Liaison to agencies (county and municipal)
Partnerships (contingency and pilot programs)
Response Times
• Definition. What defines a response time?
• Industry standards. 4 minutes? 8 minutes?
From where did these times evolve?
• Measure. What’s the most transparent formula
for illustrating response times?
• Do response times affect patient
outcome?
Anatomy of a Response
Recognition:
delay between
initial illness or
injury and
activation of
EMS system (45
seconds).
Time: 0:45
Elapsed time: 0:45
1
0:30
1:15
Reaction time:
difference in time
between receipt of
alarm and ’wheels
moving’ on apparatus
(30 seconds).
0:30
1:45
Processing time:
difference between
notification of field
units and receipt of
call information by
the communications
center (30 seconds).
2
3
Vertical response
time: difference
between arriving at
the patient’s side and
‘wheels stop’ at the
location (45 seconds).
4:00
5:45
Response time:
difference between
‘wheels stop’ at the
location of the event
and ’wheels start’ at the
beginning of the
response (4 minutes).
5
0:45
6:30
4
Clinical Responsibilities
• Medical oversight of field & communications
staff (401.265, Florida Statutes)
- Prehospital standing medical orders
- Quality assurance
- Access to legend devices, prescription
medications, & controlled substances
- Contingency emergency medical transport
• Credentialing and
education
Challenges facing EMS
• Existing health care
- Customary reimbursement (Medicare, Medicaid, etc.)
- Revenue (FY 09-10 uncollectibles, $16 million)
• Impact of Patient Protection and Affordable
Care Act
- “EMS agencies lose money responding to calls from
the publicly insured.” – NAT’L CTR FOR POLICY ANALYSIS
- Value-based
- No one really knows.
• Better utilization of resources
- Increased efficiency without loss of effectiveness
(Emergency Medical Dispatch)
- Lost unit hours (e.g., bed delays, diversion)
• Public expectation
Challenges facing EMS - continued
• Determining an affordable, sustainable, and
outcome-driven model (i.e., optimal service)
Questions?