Guest:  Dr. Steve Stroman, Medical Director at Eagle III, Oshkosh Fire, DePere Fire and Rescue, and Oconto Falls Area Ambulance

Over the years, I’ve seen local ambulance service medical directors engaged in policy, procedures, trainings, and quality improvement projects.  Unfortunately, we have medical directors at the other end of the spectrum who are never seen and their name not known by the people working under their MD license.

When Dr. Steve Stroman from the Green Bay area stood up at last September’s Paramedic Systems of Wisconsin Conference and rattled off over six or seven major initiatives they completed for the year, I listened in amazement.  In this webcast Dr. Stroman offers some great ideas from the medical director’s perspective, and projects they’ve recently completed that you can easily pick up on and do the same.

Topics covered, include:

>> Click here to listen now!

The goal is to have seven healthcare coalition regions established in Wisconsin by July 1, 2015.  The regions are determined by the Department of Health, and mirror the previous WHEPP regions, which had been established by patient referral patterns.

 

Wisconsin identified some gaps in widespread healthcare coordination, to include: coordinated plans for large scale disasters, lack of a formal regional medical coordination structure, established indicators for crisis standards when systems are overwhelmed, evacuation plans, and patient tracking capability.

 

Healthcare coalitions don’t replace day-to-day functions of individual responder agencies or organizations.  Wisconsin is following a federal model that grew out of recent event experiences with the Joplin tornado and Hurricane Sandy.  The goal is to coordinate how public health, healthcare institutions, and first responder agencies will manage their efforts to enact a uniform and unified response to an emergency, specifically the medical surge aspect of an event.

 

Get the latest information on Wisconsin’s Healthcare Coalition efforts in this webcast from co-medical advisor Dr. Michael Clark. Click here to listen  now!

MTM recently announced they will be holding three town hall meetings for their transportation partners.  They are inviting comment on the Wisconsin non-emergency medical transportation (NEMT) program.

 

MTM, the state of Wisconsin’s non-emergency Medicaid and BadgerCare Plus transportation broker who schedules ambulance and other rides for medical appointments was recently criticized in a Journal Sentinel article for long wait times. 

 

The town hall meetings will be held in the West Milwaukee area on March 31; the Black River Falls/Tomah area on August 4; and the Green Bay/Appleton area on November 3. The West Milwaukee meeting is scheduled for the Pewaukee Holiday Inn from 5 p.m. to 8 p.m. Locations for the Black River Falls/Tomah and Green Bay/Appleton meetings are TBD and will be announced as the dates approach.

 

To RSVP, click here

The union for Green Bay firefighters has lost a nearly two-year fight against a city initiative requiring firefighters to make house calls on discharged hospital patients.

A state labor arbitrator has ruled the city was within its rights to initiate a program in which Bellin Hospital paid the city $50 for each house call.

But whether the so-called Hook and Ladder program will move forward in its original structure remains to be seen.

City officials suspended the program indefinitely while awaiting a decision on the grievance filed by the Green Bay Professional Fire Fighters Association.

The union argued that Hook and Ladder was an improper expansion of firefighters duties and that the city could not impose such new assignments unilaterally under the union's contract.

>> Read more

Source:  Green Bay Press Gazette

By Joe Covelli, PAAW Executive Director

 

At its January 8^th board of directors meeting, the Professional Ambulance Association of Wisconsin approved its 2015 – 2017 strategic work plan.  The plan was developed on December 1, 2014 when association members, staff, consultants, and invited guests attended the all-day meeting.

 

The top priority calls for continuing to build momentum gained last year and introduce legislation in the current session to expand TRIP – Taxpayer Refund Intercept Program.  Currently, only municipal ambulance services can access TRIP and file with the state to collect unpaid transport bills from the patient’s tax refund.  PAAW is working with legislators to introduce legislation that allow ambulance services contracted by a municipality to provide 911 services the same TRIP collection benefits for unpaid patient transports.  The reception by legislators to the idea has been favorable.

 

Additional items in the strategic work plan include community paramedicine, Medicaid reimbursement rates, ongoing communications, member growth, and advancing EMS leader networking opportunities.  The Wisconsin Stars of Life Awards Program will change to an every other year event, with the next one being held in September 2015, and one honoree from the group advancing to the national Stars of Life in Washington D.C. in March 2016.

The MedEvac Foundation International has approved grant funding for Dr. Daniel Patterson to investigate sleep-wake patterns and real-time fatigue reduction in emergency medical service (EMS) clinicians.

The medical transportation community requires that emergency care be available 24 hours per day. Shift work requires the prehospital emergency clinician to diverge from normal circadian sleep cycles and be alert when the pressure to sleep is greatest. While recent data suggests a link between sleep, fatigue and safety in the EMS setting, the data are limited to cross-sectional designs and subject to recall and measurement bias. The proposed study will provide detailed prospective observational data to address questions pertaining to the relationships between shift duration, sleep/wake cycles and behavioral alertness.

The overarching goal of the study is to address the Foundation’s research priority of “Educational techniques and technologies aimed at improving patient care, critical decision making, safety, or other areas pertinent to transport medicine.” Dr. Patterson, along with several colleagues, intends to accomplish this goal by performing a multi-site study of air-medical EMS clinicians. The Foundation Board has approved Phase 1 of the study, which will involve a prospective observational study of sleep/wake cycles, shift work duration, intershift recovery, fatigue and behavioral alertness (i.e., psychomotor vigilance).

The analysis of Phase 1 data will focus on differences between 12-hour versus 24-hour shifts.

>> Read more

MTM schedules non-emergency ambulance requests for Medicaid and BadgerCare

Inadequate staffing at MTM Inc.'s call center in Madison appears to be the reason why more than 24% of people who called to schedule a medical ride in September hung up before getting through to a person. That's according to MTM's corrective action plan, obtained by the Public Investigator under a public information request.

MTM provides rides to Medicaid and BadgerCare Plus members who have no other way to get to their plan-covered services. Its contract with the State of Wisconsin caps the number of hang-ups at 5%. But in 2014, rates steadily climbed from 10.3% in March to 24.1% in September. Meanwhile, state officials sat by without any enforcement.

That's because MTM's contract says the 5% hang-up limit isn't enforced until the average hold time exceeds four minutes. The company came in under that every month through August.

However, according to newly released statistics, hold times exceeded the four-minute limit in MTM's contract in September. This triggered enforcement of both the hang-up limit and the hold time.

>> Read more

Source:  JS Online

Brian Goelzer was selected as the new executive director at Orange Cross Ambulance in Sheboygan.

 

He recently wrote, “On October 1, 2014 Orange Cross Ambulance and Plymouth Ambulance services became one organization. It is my goal as the new leader to build a positive culture for all employees and their families’ while paving the way to exceed patients’ expectations and become leaders in EMS.”

EMS professionals are a critical link in successful resuscitation from cardiac arrest. Approximately 400,000 Americans experience an out-of hospital cardiac arrest every year and only 10 percent survive. However there has never been a CPR course tailored to EMS professionals until now.

The American Heart Association released, for the first time, a new CPR course geared specifically toward BLS prehospital providers.

Basic Life Support for Prehospital Providers BLS PHP, released in October 2014, combines flexibility and customization to meet department and agency needs. The course is based on the 2010 American Heart Association guidelines for CPR and ECC and will be updated when the 2015 guidelines are released in November.

Why the new course?

The American Heart Association heard from EMS providers that the previous BLS Health Care Provider course was missing essential and realistic CPR training. The new BLS for Prehospital Providers course focuses on first responders and uses realistic EMS team approaches to respond to cardiac arrests in the field.

The new course format

The BLS for Prehospital Providers course consists of both online and classroom components, and the new format stresses the importance of transition of care from BLS to ALS EMS providers.

Online

The online portion is narrated and presents the cognitive information. Students must complete all the objectives in order to complete the online portion of the course, and cannot skip ahead.

The online course focuses on three core scenarios:

• Cardiac arrest in a car
• A child drowning in a family pool
• Cardiac arrest in a home bathroom

Students must pass the online exam to move on to the classroom portion.

Classroom

Students then attend the in-classroom portion, led by an American Heart Association BLS Instructor. The classroom portion features instructor-led discussions, debriefing, coaching and support for hands-on skills. The classroom is blended with skills tests from the current health care provider course, along with discussions and a six-person team resuscitation.

The course focuses on a high-performance team approach, moving from two rescuers, to six suggested roles for responders, depending on personnel available. Teams with less than six may take on multiple roles.

Key roles include a compressor, a team member to handle compressions, a team member to handle the airway, another team member to defibrillate/AED, a team leader to delegate roles and make decisions and lastly a team member to administer an IV/IO/medication. The team approach is similar to an in-hospital resuscitation.

Course materials

All materials exist in an online format. EMS agencies can purchase multiple quantities of online keys to access materials for their personnel, and schedule the classroom sessions with their in-house American Heart Association BLS CPR Instructor.

The American Heart Association’s BLS for Prehospital Provider is fun and interactive, and incorporates EMTs, medics, firefighters and police with real life scenarios.

Source:  EMS1 Danielle Cortes DeVito

The Critical Care Emergency Medical Transport Program (CCEMTP) course will meet every Thursday and Friday, 8 am – 5pm, beginning April 2, 2015 through May 21, 2015.

A nationally recognized training program Critical Care Emergency Medical Transport Program (CCEMTP®) offers experienced paramedics and nurses a foundation that will prepare you to become a critical care transport specialist. This intense 100-plus hour course, presented at Gundersen Health System in La Crosse, WI was developed by the Department of Emergency Health Services at the University of Maryland, Baltimore County (UMBC); The curriculum has such an excellent reputation that it is accepted as the base course for many other state and national level certification training.

Course brochure containing further information and registration form can be obtained by contacting Rick Barton in the EMS Education Department at Gundersen Health System,rkbarton@gundersenhealth.org. or by phone at (608) 775-6315.

This continuing education activity is approved by UMBC, an organization accredited by the Continuing Education Coordinating Board for Emergency Medical Services (CECBEMS).

Course brochure containing further information and registration form can be obtained by contacting Rick Barton in the EMS Education Department at Gundersen Health System,rkbarton@gundersenhealth.org. or by phone at (608) 775-6315.