Florida’s Emergency Medical Services Strategic Plan
July 2010 – June 2012 EMSAC Members EMS Educator Daniel Griffin, AS, CCEMT-P The following is a list of the EMSAC members at the time this strategic Emergency Medical Services for Children Liaison plan was published. EMSAC members are appointed by the State Julie Bacon, RNC, BA, CPEN, C-NPT Surgeon General for a term of four years. Ex-officio members of the EMSC Advisory Committee EMSAC are appointed by the respective agency head. For a current list of members, a copy of the EMSAC bylaws, or general information about the Emergency Medical Technician (Non-Fire Service) Tom Quillin, Chief EMSAC, visit the BEMS website at: http://www.fl-ems.com. Leon County Emergency Services
Chair- Air Ambulance Operator Emergency Nurse John Scott, RN, EMT-P Amy Paratore, RN Tampa General Hospital Tampa General Hospital Hospital Administrator Commercial Ambulance Operator Maria Fernandez, MSN Alan Skavroneck, Chief Operating Officer Miami Children’s Hospital LifeFlight Ambitrans Medical Transport Lay Elderly Department of Highway Safety and Motor Vehicles Doris Ballard-Ferguson, BSN, ARNP, MNSc, PhD Walter Liddell, Trooper Florida A & M University School of Nursing Florida Highway Patrol Lay Person Regina E. Sofer, MPA Department of Education Florida Education Center Tracy Yacobelis Program Specialist, Health Sciences Education State EMS Medical Director Joe Nelson, DO, MS, FACOEP, FACEP Department of Financial Services Bureau of Emergency Medical Services Barry Baker, Chief Division of Emergency Medical Operations Bureau of Fire Standards and Training Florida Department of Health State Fire Marshall Paramedic (Non-Fire Service) Karen Chamberlain, EMT-P, RN, BSN, CFRN, CEN, CCRN Department of Transportation Trenda McPherson Paramedic (Fire Service) DOT Traffic Safety Specialist Charles E. Moreland, EdD Division Chief, Jacksonville Fire and Rescue Emergency Medical Technician (Fire Service) Physician Cory S. Richter, EMT-P Patricia Byers, MD Battalion Chief, Indian River County Fire Rescue University of Miami, Miller School of Medicine Division of Trauma & Critical Care EMS Administrator (Non-Fire Service) Michael Patterson, Chief Physician Putnam County EMS Cover photo courtesy of Nature Coast EMS Bradley Elias, MD 2010 Florida EMS Photo of the Year - best Baptist Medical Center EMS Administrator (Fire Service) depicting the 2010 National EMS week William R. Colburn, Chief theme. Reedy Creek Fire Department “EMS: Anytime. Anywhere. We’ll be there.” Table of Message from the State Surgeon General ...... 2 2009 EMS Photo of the Year...... 3 Executive Summary...... 4 Contents 2010-2012 Goals...... 5 About the Emergency Medical Services Advisory Council ...... 6 Why Strategic Planning? ...... 8 2010-2012 EMS Strategic Plan Goals and Objectives...... 10 Goal 1:...... 10 Florida’s Emergency Medical Services Goal 2:...... 12 Strategic Plan July 2010 – June 2012 Goal 3:...... 14 All photos used with the expressed Goal 4:...... 16 consent of: Julie Bacon Goal 5:...... 18 Indian River Fire Rescue Leon County EMS Goal 6:...... 20 Miami Dade Fire Rescue Goal 7:...... 24 Nature Coast EMS Seminole Tribe Fire & Rescue Goal 8:...... 28 Shands Air Care Goal 9:...... 32 Strategic Planning Coordinator: Goal 10:...... 34 Melissa Keahey Bureau of Emergency Medical Services Celebrating Our Successes ...... 36 4052 Bald Cypress Way, Bin C-18 Acknowledging Our Partners...... 38 Tallahassee, FL 32399 (850) 245-4440 ext *2686 Glossary...... 40 [email protected] Acronyms...... 42 Special thanks to Lynne Drawdy, DEMO Appendix A ...... 44 Quality Improvement Coordinator for her commitment to performance Appendix B ...... 46 excellence and support to the Strategic Appendix C ...... 48 Visions Committee.
1 consensus-building discussions, projects, and prioritization exercises. The ten Message from the goals with supporting objectives were presented to the Florida Emergency Medical Services Advisory Council for endorsement in January 2010. The State council endorsed these recommendations and will focus on the following emphasis areas for the next two years: leadership, Surgeon prehospital incident data collection, outreach, injury prevention, access to care, public education, workforce General education and development, workforce satisfaction, service delivery, disaster preparedness and response, air medical safety, patient safety, personnel safety, radio communications, and emergency On behalf of the Florida Department medical dispatch. of Health and our partners I present to you the July 2010–June 2012 Florida We all play a key role in the EMS Emergency Medical Services Strategic system. Continuing to grow and Plan for Florida’s EMS system. This plan is expand our community partnerships an evolving and fluid document that will and collaborative efforts strengthens change as best practices are discovered the success of the plan and the services and implemented. The Florida Emergency provided to Floridians. I recognize all Medical Services Advisory Council and those involved in the development its Strategic Visions Committee are the and implementation of this plan. Their strategic plan oversight team. This team is continued drive to link the continuum comprised of health and medical leaders of care through their strategic planning from all disciplines around the state efforts is to be commended. and is responsible for setting priorities, allocating resources, providing oversight Sincerely, and coordination, and communicating and monitoring progress against targets. Ana M. Viamonte Ros The new 2010-2012 EMS State Strategic Ana M. Viamonte Ros, M.D., M.P.H. Plan was developed through a series of State Surgeon General
2 2009 EMS Photo of the Year
Photo courtesy of: Seminole Tribe Fire Rescue - Best depicting the 2009 National EMS Week Theme, “EMS: A Proud Partner in Your Community.”
3 Executive Summary
Photo courtesy of Leon County EMS - 2010 Florida EMS Provider of the Year.
4 Florida Statute 401.24 requires the Florida 2010-2012 Department of Health, Bureau of Emergency Medical Services, to develop and biennially Goals revise a comprehensive state plan for basic and advanced life support services. At a minimum, the plan must include:
1) emergency medical systems planning, including the prehospital and hospital phases of patient care, injury control efforts, and the unification Goal 1: Improve the EMS system through effective leadership of such services into a total delivery system to include air, water, and land and communication by the EMS Advisory Council. transport; Goal 2: Improve EMS data collection and participation through advocacy, outreach, and improved accessibility to EMS 2) requirements for the operation, coordination and ongoing development incident-level data. of emergency medical services which include: basic life support or advanced life support vehicles, equipment, and supplies; Goal 3: Improve customer satisfaction through injury prevention, communications; personnel; training; public education; state trauma public education and knowledge of the EMS system. system; injury control; and other medical care components; and (Customer as defined by the EMS agency). Goal 4: Improve EMS work-force education, performance, and 3) the definition of areas of responsibility for regulating and planning the satisfaction. ongoing and developing delivery service requirements. Goal 5: Ensure economic sustainability of the EMS system and serve as a clearinghouse for EMS legislative issues. Goal 6: Improve performance of key EMS processes through benchmarking and partnerships. Goal 7: Assure the EMS system is prepared to respond to all Florida Statute 401.245 created the Emergency hazard events in coordination with state disaster plans. Medical Services Advisory Council (EMSAC) for Goal 8: Maintain an accident-free environment and promote a the purpose of acting as the advisory body to culture of safe and appropriate utilization of Florida air assets. the state’s emergency medical services program. Goal 9: Increase access to care by improving patient safety, The duties of the council are outlined in Section responder safety, and the safety of the general public. Goal 10: Improve consistency, efficiency and education of 401.245, F.S., and includes 401.245(1)(f), F.S.: public safety personnel with respect to incident related emergency medical dispatch (EMD) and radio “Providing a forum for planning the continued development of the state’s emergency communications. medical services system through the joint production of the emergency medical services state plan.”
5 About the Emergency Medical Services Advisory Council
“EMS: Anytime. Anywhere. We’ll be there.” Photo courtesy of Nature Coast EMS - 2010 Florida EMS Photo of the Year best depicting the 2010 National EMS week theme.
6 EMSAC Mission: The Emergency Medical Services Advisory Council was created for To facilitate, promote, and ensure the best the purpose of acting as the advisory body to the emergency medical prehospital emergency medical care to the residents and visitors of Florida. services program. Pursuant to Section 401.245, Florida Statutes, the duties of the council include, but are not limited to: EMSAC Vision: A unified EMS system that provides evidence (a) Identifying and making (f) Providing a forum for planning the based prehospital care to the people of Florida and recommendations to the department continued development of the state’s serves as the recognized leader in EMS response concerning the appropriateness of emergency medical services system nationwide. suggested changes to statutes and through the joint production of the administrative rules. emergency medical services state plan. EMSAC Values (b) Acting as a clearinghouse for (g) Assisting the department in developing Leadership: To achieve and maintain quality results, information specific to changes in the emergency medical services quality accountability, and outcomes through guidance, the provision of emergency medical management program. direction, encouragement, and reinforcement. services and trauma care. (h) Assisting the department in setting Customer Service & Satisfaction: To put the (c) Providing technical support to the program priorities. patient first – always!!! department in the areas of emergency medical services and trauma systems (i) Providing feedback to the department Public Welfare & Safety: To dedicate ourselves to design, required medical and rescue on the administration and performance ensure services are available that benefit and protect equipment, required drugs and of the emergency medical services the public. dosages, medical treatment protocols, program. emergency preparedness, and Collaboration: To encourage active collaboration emergency medical services personnel (j) Providing technical support to the to solve problems, make decisions and motivate education and training requirements. emergency medical services grants providers to work together in provider evidence- program. based prehospital care to achieve common goals. (d) Assisting in developing the emergency medical services portion (k) Assisting the department in emergency Ethics: To ensure ethical behavior in all decisions, of the department’s annual legislative medical services public education. actions, and stakeholder interactions. package. (l) Assisting in the development of the Quality Improvement: To use the most rigorous (e) Providing a forum for discussing department’s injury prevention and of scientific methods to support our policies and significant issues facing the emergency control program. decision making. medical services and trauma care communities. Evidence-based Medicine: To research, identify and adopt evidence-based science and best practices shown to reduce mortality and morbidity.
Education: To continually educate the public, the EMS system, and all EMS stakeholders (i.e. personnel).
7 Why Strategic Strategic Planning Phases The four-phase process includes Plan, Develop, Implement and Review. The Florida Emergency Medical Services Strategic Plan is the result of these processes vision Planning? and is outlined in this document.
1) The Plan phase includes a foundation review of existing goals, objectives, and strategies; identification, analysis, and prioritization of key organizational factors. action
Strategic planning is the process that supports the 2) The Develop phase includes identification joint efforts between the EMS Advisory Council, the and prioritization of strategic goals; EMS community, and the Florida Department of development of strategic objectives and Health. No single force working alone can accomplish strategies; and determination of leads everything needed to improve and expand and measures. results prehospital care in Florida. 3) Communication of strategies to staff and stakeholders and In coordination with the Florida Department of development of detailed Health’s Bureau of Emergency Medical Services, the action plans complete the EMS Advisory Council took a collaborative approach Implementation phase. with a multitude of EMS constituency groups to objectives develop Florida’s 2010-2012 Emergency Medical 4) Reviews of measures, Objectives support goals, mission, and vision. Services Strategic Plan. This plan is designed to be outcomes, action plans, a framework to strengthen Florida’s EMS system to and an annual review at achieve one vision. the first EMS Advisory Council of each year Vision: A unified EMS system that provides evidence- ensures strategies and goals based prehospital care to people of Florida and actions stay current Goals support mission and vision, and dictate objectives serves as the recognized leader in EMS response with organizational, nationwide. customer and stakeholder Strategic planning is a tool that provides a pathway for needs and an organization or system to fulfill its vision. Florida’s changing strategy EMS Advisory Council provides a voice for Florida’s requirements. EMS community and the patients we serve.
mission Mission supports vision, and dictates goals.
8 vision
action
results
objectives
goals
strategy
mission Photo courtesy of Miami Dade Fire Rescue – 2009 Florida EMS Provider of the Year
9 2010-2012 EMS Strategic Plan Goals and Objectives Goal 1: Improve the EMS system through effective leadership and communication by the EMS Advisory Council. Goal Owner: EMS Advisory Council
EMS system is defined as all licensed providers, EMS personnel, and EMS training centers.
Photo Courtesy of Leon County EMS – 2010 Florida EMS Provider of the Year
10 Objectives Measure(s) Strategies Lead Resource Timeline 1.1: Amend the EMSAC Successive leadership Amend the EMSAC bylaws to support Strategic Plan EMSAC EMSAC Members Ongoing bylaws to support Parliamentarian Assign goals to EMSAC subcommittees- these committees serve as Strategic Plan Officer’s leadership EMSAC goal owners who are to report status at each council meeting Subcommittees Each committee has a tie in to strategic plan Encourage all EMSAC members and constituency group presidents EMS Constituency (or designated liaisons) to attend every Strategic Visions meeting Groups # of strategic planning milestones met and conference calls to ensure plan is being deployed and to facilitate the dissemination of information Develop strategic planning guidelines for the EMSAC 1.2: Improve the # of EMSAC members participating with Measure dissemination of strategic plan and strategic planning EMSAC Goal Owners Ongoing relevancy and regularity an EMSAC subcommittee (minimum two initiatives through agencies and hospital based systems Objective Leads of communication members) Track EMSAC members who are responding back with information between the EMSAC and EMS Constituency related to the strategic plan the EMS system # of constituency group meetings covered Groups by an EMSAC member Publish or post best practices, strategic planning updates, and other EMS Stakeholders strategic planning resources on the Bureau of EMS (BEMS) website, the Florida EMS Community Listserv (FLEMSCOMM), and the Bureau of EMS quarterly EMS newsletter (EMS Vitals) (BEMS) 1.3: Identify the # of groups who include the strategic plan Require all EMS constituency groups and EMSAC subcommittees to EMSAC EMSAC Ongoing EMS direct customer in their agenda and meeting minutes submit meeting agendas and meeting minutes Subcommittees base and strengthen (minimum of two items) Educate all EMS stakeholders that the Strategic Visions Committee EMS Constituency the relationship provides a forum in which customer needs can be raised to be Groups by monitoring the # of meeting minutes submitted to be incorporated into strategic planning efforts achievement of the posted to the EMSAC webpage EMSAC Strategic Plan through # of action plan updates submitted to the Track customer complaints and resolution of complaints Coordinator the meetings held in EMSAC Strategic Visions Committee Integrate work being done between EMSAC and EMS Constituency EMS Strategic conjunction with the Groups Planning EMSAC # of EMS constituency groups and other Coordinator EMS stakeholders participating in strategic Improve communication between groups by linking them together planning efforts under objectives that require the expertise of multiple EMS stakeholder groups 1.4: Conduct or host # of new members assigned a mentor Assign EMSAC mentors to new members EMSAC BEMS Ongoing leadership workshops Assign mentors to new members of an EMSAC subcommittee for the EMSAC and # of EMSAC members who have served as provide information on mentors Develop an EMSAC orientation that is facilitated by EMSAC leadership seminars, # of new members who have received an leadership fellowship opportunities orientation Disseminate leadership resources (articles and webinars) to EMSAC to the EMS system members which may include information on quality improvement # of EMSAC members who have and facilitating meetings participated in leadership workshops, seminars, webinars, or other fellowship Develop measurement tool to track EMSAC members who have opportunities participated in leadership workshops, seminars, or other fellowship opportunities 1.5: Develop a Succession plans developed Research other boards EMSAC Executive EMS Constituency October Groups 2010 succession plan for Ensure new members have been oriented Committee the EMSAC members, Florida Association chair, and EMS System Ensure new members have mentors in place of EMS Providers leadership to ensure Orient new members to strategic planning process and plan succession is fluid FAREMS Identify areas of the state that will be experiencing increased Florida Association number of personnel retiring (high-risk retirement) or receiving of County EMS promotions Providers Communicate succession planning best practices to the EMS system FFCA – EMS Section to alleviate disruptions in service during periods of transition at the local level Florida EMS System 11 Goal 2: Improve EMS data collection and participation through advocacy, outreach, and improved accessibility to EMS incident-level data.
Goal Owner: EMSAC Data Committee
Photo Courtesy of Leon County EMS – 2010 Florida EMS Provider of the Year
12 Objectives Measure(s) Strategies Lead Resource Timeline 2.1: Improve leadership % of committee membership turnover rate Annual review of bylaws/operations to ensure effective operation of EMSAC Data BEMS Data Unit Ongoing effectiveness and by year (less than one member each year) subcommittee (define term of service in action plan) Committee participation of EMSAC Data Committee 85% participation rating score of committee Formalize participation rating score, monitoring and reporting members attending meetings (including process face-to-face meetings, conference calls, and Develop/implement mentoring/ succession plan to include new web conferences within a calendar year) member orientation Foster sustained leadership skills 2.2: Maintain statewide Maintain a defined and adopted Data Use the expertise of the EMSAC Data Committee to review/define/ EMSAC Data BEMS Data Unit Ongoing standards for data Dictionary (all Florida Data Dictionary data maintain all data elements in Florida Data Dictionary consistent with Committee collection for EMS elements defined and accepted by EMSAC) national mandatory requirements EMSAC Data incident level data Committee 100% compliance with national mandatory (Definitions data collection requirements Subcommittee) 2.3: Provide advocacy # of outreach events provided by or Use the expertise of the EMSAC Data Committee to identify EMSAC Data EMSAC Data TBD via and outreach in sponsored by EMSAC Data Committee outreach opportunities/events for the advocacy, outreach, Committee Committee - action plans support of National education/training for statewide data collection Education/ Training Highway Traffic Safety % of annual increase in participation Subcommittee Administration (NHTSA) Define consistent training and education curriculum and delivery participation targets for mechanisms EMSAC Data Florida’s statewide data Work closely with remaining agencies to ensure smooth transition; Committee –Outreach collection system implement lessons learned from startup Subcommittee Identify funding resources BEMS Data Unit Work closely with BEMS Data Unit in federal grant justification for enabling EMS agencies participation Conduct annual surveys to identify agency participation targets and agency assistance needs Provide implementation assistance to agencies seeking participation assistance 2.4: Improve access % increase in number reports available to Collaborate with EMRC on report definition and specifications BEMS Data Unit DOH IT Ongoing to EMS incident level EMRC for evaluation and benchmarking data for evaluation and Collaborate with EMRC and EMSAC Data Committee on key EMRC benchmarking activities % increase in number reports available performance indicators (KPI’s) for evaluation and benchmarking to EMS agencies for evaluation and Continue to seek grant funding to maintain resources for report EMSAC Data benchmarking development Committee Collaborate with DOH IT organization to create data warehouse/ data mart solution Continue to seek grant funding to maintain data warehouse/data mart solution 2.5: Link EMS Tracking # linked data sets Establish relationships to share data between agencies BEMS Data Unit EMSAC Data Ongoing and Reporting System Committee (EMSTARS) incident- Collaborate with DOH IT organization to establish technical level data with other environment to enable data linkages and sharing EMRC state data for outcome Utilize expertise of EMSAC Data Committee and EMRC to Identify DOH IT assessments data linkage requirements for linking incident level data for outcome assessments DOH Trauma AHCA
13 Goal 3: Improve customer satisfaction through injury prevention, public education and knowledge of the EMS system. (Customers defined by the EMS agency).
Goal Owner: EMSAC Public Information Education and Relations (PIER)Committee
Photo courtesy of Julie Bacon – 2009 EMSC Read for Health Program
14 Objectives Measure(s) Strategies Lead Resource Timeline 3.1: Provide injury Increase by 5% the number of Identify funding sources, resources and partnerships EMSAC PIER EMSC Advisory Ongoing Committee Committee prevention programs educational programs provided to Look at alternative distribution mechanisms to the public the public through EMS/fire agencies DOT Resurvey EMS agencies and increase response rate Motorcycle Safety Reduce the number of hospital ED Partner with Access to Care Committee, Office of Trauma, the Office of Injury Coalition visits caused by injuries Prevention, and the DOT to obtain stats, provide programs, and improve the allocation of resources for these programs Florida Injury Prevention Advisory Data Source: AHCA Develop a central repository of injury prevention projects and programs by EMS and Council Top 5 injuries: falls, motor vehicle/ Trauma Centers pedestrian, bicycle safety, drowning/ Office of Injury Develop a measurement tool to determine the effectiveness of injury prevention Prevention water safety, fire/burns programs in reducing injuries, and reducing emergency department (ED) visits EMSAC Access to Care Identify injury prevention programs and opportunities for the general public by Committee Reduce the number of motorcycle making them available to any agency in the state crashes Florida Emergency Provide public injury prevention/educational programs directed towards the top five Nurses Association injuries in Florida by working with EMS agencies to start or expand injury prevention (FENA) programs in their areas United States Act as a resource for injury prevention programs throughout Florida- data source: Lifesaving Association Office of Injury Prevention (USLA) Work with the Office of Injury Prevention and the Injury Prevention Advisory Council National Oceanic to identify number of hospital ED visits caused by injuries and partner with them to and Atmospheric promote educational programs Administration (NOAA) 3.2: Improve Establish baseline list of current Quality managers will query EMS providers to develop a list of agency personnel Quality Medical Care Ongoing customer satisfaction attendance and participation of local who perform quality management activities Managers Committee by increasing quality managers Quality managers will review past, present, and future meeting attendance list to participation by local create baseline attendance numbers quality managers Increase attendance and Quality managers will reach out to colleagues on the provider level to encourage in statewide EMS participation in quality management and motivate participation in state activities activities activities on a state level Quality managers will host a pilot one day seminar on current day strategies for improving customer satisfaction at the provider level 3.3: Identify, educate % of EMS agencies that have Identify top three issues affecting access to care and develop measurement tool to EMSAC Access Florida Hospital Ongoing and partner with all representation on hospital establish baseline for improvement to Care Association (FHA) Committee stakeholders committees Survey EMS agencies to determine how many have representation on hospital PIER (i.e. patients, health committees. Note: Joint Commission on Accreditation of Healthcare Organizations (JCAHO) does not require, but is a positive point in the accreditation process care providers, and Reduction in ED overcrowding Florida Association of hospitals) on Access to Publish the current Prehospital Best Practices paper and use it as a tool to educate all EMS Medical Directors stakeholders Care while continuing Reduction in unnecessary ED visits Office of Trauma to share best practices (define unnecessary or non-critical Publish paper from the emergency nurses’ perspective on ED overcrowding, to all EMS providers conditions and reduce number of including impact to ED due to Baker Acts (BA52) and psychiatric emergencies (lack of Office of Injury within the state those visits) places to send BA52s) Prevention Utilize mechanisms such as the quarterly EMS newsletter, BEMS website, and FLEMSCOMM to share best practices that are evidence and outcome based FENA
Identify funding mechanisms to support health fairs, statewide PSA, and share best practices for health fairs Develop template letter for each EMS agency to send to their respective hospital administrators Educate the public about ambulance and ED use Publish/email quarterly/biannual report on hospitals and send to hospital administrators (Phase II of objective 6.3) 15 Goal 4: Improve EMS workforce education, performance, and satisfaction.
Goal Owner: EMSAC Education Committee
Photo courtesy of Miami Dade Fire Rescue – 2009 Florida EMS Provider of the Year
16 Objectives Measures Strategies Lead Resource Timeline 4.1: Remove current Sponsorship in both House and Senate Seek statutory change EMSAC EMSAC Education June 2012 statutory requirement of Legislative Committee two-hour HIV/AIDS Need legislative committee to delete reference to Chapter 401, F.S., Committee from Section 381.034, F.S. FAEMSE Change HIV to Infectious Disease/Bloodborne Pathogens 4.2: Establish guidelines Compare to national standards Review national guidelines and identify funding sources Dispatch Work FAMA June 2012 for EMS dispatch training Group for ground services Monitor possible legislative proposals to change voluntary Florida Chapter, ASTNA certification to mandatory certification EMSAC Legislative Committee 4.3: Measure and % overall satisfaction Implement process to identify and resolve potential areas of FFCA – EMS Florida Association of EMS Ongoing identify opportunities to statewide EMT/paramedic dissatisfaction Section Providers improve EMT/paramedic % turnover rate satisfaction Review data from 2008 recertification survey to identify DOH Division of Medical # EMTs/# paramedics (increase or opportunities for next steps Quality Assurance (MQA) decrease from previous years) FAREMS Resurvey EMTs and paramedics during recertification (include indicators such as rural vs. urban, fire vs. non-fire) Florida EMS Quality Managers Association 4.4: All Florida approved # of training centers who obtain National Education Committee will contact all EMS training centers that EMSAC FAEMSE 2013 EMS paramedic training EMS Education accreditation are not currently accredited by the Committee on Accreditation Education programs, as defined in of Educational Programs for the Emergency Medical Services Committee EMSAC Legislative Florida Administrative Professions (CoAEMSP) to determine if they intend to become Committee Code (FAC) 64J-1.020, accredited and if assistance is needed during the process will be nationally accredited or have BEMS will monitor for compliance during inspections initiated the procedures FAEMSE partnering with DOE and DOH to promote this type of of accreditation in accreditation accordance with the NHTSA - EMS Education Research the language of the previous rule that was deleted which Agenda for the Future by required CoAEMSP accreditation January 1, 2013 4.5: Begin Use survey results to determine most Survey providers to ascertain what scope of practice levels would be EMSAC FAEMSE 2013 implementation of the supported levels to be adopted supported Education National EMS Education Committee EMSAC Legislative Agenda for the future Monitor for legislative changes that Identify provider levels to be adopted (EMR, EMT, AEMT, paramedic) Committee reflect adopted provider levels Legislative Committee adopt provider levels through legislation Florida Association of EMS Review DOE curriculum frameworks for Providers changes to National education standards Adjust DOE curriculum frameworks to match adopted scope of practice levels and education standards Adopt national test for each approved provider level Define a statewide transition process from National Standard Curricula (NSC) to education standards for each approved level of provider 4.6: Facilitate pediatric/ Provide eight hours minimum pediatric/ Identify rural counties/regions in need of additional training EMSC Advisory FAREMS June 2012 neonatal educational neonatal education in each Regional Committee programs throughout Domestic Security Task Force Survey to determine pediatric/neonatal programs most requested EMSAC Education the state (RDSTF) region on an annual basis or needed Committee Establish a “speakers bureau” to provide quality education FAEMSE Florida Neonatal Pediatric Transport Network Association (FNPTNA) 17 Goal 5: To ensure economic sustainability of the EMS system and serve as a clearinghouse for EMS legislative issues.
Goal Owner: EMSAC Legislative Committee
Photo Courtesy of Leon County EMS – 2010 Florida EMS Provider of the Year
18 Objective Measure(s) Strategies Lead Resource Timeline 5.1: Measure and % of reimbursable calls Explore non-traditional transport options Florida Association FFCA – EMS Section Ongoing improve % of of EMS Providers reimbursable calls Develop measurement tool Compile best practices of EMS providers in Florida Florida Ambulance TBD in Association action plans Identify baseline through June FAMA Improve baseline 2012
5.2: Measure and % billed charges collected Identify best practices for achieving improvement in billing Florida Ambulance FFCA – EMS Section Ongoing improve % of billed practices that result in higher collection rates Association charges collected Develop measurement tool Florida Association of EMS TBD in Publish ratings in action plan on statewide website while Providers action plans Identify baseline maintaining confidentiality of providers through June FAMA Improve baseline 2012
5.3: Identify Improve efficiency of EMS use Identify strategies to improve the use of EMS by community Florida Association Florida Ambulance Ongoing opportunities to provide users, i.e. skilled nursing facilities, physician offices, and of EMS Providers Association public education Develop measurement tool medical alarms TBD in regarding the utilization FFCA – EMS Section action plans of EMS Identify baseline Publish best practices quarterly until 2012 through June PIER Committee 2012 Improve baseline Conduct literature review for baseline EMSAC Access to Care Committee 5.4: Identify cost saving Develop measurement tool Identify best practice for vendor bidding and contracts Florida Association FFCA – EMS Section Ongoing measures to offset EMS of EMS Providers expenses Identify baseline Conduct literature review for baseline or measure at the local DOH, Bureau of Statewide TBD in level Pharmaceutical Services action plans Improve baseline through June Conduct annual classes on public purchasing procedures, 2012 including the use of state bidding Conduct training in public purchasing bid quotes Identify best practices utilized by other agencies such as Co-Operative supply purchases (example Bureau of Pharmacy services through DOH i.e. Cardinal Health)- varies between municipalities and counties 5.5: Identify alternative Compile successful programs from the Identify best practice for acquiring funding from alternative Florida Association FFCA – EMS Section Ongoing revenue sources EMS community for others to implement sources, i.e.: of EMS Providers in their localities (rural, urban, county, Florida Ambulance TBD in municipalities) • Marketing of the EMS system Association action plans • United Way campaign through June • Foundations (private) FAREMS 2012 • % of fees for courses taught Florida Association of • Federal stimulus money County EMS Providers Publish opportunities by 2012 in quarterly action plan on state (FACEMS) website
5.6: Ensure that Include at least one representative from each Liaison with constituency groups in identifying adequate EMSAC Legislative FAMA 2012 industry experts within of the following areas: fire, non-fire, private, representation Committee specific areas of EMS education, air, pediatric/neonate, dispatch EMSC are represented on the Legislative Committee FFCA – EMS Section Dispatch Group 5.7: Adopt initial and Two hours of altitude physiology course and Identify statutory authority to develop a rule proposal to EMSAC Legislative FAMA 2012 continuing educational aircraft safety/ emergencies for refresher submit to the BEMS or seek statutory change Committee training requirements training FNPTNA for aircrew of licensed air providers ASTNA
19 Goal 6: Improve performance of key EMS processes through benchmarking and partnerships.
Goal Owner: EMSAC Medical Care Committee
Photo courtesy of Miami Dade Fire Rescue – 2009 Florida EMS Provider of the Year
20 Objective Measure(s) Strategies Lead Resource Timeline 6.1: Measure % of primary Public Safety Answering Points Establish baseline and benchmark to identify best practices Dispatch Group Florida Association of Ongoing and identify (PSAP) utilizing a nationally recognized EMD EMS Providers opportunities for system Promote use of Emergency Medical Dispatch (EMD) system quality May require improvement of improvement processes FAMA multiple dispatch system Notes: (a PSAP would be counted as a YES phases that if the Primary PSAP transfers EMS calls to Promote ongoing continuing education of emergency medical dispatchers Florida Association of extend effectiveness EMS Medical Directors a secondary PSAP that utilizes an EMD Complete survey of PSAPs Note: Amber Lee Foundation, survey from beyond June system. Currently Priority Medical Dispatch, Dispatch Group 66% return, data being evaluated 2012 Powerphone and APCO are nationally recognized) Promote involvement of EMS Medical Directors in EMD Phases TBD % of agencies that utilize an EMD QA process Promote utilization of National Association of Air Medical Communication Specialists (NAACS) standards by all communications centers that handle air medical transport Identify challenges/barriers for agencies that currently do not provide EMD Develop measurement tool - survey questions Disseminate survey Analyze results Identify challenges/barriers for agencies that currently do not provide EMD QA 6.2: Measure, stratify Evaluate EMS response time (from incident Establish baseline and benchmark to identify best practices Dispatch Group Florida Association of Ongoing and identify EMS notification of PSAP to EMS patient contact) EMS Providers response time Partner with the EMSAC Data Committee to determine if prehospital data May require % of calls meeting response time targets collection systems, such as EMSTARS, may be used to gather data FFCA – EMS Section multiple phases that Adopt a standardized model for defining/stratifying call types: non life EMSAC Access to Care extend threat, potential life threat, life threat, immediate life threat Committee beyond June Adopt a standardized model for defining PSAP call processing time EMSAC Data 2012 Committee Adopt a standardized method for reporting response times via EMSTARS Phases TBD Explore delineation of three response demographic areas: urban, suburban, rural 6.3: Changes to All data elements needed to capture EMS Establish uniform definition of “EMS- hospital turnaround time” EMSAC Data Trauma Committee June 2012 EMSTARS Data off load and diversion times accepted by the Committee Dictionary and EMSAC Establish uniform definition of hospital “diversion” status Florida Emergency Disaster Response Nurses Association Tracking System to (FENA) be able to capture Florida Association of EMS off load and EMS Medical Directors diversion times EMSAC Access to Care Committee Promote an Emergency System Status (ESS) Utilize Data Committee and Disaster Committee expertise and knowledge EMSAC Disaster EMSAC Access to Care Ongoing internet based process on a statewide basis to develop requirements Committee Committee Partner with agencies that have piloted EMSystem EMSAC Medical Care Committee Measure number of counties utilizing EMSystem EMSAC Data Ensure more than 75% of trauma systems utilize system Committee Continue to work with Office of Public Health Preparedness Steering Committee
21 Objective Measure(s) Strategies Lead Resource Timeline 6.4: Measure 6.4.1 Cardiac: Review of data to identify opportunities for improvement EMSAC Medical EMS Medical Directors Ongoing and identify key % ROSC (return of spontaneous circulation Care Committee opportunities for as defined by the UTSTEIN criteria) in the Systemized care of STEMI/stroke American Heart improvement/ prehospital environment Association (AHA) effectiveness of on- Look at accrediting agencies site EMS treatment % of time 12 lead EKG was captured on EMRC in the following a patient with suspected cardiac related Determine mortality rate areas: cardiac symptoms Quality Managers (including STEMI Use UTSTEIN template reporting style and cardiac arrest), % of EMS agencies that obtain 12 lead EKG UTSTEIN template stroke, trauma, on cardiac related patients per protocol Establish uniform definitions of STEMI alert and cardiac alert is the recognized pediatric/neonatal standard for reporting management and % of time aspirin was given to patients with Identify mechanisms for benchmarking utilizing EMSTARS and expertise of and research, other treatments as cardiac related symptoms or intentionally the EMRC to identify best practices allowing appropriate identified held due to medical considerations(e.g. comparison of data allergy) The EMS Medical Directors have established a position statement on the definition of STEMI alert 6.4.2 Stroke: Identify mechanisms for benchmarking utilizing EMSTARS and expertise of Quality EMS Medical Directors 2012 % of time a Stroke Alert was initiated based the EMRC to identify best practices Managers upon primary or secondary impression EMRC Monitor EMSTARS/EMRC/Medical Care Committee AHA’s Florida Stroke Systems Workgroup 6.4.3 Trauma: Identify mechanisms for benchmarking utilizing EMSTARS and expertise of EMSAC Medical EMS Medical Directors 2012 Identify average time on scene for trauma the EMRC to identify best practices Care Committee alert patients Trauma Committee Monitor EMSTARS/EMRC/Medical Care Committee EMRC
6.4.4 Pediatric/Neonatal: Survey EMSC, FNPTNA, and other stakeholders to determine the top three EMSC Advisory FNPTNA 2012 Identify and address top three challenges to challenges to prehospital care of pediatric and neonatal patients Committee prehospital care EMS Medical Directors Work with Division of Medical Quality Assurance (MQA) to develop method of capturing this information during recertification Work with EMRC to identify treatment challenges 6.4.5 Airway management: Define attempted intubation EMSAC Medical EMS Medical Directors 2012 % recognition of proper placement Care of endotracheal tube placement as Identify mechanisms for benchmarking utilizing EMSTARS and expertise of Quality Managers documented by end-tidal capnography the EMRC to identify best practices EMRC % of patients in which endotracheal intubation is attempted and is not successfully completed % of patients in which active airway assistance is utilized other than ET
22 Objective Measure(s) Strategies Lead Resource Timeline Objective Measure(s) Strategies Lead Resource Timeline 6.5: Measure 6.5.1: % of patients refusing transport Benchmarking to identify best practices Quality Providers 2012 and Identify appropriately Managers Fire Chiefs opportunities for improvement in EMS EMRC system processes 6.5.2: % of victims meeting trauma alert Identify mechanisms for benchmarking utilizing EMSTARS and expertise of EMSAC Medical EMRC criteria transported to trauma center the EMRC to identify best practices Care Committee Trauma Committee Identify the percentage of time trauma alerts called on the basis of Quality objective criteria (state score card, except for paramedic discretion) vs. the Managers percentage of time called on subjective criteria (paramedic discretion) 6.5.3: % of STEMI Alert patients field triaged Identify mechanisms for benchmarking utilizing EMSTARS and expertise of Quality EMS Medical Directors 2012 to interventional cardiac cath capable facility the EMRC to identify best practices Managers EMRC AHA 6.5.4: % of stroke patients transported to a Identify mechanisms for benchmarking utilizing EMSTARS and expertise of Quality EMS Medical Directors June 2010 stroke center the EMRC to identify best practices Managers EMRC Identify and benchmark the percentage of times an objective stroke AHA assessment tool (eg. stroke alert checklist) is utilized in declaring a stroke alert or affecting transportation destination (e.g. to an identified stroke center) 6.5.5: % of pediatric and neonatal patients Identify centers for pediatric and neonatal care EMSC Advisory Providers 2012 transported utilizing appropriate transport Committee Work with EMRC in identifying transporting agencies FNPTNA agency to center capable of appropriate medical treatment FAMA Quality Managers 6.6: Develop a % of EMS agencies utilizing a standardized Develop a QA template EMRC Florida EMS Quality June 2010 standardized QI/QA template (will be developed by EMRC) Managers Association template for use by Develop a survey of EMS providers to obtain % of agencies using EMRC all EMS providers template or similar template Florida EMS Medical and encourage Directors use of template or similar document 6.7: Prioritize and # of service delivery or patient care Use the expertise of the EMRC to identify patient outcome and service EMRC EMSAC Data June 2012 begin setting components measured and benchmarked delivery components for uniform measurement; also, use and publish the Committee performance targets data, while still protecting the data based on the established benchmarks and utilizing EMSTARS data 6.8: To provide Identify number of coastal lifeguard agencies Phase 1: Survey to identify number, location of coastal lifeguard agencies USLA EMSAC Legislative 2012 effective injury operating in Florida Committee prevention, rescue Liaison with provider/constituency groups to determine the role of and prehospital lifeguard agencies within their arena emergency medical Identify % of Florida bathing places that are care at Florida’s currently lifeguard protected Phase 2: Pursue legislative action and rule that would license and/or certify public bathing lifeguard agencies as BLS non-transport agencies and/or certify agencies places (coordination under the USLA agency certification program of rescue and prehospital Pursue legislative action that would require lifeguard protection at defined emergency care with coastal public bathing places transport providers) 23 Goal 7: Assure the EMS System is prepared to respond to all hazard events in coordination with state disaster plans.
Goal Owner: Disaster Committee
Photo courtesy of Miami Dade Fire Rescue – 2009 Florida EMS Provider of the Year
24 Objectives Measure(s) Strategies Lead Resource Timeline 7.1: Ensure all EMS personnel % of EMS providers that train their Compare current standards in Florida Statute/Rule, Florida Fire EMSAC BEMS, December (paramedics, EMTs, nurses and staff annually on local and regional Chiefs State Emergency Response Plan, National Fire Protection Disaster Health and Medical Co- 2010 dispatchers) are knowledgeable disaster plans Association, Florida OSHA, county emergency response plans Committee Chairs, Trauma Committee, about local agency and regional and Catastrophic Health Incident Response Plans Office of Public Health disaster plans % of agencies that include the local, Preparedness, regional and state disaster response Develop standards that apply to fire EMS, non-fire EMS and air Office of Emergency plans as part of orientation medical EMS providers Operations, EMSAC Dispatch Workgroup Disaster Committee 7.2: Enable EMS providers to Amend Florida Statutes to enable Research and develop enabling language EMSAC BEMS December transport patients to Air Medical EMS providers to transport patients to Legislative PHMP, Office of Emergency 2012 Transport Services (AMTS) during AMTS during times of local/regional Committee Operations, Disaster times of local/regional disaster disasters Committee & Community conditions Surge Team, FHA, Office of Coordinate with EMS Medical Directors Trauma to develop legislation that will enable EMSAC EMS to transport to AMTS under Legislative specific circumstances Committee
Better define “disaster conditions” 7.3: Ensure EMS plans and related % EMS agency plans that specifically Ensure plans, training and exercises address at-risk populations EMSC EMSAC Disaster Committee, December documents include consideration address each identified at-risk Advisory EMSAC PIER Committee, 2012 for at-risk populations: populations Establish baseline and benchmark to identify best practices Committee PHMP Community Surge Team, Office of Trauma, EMS 1. Pediatrics % of EMS providers that train their staff Based on best practices, develop specific training for at-risk Medical Directors, FENA, PHP 2. Neonatal at orientation and refresh annually on populations Medical Surge Committee 3. Pregnant women their local at-risk population plans 4. Elderly Include development of templates for plans, drills and training 5. Disabled % EMS agency and ED exercises that 6. Low/limited literacy include at-risk populations Seek to commit funding to a limited number of emergency 7. Public companions or departments and agencies who are willing to conduct drills service animals % of EMS agency and ED plans that with primarily at-risk populations 8. Special medical needs address reunification of pediatric patients EMSC develop and implement assessment tool
% EDs that plan, train and exercise for Develop a project that provides funds to hospitals to hold special needs populations training, drills/exercises that emphasize special needs populations
Partner with the Public Health Preparedness (PHP) Medical Surge Committee 7.4: Ensure all emergency % of EMS providers that train their staff Compare current standards in Florida Statute/Rule, Florida Fire EMSAC BEMS, EMS Educators, December prehospital health care providers annually on Level “C” PPE, local and Chiefs State Emergency Response Plan, National Fire Protection Disaster FFCA, Public Health and 2012 (including but not limited to regional disaster plans Association, Florida OSHA, county emergency response plans Committee Medical Preparedness paramedics, EMTs, nurses and and Catastrophic Health Incident Response Plan (PHMP) Responder Health dispatchers) are knowledgeable % of EMS providers that train their staff & Safety Committee, PHMP about level “C” Personal Protective annually on Nerve Agent antidotes Develop standards that apply to fire EMS, non-fire EMS and air Community Surge Team Equipment (PPE) and nerve agent medical EMS providers antidotes Identify statewide standards to acquire, inventory, store and disseminate and maintain protective equipment and prophylaxis/antidotes
25 Objective Measure(s) Strategies Lead Resource Timeline 7.5: Ensure all emergency % of EMS providers that train their staff Compare current standards in Florida Statute/Rule, Florida Fire Community BEMS, FFCA, PHMP, December medical services personnel (EMS annually on CBRNE detection systems, Chiefs State Emergency Response Plan, National Fire Protection Surge Team Responder Health and Safety 2012 agencies, paramedics, EMTs) are notification, verification and response Association, Florida OSHA, county emergency response plans Committee and EMS knowledgeable about Chemical, procedures and Catastrophic Health Incident Response Plans. Develop Medical Directors Biological, Radiological, Nuclear standards that apply to fire EMS, non-fire EMS and air medical and Explosives (CBRNE) detection EMS providers systems, notification, verification, reporting systems, all discipline plans and protocols, and their respective roles and responsibilities in the system 7.6: Develop processes for EMS Statewide disaster & statewide/federal Develop statewide disaster medical and large scale EMS EMS EMSAC Disaster Committee, December medical direction support of infectious disease protocols are written infectious disease protocols Medical EMS Constituency, Office of 2012 disasters, mass casualty, and large and approved by DOH & Florida Directors Trauma, Community Surge infectious disease emergencies at Association of EMS Medical Directors Formulate implementation strategies Team, Office of Emergency the state, regional and local level Operations, Office of Public Health Preparedness Develop statewide protocol for use in the event of large scale statewide disasters, mass casualty and large scale infectious disease events Develop and implement specific plans and strategies to % of EMS provider agencies who have Ensure EMS providers receive the disaster medical protocols EMS Disaster Committee, EMS December appropriately inform and educate been trained in statewide disaster Medical Constituency, Office of 2012 Florida’s EMS providers with protocols, strategies and current Directors Trauma, Community Surge current information and guidance guidance Team, Office of Emergency regarding disaster and infectious Operations, Office of PHP disease response 7.7: Develop medical direction % of local EOCs that have a process Compare current standards in Florida and Federal Emergency EMS EMSAC Disaster Committee, December support to local Emergency in place to access local EMS Medical Management Agency (FEMA) Region IV state partners Medical BEMS, EMS Providers, Office 2012 Operations Center (EOCs) Director or EMS Medical Director Directors of Emergency Operations, designee for consultation during Assess best practices at the local and state level local Emergency Managers, activations Health and Medical Co-Chairs 7.8: Align with Community Surge Disaster Committee and PHMP Determine gaps that exist between PHMP Community Surge Community EMSAC Disaster Committee In Process objectives Community Surge Team Objectives are Committee Objectives and Disaster Committee Objectives Surge Team BEMS, EMS Medical Directors aligned PHMP Community Surge and Hospital Surge Committees are actively coordinating projects and project planning 7.9: Identify facility and plan for % of the counties that have identified This project is already in process. Collaboration for the project Office of EMSAC Disaster Committee, December implementation of at least one and planned for the implementation of exits between local EMS providers, PHP, the Office of Emergency PHP Office of Emergency 2012 alternate medical treatment site an alternate medical treatment site Operations and DOH Regional Emergency Response Advisors Operations, local EMS in each county that can be used and local Emergency Management providers, DOH Regional to help mitigate community surge Emergency Response during disasters Advisors, Disaster Committee and local Emergency Managers, EMS Medical Directors, Hospitals, Lifeguard Constituency Group
26 Objective Measure(s) Strategies Lead Resource Timeline
Photo courtesy of Miami Dade Fire Rescue – 2009 Florida EMS Provider of the Year
27 Goal 8: Maintain an accident-free environment and promote a culture of safe and appropriate utilization of Florida air assets.
Goal Owner: EMSAC Access to Care Committee
Photo courtesy of Shands Air Care
28 Objectives Measure(s) Strategies Lead Resource Timeline 8.1: Develop statewide % of air medical providers that have Establish baseline and identify best practices FAMA ASTNA 2012 criteria for appropriate established criteria for appropriate air asset air asset utilization utilization Define appropriate air asset utilization Florida EMS Pilots (prehospital and Association (FLEMSPA) interfacility transfers) % of air medical providers that have an Promote use of a utilization review process established utilization review process FNPTNA Educate requestors (EMS, hospitals) on risks associated with EMS Medical Directors Statewide measures developed helicopter shopping FFCA Develop a repository of centralized information regarding capability/availability to ensure appropriate use of specialty EMS Providers providers Florida Committee on Trauma (FCOT) Association of Air Medical Services (AAMS) American College of Surgeons (ACS) National EMS Physicians Air Medical Physician Association (AMPA) 8.2: Improve air medical # of air medical communication centers FAMA ASTNA 2012 communications and that perform duties other than air medical Develop and implement a quality improvement process for dispatch procedures for flight-related duties air medical communication centers FLEMSPA communication centers, flight crew, hospitals, and # of air medical communication centers Promote formalized flight following and dispatch FNPTNA EMS providers with established helipad communication procedures including up-to-date weather per the National procedures Transportation Safety Board (NTSB) recommendations Technical Advisory Panel (TAP) # of air medical communication centers Identify, research, and implement the use of technological with an established quality improvement services to improve information sharing BEMS process # of air medical communication centers Identify and adopt initial minimum criteria for air medical EMS Providers that are utilizing technology for communication specialists information sharing FFCA Develop mechanism for inclusion of fixed wing aircraft in # of air medical communication centers dispatch measures EMS Communications that utilize aviation-based technology for Engineer flight management Establish BEMS support for inspections process and compliance with the Florida Communications Plan NAACS # of Florida receiving facilities and EMS providers that are non-compliant with FHA state Med8 requirements Emergency Dispatch # of air medical providers that are non- Workgroup compliant with state air secondary requirements # of air medical communication centers that have established continuing education requirements
# of air communication centers that have a rest/fatigue policy in place
29 Objective Measure(s) Strategies Lead Resource Timeline 8.3: Improve air # of programs that have established air Establish baseline and benchmark to identify best practices FAMA ASTNA 2012 medical crew resource medical crew resource management as part management and of both the initial orientation process and Assess operational education and training needs of flight FLEMSPA education annual training requirements programs FNPTNA Identify current risk assessment tools for air medical # of programs using a risk assessment tool EMS Providers for flight crew providers Establish standardized minimum initial safety core Fire Chiefs # of programs/providers that have a competencies for all personnel involved in air medical dedicated operational education committee transport EMSAC Education or training coordinator Committee Develop and adopt recommended safety continuing education # of programs that have initial training for all personnel involved in air medical transport AAMS requirements that include fours hours of Commission on safety training and fours hours of flight Establish operational awareness training for ground crews involved in transport (safety, landing zone, approach) Accreditation of Medical specific training Transport Services Establish a minimum one day annual air medical safety summit (CAMTS) # of air medical programs with an operational awareness course with representation from all stakeholders involved in air medical transport to include but not limited to: aviation and FNPTNA medical crews, maintenance, communications, administration, and any associated transport (assisting fire department or ambulance services) not within air transport program 8.4: Improve use of air # of air medical aircraft with Terrain Promote training for safe operations and IIMC procedures FAMA FLEMSPA 2012 asset technology to Awareness and Warning Systems (TAWS) and enhance safety radar altimeters Promote compliance with Federal Aviation Administration FNPTNA (FAA) and NTSB safety recommendations # of air medical providers utilizing night FAA vision goggles (NVGs) Promote compliance with the commercial/ instrument standards set by the FAA NTSB # of air medical programs utilizing satellite based flight following systems Promote personal safety through Nomex flight suits and safety International Helicopter helmets Safety Team (IHST) # of air medical providers that have established Inadvertent Instrument Identify and include fixed-wing recommendations from NTSB Meteorological Conditions (IIMC) procedures and training Promote FAA best practices # of air medical programs that require Nomex flight suits and helmets # of air medical providers actively utilizing NVGs 8.5: Adopt initial and Two hours of altitude physiology course and Identify statutory authority to develop a rule proposal to EMSAC Legislative FAMA 2012 continuing educational aircraft safety/emergencies for refresher submit to the BEMS; or seek statutory change Committee training requirements training FNPTNA for aircrew of licensed air providers ASTNA
30 Objective Measure(s) Strategies Lead Resource Timeline
Photo courtesy of Indian River Fire Rescue
31 Goal 9: Increase access to care by improving patient safety, responder safety, and the safety of general public.
Goal Owner: EMSAC Access to Care Committee
Photo courtesy of Miami Dade Fire Rescue – 2009 Florida EMS Provider of the Year
32 Objectives Measure(s) Strategies Lead Resource Timeline 9.1: Determine Locate funding and resources to initiate a Fund and execute a study of EMS medication error rate and EMSAC Medical Care 2012 medication error rate in study of medication error rate in Florida EMS identify three to five of the most serious or frequent errors in EMSAC Medical Committee Florida’s EMS systems systems Florida as a baseline Care Committee Determine strategy to mitigate errors and institute plan for State EMS Medical mitigation during the next planning cycle Director 9.2: Quantify EMS vehicle Reduce rate by 10% by 2012 State EMS Medical Objective Safety 2012 collision rate in Florida in Work with Florida DOT to fund project to study EMS vehicle Director a measurable way collision rate and a mitigation plan to reduce rate by 10% by Department of Highway the end of 2012 Florida DOT Safety and Motor Vehicles National EMSAC Committee on Ambulance Crashes for personnel safety 9.3: Improve safety of Identify process for tracking number of Identify process for staff safety in ED FENA State EMS Medical Director 2012 staff from increasing incidents in the ED violence in emergency departments (from psychiatric patients, trauma patients, and irate patients/ families)
9.4: Reduce the number 9.4.1: # of injuries based upon reports from Identify process to track all injuries/serious infectious illnesses Providers Fire Chiefs 2012 of on-the-job injuries or Workers’ Compensation and utilize the Department of Financial Services database for serious infectious illnesses Workers’ Compensation claims EMSAC PIER Committee in the EMS population Publish findings in quarterly action plan 9.4.2: # of infectious diseases Identify process to track all injuries/serious infectious illnesses Providers Fire Chiefs 2012 and utilize the Department of Financial Services database for Workers’ Compensation claims EMSAC Legislative Committee Publish findings in quarterly action plan 9.4.3: # workers’ compensation days based Utilize the Department of Financial Services database for Providers EMSAC PIER Committee 2012 upon reports from Workers’ Comp Workers’ Compensation claims Publish findings in quarterly action plan 9.4.4: # educational programs provided on Identify/provide educational programs on injury prevention/ EMSAC PIER EMSAC Access to Care Ongoing injury prevention and infectious disease to infectious disease Committee Committee EMS personnel 9.5: Improve EMS # air calls in which pediatric patients were Analyze data and identify improvement opportunities EMSC Advisory FNPTNA 2012 transport safety for the transported in an approved FAA child safety Committee pediatric patient device Utilize Data Committee in determining mode of transport; ASTNA comparison of agencies with approved devices # ground calls in which pediatric patients FAMA were transported in a child safety device Review of survey results from agencies regarding practice Providers Literature review/review of national guidelines regarding pediatric/neonatal transport safety Fire Chiefs
33 Goal 10: Improve consistency, efficiency and education of public safety personnel with respect to incident related Emergency Medical Dispatch (EMD) and radio communications.
Goal Owner: EMSAC Access to Care Committee
Photo Courtesy of Leon County EMS – 2010 Florida EMS Provider of the Year
34 Objectives Measure(s) Strategies Lead Resource Timeline 10.1: Improve EMS radio Determine percentage of primary systems Develop survey to determine which agencies/counties are EMSAC AHCA 2012 communications between using UHF vs. 800 MHz vs. SLERS vs. FIN using UHF vs. 800 MHz vs. other Communications transports and receiving Committee Department of hospitals Determine percentage of MED 8 capable Develop survey to determine MED 8 compliance Management Services agencies (DMS) Partner with AHCA to improve inspection procedures by AHCA Division of Determine percentage of narrowband for hospitals Telecommunications compliance agencies and counties BEMS Revise and release new version of Volume I of the EMS Communications Plan State Working Group – Interoperable Communications Committee (SWG-ICC) Initiative Working Group (IWG) Department of Homeland Security (DHS)/FEMA Regional Emergency Communications Coordination Working Group (RECCWG) Office of Trauma 10.2: Improve agency Develop training curriculum for radio Create and update regularly a list of approved radio makes/ EMSAC SWG-ICC 2010 access to training and systems education models for EMS communications Communications education Committee IWG Develop training curriculum for radio Operational radio/system use DMS/DivTel programming/ operation Compliance/ statutory requirements Florida Department of Law Develop training for upcoming changes to Enforcement (FDLE) public safety radio (P25, 700MHz) Purpose/intent of system design Florida Division of Research future trends, grant requirements and new Emergency Management technologies (FDEM) Putnam County RECCWG 10.3: Improve agency Determine available grants, qualifications, Improve grant awareness EMSAC Lee Connor, 2011 access to federal and state timelines and processes Communications DOH/PHP funding Improve grant submission process Committee DOH/EMS
35 Objectives Measure(s) Strategies Lead Resource Timeline 10.4: Improve Determine agency access to mutual aid Determine % of agencies capable of communicating with EMSAC RECCWG 2011-2012 interoperable channels other public safety radio systems Communications communications Committee FDLE capabilities Develop standard operating procedures Determine requirements to improve interoperable SWG-ICC between disciplines communications statewide IWG Build out Phase I and II of the Health & Medical Interoperable Communications DOH/Office of Trauma Initiative (HMICI) project 10.5: Improve capability Determine communication methods being Between EMS agencies in non-home areas EMSAC Disaster Response 2011 to communicate used by Emergency Service Function 8 Communications Committee preparation for disasters (ESF8) Between EMS agencies and non-standard dispatch centers Committee SWG-ICC Develop standard operating procedures that Between EMS agencies and other public safety agencies involve EMS 10.6: Increase awareness, # of agencies utilizing EMD Actively monitor dispatcher certification legislation initiatives EMSAC Department of 2012 integration, and support Communications Management Services of EMD in the Florida Provide a point of resource to assist agencies with EMD best Committee (DMS) public safety environment practices
Review and evaluate EMSTARS data points relative to dispatch and work with the Data Committee to fine tune
Photo courtesy of Indian River Fire Rescue
36 • As of April 2010, the state of Florida has • Development of air ambulance safety video successfully uploaded over 1.5 million to educate stakeholders on Florida’s proactive EMSTARS records to the national database approach to safety and the important role air (NEMSIS) and is currently the second highest ambulances play in patient care. The video ranking state in total number of records won the 2009 Silver submitted to NEMSIS. Award for Excellence • The first iteration of the Data Warehouse/EMS in Public Health Data Mart is underway and is expected to be Communication, completed by July 2010. Upon completion of In-House Special the first iteration, the BEMS Data Unit will have Audio/Visual a workable solution for its decision support Projects, by the Celebrating Our needs and future linkage with Trauma Registry National Public and AHCA (Hospital Discharge Data). Health Information Coalition. Successes Goal 3 - Improve EMS workforce safety, education, performance, and satisfaction. • Developed minimum standards for critical care paramedic education curriculum. 2008 - 2010 • Developed and promulgated EMS instructor criteria to enhance the quality of education Florida EMS Strategic Plan Goal 2 – Improve customer satisfaction with being provided to EMT and paramedic students. Accomplishments and knowledge of the EMS system (customers are defined as patients, providers, and all • Provided continuing education units to 244 Through the joint efforts of the BEMS, EMSAC, stakeholders). providers via webinar and on-site at the 2009 and 25 EMS constituency groups and other • Currently working with EMS agencies to start Prehospital Pediatric Education Symposium stakeholders, the 2008-2010 Florida EMS Strategic or expand injury prevention programs in (EMLRC and EMSC partnership). Plan accomplishments include, but are not limited their areas by providing educational and best • Approved 15 new EMS training programs, to: practice forums, such as the “Senior Falls: An totaling 168 in the state, and well over 550 Increasing Issue in EMS” seminar conducted by continuing education programs. Goal 1 – Improve patient care, safety, and the EMSAC PIER Committee in June 2009. outcomes through the EMS system leadership, • Florida currently has 70 schools offering 175 evaluation, and benchmarking. • Expanding existing partnerships with the EMT and paramedic courses. Florida Department of Transportation • The EMS Tracking and Reporting System • Enhanced EMS training requirements through by providing EMS representation on the the development and adoption of: (EMSTARS), Florida’s prehospital incident data Motorcycle Safety Coalition. Assisting the collection system, went live in July 2008 as coalition with the development of the • Minimum standards for EMS instructors in a result of the efforts of the EMS Advisory Motorcycle Safety Strategic Plan and linking order to produce high-quality EMS students. Committee’s (EMSAC) Data Committee. their injury prevention efforts with EMS. • Minimum standards for EMS training • As of April 2010, 116 EMS providers are actively • Partnering with the Read for Health program programs, including Medical Director submitting data to Florida’s prehospital to raise awareness for Emergency Medical participation, course length and equipment incident data collection system with an Services for Children (EMSC), thirty four list. additional 45 EMS providers committed to counties participated and 784 “A Day with • Paramedic training programs may allow a submit in the near future. Paramedics” books were distributed to portion of the field internship experience • Florida became the tenth state to report to the volunteer readers to read to kindergarten and to be done aboard an advanced life support National EMS Information System (NEMSIS). first and second grade students. permitted vehicle other than an ambulance.
37 Goal 4 - Ensure economic sustainability of the EMS • Established mechanism for key stakeholders system. to provide input and share best practices • Supporting the economic sustainability of regarding STEMI, stroke, and trauma. the EMS system through the EMS grants • The EMRC has continued to provide a program which recently awarded 64 grants for mechanism for statewide EMS data analysis approximately 4.7 million dollars for fiscal year and review for the purpose of statewide and 2009-2010. national quality improvement initiatives. The • Assisting our rural EMS partners by awarding EMRC also established a report review process 15 paramedic scholarships, 5 EMT scholarships, that will assist the BEMS and EMS provider and 3 scholarships for rural EMS leaders to agencies in mapping all report queries to assure data elements and data subset elements are attend a leadership conference; and producing Goal 6 – Ensure the EMS system is prepared to a recruitment video targeting rural youth. appropriate for the report and/or research being examined. As the EMS Tracking and respond to all-hazard events in coordination with • March 1, 2009, EMSC Federal Partnership Grant Reporting System database grows, the EMRC state plans. Awarded for $130,000 and March 8, 2010 EMSC will identify benchmarks, best practices, trend • EMS Mass Casualty Incident Rodeo – a received another $130,000 from the Federal identification and research opportunities for gathering of all the assets from around the Partnership Grant Award. the Florida EMS Community for the purpose of state where equipment standardization, best • EMSC and other partners providing high-level statewide and national quality improvement load practices, and deployment strategies were pediatric education to rural communities (i.e. initiatives. among the topics covered. EMS agencies, hospitals, air medical providers) • Establishment of a certification process for 911 • Continued updates to the Ambulance that do not have access to training due to emergency dispatchers. The BEMS has certified Deployment Plan. limited budget. nearly thirteen hundred 911 emergency Continued training of Ambulance Deployment dispatchers since inception. • • Provide disaster preparedness/response Plan strike team leaders. equipment and training through federal grants Enhanced EMS delivery of patient care through • Development of an EMS Pan Flu Plan underway. (ASPR and CDC grants). the development/revision and adoption of: • Increase EMS community surge capabilities Increased minimum standards for neonatal • • through the distribution of personal protective transport staffing and medical direction. equipment, training, and development of • Defining certificate of public convenience and statewide disaster protocols through federal necessity (COPCN). cooperative agreements. • Increased service delivered by EMTs through Goal 7 – Maintain an accident-free environment Goal 5 - Improve performance of key EMS additional skills (glucometer use, providing and promote a culture of safe and appropriate processes. aspirin, and premeasured auto injectors). utilization of Florida air assets. • Development of the first Florida air medical • Continue to improve the delivery of EMS • Coordinated a one day air medical safety strategic plan, which we believe to be the first to children by meeting national EMSC conference, bringing in national industry such plan in the country. Goal 7 “to maintain performance measures. experts and representation from all an accident‐free environment and promote a • Established pediatric recertification stakeholders involved in air medical transport. culture of safe and appropriate utilization of requirements. Developed and approved as part of the EMS Florida air assets” has been added to the current • Strategic Plan a seventh goal addressing all strategic plan by the EMSAC. • Continued implementation of the “Denise Amber Lee Act.” aspects of air medical safety. Development of an air medical safety video • Coordinate the first tabletop disaster exercise that received the silver award by the National • The EMRC in conjunction with the BEMS Data • utilizing the revised State of Florida Air Medical Public Health Information Coalition 2009 Unit developed online reports to measure the Services Disaster Response Plan 2010. Annual Awards for Excellence in Public Health improvement of key EMS processes. Communications.
38 Acknowledging Our EMS Quality Managers Association Life Support Association Federal Emergency Management Agency (FEMA) Florida Legislature Florida Aeromedical Association (FAMA) Florida Medical Association Florida Agency for Healthcare Administration (AHCA) Partners Florida Air and Surface Transport Nurses Association Florida Neonatal & Pediatric Transport Network (ASTNA) Associations (FNPTNA) Florida Ambulance Association Florida Pilots Association Access to Care Task Force Florida Association of County EMS (FACEMS) Florida Professional Firefighters American College of Emergency Physicians Florida Association of EMS Educators Florida Sterling Council American Heart Association/American Stroke Association Florida Association of EMS Medical Directors Association of Florida Trauma Agencies Florida Association of Professional EMTs & Paramedics Florida Traffic Records Coordinating Committee Association of Florida Trauma Coordinators (FAPEP) Health & Medical Co-Chairs Brain and Spinal Cord Injury Program Office Florida Association of Rural EMS Providers (FAREMS) Health Resources & Services Administration (HRSA) Bureau of Emergency Medical Services Florida Basic Trauma Life Support Joint Administrative Procedures Committee (JAPC) Center for Disease Control and Prevention (CDC) Florida Chapter of Air and Surface Transport Nurses Association Children’s Medical Services, Florida Department of Health National Association of County and City Health Officials Florida Chapter of the American College of Surgeons- (NACCHO) County Health Departments Committee on Trauma Critical Incident Stress Management Florida College of Emergency Physicians National Association of State EMS Officials (NASEMSO) Division of Medical Quality Assurance, Florida Florida Council on Rural EMS (COREMS) National EMSC Data Analysis Resource Center (NEDARC) Department of Health Florida Department of Agricultural and Consumer Services National EMS Information System Technical Assistance Domestic Security Oversight Council Florida Department of Business and Professional Center (NEMSIS TAC) Emergency Medical Dispatch Association Regulation National Highway Traffic Safety Administration (NHTSA) Emergency Medical Review Committee (EMRC) Florida Department of Children and Families Emergency Medicine Learning and Resource Center Florida Department of Community Affairs National Standard Curricula (NSC) EMSAC Access to Care Committee Florida Department of Education Occupational Safety & Health Administration (OSHA) EMSAC Data Committee Florida Department of Environmental Protection Office of Emergency Operations EMSAC Disaster Response Committee Florida Department of Financial Services Office of Injury Prevention EMSAC Education Committee Florida Department of Health EMSAC Legislative Committee Florida Department of Highway Safety and Motor Vehicles Office of Public Health Preparedness EMSAC Medical Care Committee Florida Department of Management Services Office of Trauma EMSAC Paramedic Shortage Committee Florida Department of Transportation Public Health & Medical Preparedness Teams EMSAC PIER Committee Florida EMS Quality Managers Association Public Health & Medical Target Capability EMSAC Strategic Visions Committee Florida Emergency Nurses Association (FENA) United States Department of Health and Human Services EMS for Children (EMSC) Advisory Committee Florida Emergency Services Pilots Association (FLEMSPA) (HHS) EMSC National Resource Center Florida Fire Chiefs’ Association EMS Communications- Technical Advisory Panel (TAP) Florida Health Care Association United States Department of Homeland Security EMS Providers of Florida Florida Hospital AssociationFlorida International Trauma United States Life Saving Association 39 Glossary
Action Plan Charter Legislation Tool used to deploy resources and/or assign The charter is a clear description of the goal team’s A proposed or enacted law or group of laws. activities to achieve specific objectives. Plans purpose or mission, and identifies the champions, usually include the following: team members, technical support, resources, and Measure stakeholders. It clarifies team expectations, keeping A specific indicator that tracks your progression or • key activities for the corresponding objective; the team focused and aligned with organizational status of point in reaching an end result or specific priorities. It serves as a contract to ensure target. Answers the questions: • lead person/accountability mechanism for accountability by team members. each activity; 1) ”What’s our current performance?”; Goal • timeframes/milestones for completing 2) “How do we compare against others?”; activities; Broad statement describing a desired result. Goals may be results or process oriented. 3) “Are we improving or declining?”. • status of activities; and Goal Owner Indicators to measure/monitor success against • evaluation indicators to determine quality and EMS Advisory Council Subcommittee that strategic goals and objectives. The frequency in effectiveness of the activities in reaching the provides oversight to the objective leads which measures are reviewed assists teams to strategy. for a specific goal. The chairpersons of these identify potential process problems in order to subcommittees provide a high-level overview of meet desired outcome (ie. complete objective to Balanced Scorecard the status of their specific goal fulfill goal). A tool to measure success against strategic goals at the EMS Advisory Council meetings. and objectives. Mission Lead A brief, comprehensive statement of purpose Benchmarking EMS Advisory Council Subcommittee, of the organization or system. Answers the Gathering information about model efforts or constituency group, or other work group that questions: best practices by other organizations or systems is responsible for the fulfillment of a specific 1) “What is our purpose?”; engaged in similar endeavors to help establish objective. The chairperson of the committee or project targets and goals. Benchmarking is often their designated liaison provides quarterly status 2) “What do we stand for?”; incorporated into a balanced scorecard. reports to the Goal Owner, the Strategic Visions Committee, and Strategic Planning Coordinator. 3) “What will we strive to do?”
40 Objectives Sterling Management System SWOT Specific and measurable targets for accomplishing Business framework based around seven A tool to conduct an analysis of environmental goals to be accomplished by specific teams or categories that makeup the Governor’s Sterling strengths, weaknesses, opportunities and threats individuals within time limits. Addresses the Award criteria: leadership; strategic planning; (sometimes referred to as an environmental scan or question, “What do we have to do to get there?” customer and market focus; measurement, informal internal/external assessment) that affect analysis, and knowledge management; workforce the organization or system. Often organizations Outcomes focus; process management; and results. or systems use/build upon existing strengths to The long-term end goals that are influenced by For more information visit: http://www. overcome areas identified as opportunities for the project, but that usually have other influences floridasterling.com. improvement. Provides situational awareness for affecting them as well. Outcomes reflect the actual those involved in the development of a strategic results achieved, as well as the impact or benefit Strategic Planning Process plan in order to develop the plan. of a program. A process by which the Florida Department of Health, Bureau of Emergency Medical Services, Values Resource the EMS Advisory Council, and EMS constituency The EMS Advisory Council’s framework for carrying EMS Advisory Council Subcommittee, envision the future and develop goals, objectives out its mission and activities. Values that guide constituency group, workgroup, or other EMS strategies and action plans to achieve that future. the priorities, attitudes, policies and behaviors of partner that an objective lead may contact as the EMS Advisory Council and those working to subject matter experts or for other assistance to Strategy implement the strategic plan. complete action plan activities associated with a Techniques or tactics that may be used to specific objective. accomplish an objective or goal. Vision Note: Some groups may be identified as resources Note: The strategies listed in this plan are meant to An overarching statement of the way we want after the publication of this plan. be fluid and revised as needed. to be; an ideal state of being at a future point. Answers the questions: Stakeholder Any person or group with a vested interest in the 1) “Where do we want to go?”; and outcome of a project or plan. 2) “Where do we want to be?”
41 Acronyms
AAMS – Association of Air Medical Services CBRNE- Chemical, Biological, Radiological, EMSAC – Emergency Medical Services ACS – American College of Surgeons Nuclear and Explosives Advisory Council AEMT – Advanced Emergency Medical CDC – Centers for Disease Control EMSC – Emergency Medical Services for Technician CoAEMSP – Committee on Accreditation of Children AHA – American Heart Association Educational Programs for the EMSTARS – Emergency Medical Services Emergency Medical Services Tracking and Reporting System AHCA – Agency for Health Care Professions Administration EMT – Emergency Medical Technician DHS – Department of Homeland Security AIDS – Acquired Immune Deficiency ESF8 – Emergency Services Function 8 Syndrome DivTel – Division of Telecommunications (Health and Medical) ALS – Advanced Life Support DMS – Department of Management ESS – Emergency System Status Services AMPA – Air Medical Physicians Association ET – Endotracheal DOE – Department of Education AMTS – Air Medical Transport Services FAA – Federal Aviation Administration DOH- Department of Health APCO – Association of Public Safety FAC – Florida Administrative Code Communications Officials DOH IT – Department of Health Information FACEMS – Florida Association of County Technology ASPR – Assistant Secretary for Preparedness Emergency Medical Services and Response DOT – Department of Transportation FAEMSE – Florida Association of Emergency ASTNA – Air Service and Transport Nurses ED – Emergency Department Medical Services Educators Association EMD – Emergency Medical Dispatch FAMA- Florida Aero Medical Association BA52 – Baker Act EMD QA – Emergency Medical Dispatch FAREMS – Florida Association of Rural BEMS – Bureau of Emergency Medical Quality Assurance Emergency Medical Services Services EMR – Emergency Medical Response FCOT – Florida Committee on Trauma BLS – Basic Life Support EMRC – Emergency Medical Review FD – Fire Department CAMTS – Commission on Accreditation of Committee FDEM – Florida Division of Emergency Medical Transport Services EMS – Emergency Medical Services Management
42 FDLE – Florida Department of Law MHz - Megahertz QA- Quality Assurance Enforcement MI – Myocardial Infarction RDSTF – Regional Domestic Security Task FEMA – Federal Emergency Management MQA – Medical Quality Assurance Force Agency NAACS – National Association of Air Medical RECCWG – Regional Emergency FENA – Florida Emergency Nurses Communication Specialists Communications Coordination Association Working Group NEMSIS – National Emergency Medical FFCA – Florida Fire Chiefs Association Services Information System ROSC – Return of Spontaneous Circulation (as defined by the UTSTEIN criteria) FHA – Florida Hospital Association NOAA – National Oceanic and Atmospheric FLEMSCOMM – Florida Emergency Medical Services Administration SLERS – Statewide Law Enforcement Radio System Community NHTSA – National Highway Traffic Safety FLEMSPA – Florida Emergency Services Pilots Administration SSG – State Surgeon General Association NSC- National Standard Curricula STEMI – ST-Segment Elevated Myocardial Infarction FNPTNA – Florida Neonatal Pediatric Transport NTSB – National Transportation Safety Network Association Board SWG – State Working Group HIV- Human Immunodeficiency Virus NVGS – Night Vision Goggles SWG-ICC – State Working Group - Interoperable Communications HMICI - Health & Medical Interoperable OEO – Office of Emergency Operations Communications Initiative Committee PHMP – Public Health and Medical TAP – Technical Advisory Panel IHST – International Helicopter Safety Preparedness Team TAWS – Terrain Awareness Warning Systems PHP – Public Health Preparedness IIMC – Inadvertent Instrument TBD – To Be Determined Meteorological Conditions PIER – Public Information , Education and Relations UHF – Ultra High Frequency IWG – Initiative Working Group PSA – Public Service Announcement USLA – United States Lifesaving Association JCAHO – Joint Commission on Accreditation PSAP – Public Safety Answering Point UTSTEIN – Standard template for study of of Healthcare Organizations Cardiac Arrest KPI – Key Performance Indicators
43 Appendix A
Florida ASTNA Introduction: Air medical transport is a highly Initial Requirements for Flight Paramedics: specialized and unique component of the Florida Recommendations State EMS community. Air medical crews require 1) Completion of a paramedic training program specialized training and skills to provide safe, rapid based upon the US DOT EMT-Paramedic EMS Strategic Plan Goal 8.5 transport and advanced clinical care for complex National Standard Curriculum patients. Utilizing the framework set forth by the Association of Air Medical Services (AAMS) to 2) Certification in the state of the base of meet Goal 8.5 of the Florida State EMS Strategic operations Goal 8.5: Adopt initial and continuing Plan, the Florida chapter of ASTNA recommends educational training requirements for aircrew the following: 3) Minimum of 3 years experience as a of licensed air providers paramedic in the prehospital setting ASTNA OBJECTIVES: Initial Requirements for Flight Nurses: 4) BLS provider (or equivalent) In meeting this Strategic Plan goal, we recommend that the current RN and paramedic continuing 1) Graduation from an accredited Registered education requirements incorporate specific Professional Nursing Program 5) ACLS or PALS or NRP provider certification (or education required by air medical personnel vs. equivalent) as appropriate for the program requiring additional education hours. Allocation of 2) Licensure in the state of base of operations mission hours specific to air medical transport will meet the needs of our licensed air medical providers while 3) Minimum of 3 years critical care and/or 6) Air crew curriculum course as approved by the minimizing the financial hardship that imposing emergency nursing experience State Bureau of EMS additional educational hours would incur. FL ASTNA also recognizes that minimum 4) BLS provider (or equivalent) Continuing Education Requirement for Flight qualifications for employment should include Nurses and Paramedics: training specific to the service (rural vs. urban), 5) ACLS or PALS or NRP provider certification (or demographics of the patient population (neonatal, equivalent) as appropriate for the program 1) Two hours related to Safety Training pediatric, maternal, adult), the mission profile of mission the program (scene vs. interfacility, short vs. long transport distances), and type of transport vehicle 2) Two hours related to Flight specific training 6) Air crew curriculum course as approved by the (fixed wing vs. rotor wing). State Bureau of EMS
44 Summary: FL ASTNA endorses minimum educational requirements be established for Flight Nurses and Flight Paramedics in the State of Florida. These minimum initial and continuing education requirement recommendations are intended to provide all licensed air providers an education guideline that is attainable. It is our hope that licensed air providers in Florida will utilize these guidelines not only to meet, but exceed these requirements to provide the safest, most advanced air medical transport and clinical care to the population in Florida.
Photo Courtesy of Leon County EMS – 2010 Florida EMS Provider of the Year
45 Appendix Executive Section Data Jean Kline, RN, BSN, MPH DEMO Director Stephanie Daugherty Deputy Chief [email protected] ext *4054 [email protected] ext *2747
B John C. Bixler Bureau Chief John Ross Systems Project Analyst [email protected] ext *4053 [email protected] ext *2692
Bureau of Emergency Dr. Joe Nelson State Medical Director Steve McCoy Manager Data Reporting Services Medical Services [email protected] [email protected] ext *2727 Functional Directory as of Desi Lassiter Deputy Chief, Administration Olajide Thomas Supervisor Aggregate Data [email protected] ext *4055 [email protected] ext *2761 July 2010 Donna Bruce Administrative Secretary Jennifer Pitts Administrative Secretary Street Address: [email protected] ext *2782 [email protected] ext *2738 4025 Esplanade Way, 3rd Floor Tallahassee, FL 32311-1747 Mary Klein Budget Wendy Parkinson [email protected] ext *3216 Administrative Secretary/Safety Officer Mailing Address: [email protected] ext *3901 4052 Bald Cypress Way, Bin C-18 Michael Greif Legal Counsel Tallahassee, FL 32399-1738 [email protected] ext *2027 Statewide Planning Main Telephone Number: (850) 245-4440 April Thornton Paralegal Specialist Melia Jenkins Deputy Chief [email protected] ext *3919 Fax Numbers: (850) 488-9408 / (850) 488-2152 [email protected] ext *2773
Websites: Operations Alan Van Lewen Grants Manager http://www.fl-ems.com [email protected] ext *2734 http://www.floridaemstars.com R.C. Pippin Deputy Chief [email protected] ext *2752 Melissa Keahey EMSC Program Manager E-mail: [email protected] [email protected] ext *2686 Shelly Lewis Compliance Officer/Inspections All issues related to EMT and Paramedic [email protected] ext *2771 Kimberly Moore Supervisor Investigations certifications should be sent to: [email protected] ext *2759 Florida Department of Health Rickey Stone Division of Medical Quality Assurance Senior Training & Education Coordinator Richard McNelis Investigations Legal Counsel EMT/Paramedic Certification Office [email protected] ext *2753 [email protected] ext *4028 4052 Bald Cypress Way, Bin C85 Tallahassee, FL 32399-3285 Rebecca Cash Training & Education Coordinator Tikia McGhee Investigator Phone (850) 245-4910 or (850) 488-0595 [email protected] ext *2725 [email protected] ext *2779 Fax: (850) 921-6365 Web: www.doh.state.fl.us/mqa/EMT-Paramedic Barbara Hyde Provider Licensure Specialist Alyshia Dark Investigations Specialist II E-mail: [email protected] [email protected] ext *2723 [email protected] ext *2722 46 Photo Courtesy of Leon County EMS – 2010 Florida EMS Provider of the Year
47 Appendix Strategic Plan Organizational Chart – July 2010
EMS Advisory Council (EMSAC)
C John Scott, Chair Executive Champion Goal Owners Roles: SVC Compostion Leads: *Oversight & Coordination of objectives Cory Richter, Julie Bacon for respective goal Goal Owners: *Communication EMSAC Objective Lead Liaisions, State Plan Coordinator *Champions/Leadership Strategic Visions Committee (SVC)
Goal 1 Owner Goal 2 Owner Goal 3 Owner Goal 4 Owner Goal 5 Owner Goal 6 Owner Goal 7 Owner Medical Care EMSAC Data Committee PIER Committee Education Committee Legislative Committee Committee Disaster Committee John Scott Chief Charles Moreland Chief Cory Richter Daniel Griffin TBD Dr. David Meurer Dr. Brad Elias
Objective Leads Objective Leads Objective Leads Objective Leads Objective Leads Objective Leads Objective Leads
EMSAC Data Committee PIER Committee Legislative Committee Florida Association Dispatch Work Group Disaster Committee Executive Committee EMSAC Quality Managers Dispatch Work Group of EMS Providers Data Committee Legislative Committee Bureau of EMS Data Unit Access to Care FFCA-EMS Section FL. Ambulance Assoc. Disaster Committee EMSC Committee Education Committee Legislative Committee Medical Care Committee Community Surge Team EMSAC Quality Managers Medical Directions EMSC Office of PHP EMRC Goal 8 Owner Goal 9 Owner Goal 10 Owner State Plan Coordinator Roles: USLA *Coordinates requests and feedback Access to Care Access to Care Access to Care between work groups Objective Lead Liasions: Committee Committee Committee *Organizes meetings, mailings, surveys BEMS Data Link Karen Chamberlain Michael Patterson Michael Patterson *Posts updates to web and/or Stephanie C. Daugherty flemscomm Community Surge Team *Provides technical support and/or Lynn Drawdy facilitates technical support from Objective Leads Roles: Dispatch Work Group Objective Leads Objective Leads Objective Leads DEMO QI coordinator (Lynne Drawdy) *Develop, execute, and revise Jim Lanier EMS Medical Director or other sources action plans that meet Communications Dr. Joe Nelson FAMA Medical Care *Facilitates integration between the objectives Legislative Committee Committee Committee EMSAC Parlementarian various system plans (trauma, injury *Ensure that the plan is an Regina Sofer State EMS Medical prevention, preparedness, etc.) and agenda item at meetings EMRC - Steve McCoy Director national initiatives *Participate in meetings by EMSC - Julie Bacon Florida DOT *Facilitate communication between teleconference or in person as Executive Committe FENA Providers the EMSAC subcommittees, EMS determined by workgroup John Scott (or current Chairman) PIER Committee constituency groups, and other *Report status at least quarterly FFCA, EMS Section Chief Ray Colburn stakeholders involved in the strategic *Report changes in objective EMSC FL Assoc. of EMS Providers planning process to foster lead liaisons to the Strategic Dan Azzariti integration between the groups Visions Committee FL Ambulance Assoc. *Provide resources such as information *Respond to inquiries from state Jim Judge from the National Assoc. of State EMS plan coordinator and members Quality Managers Officials, EMS Agenda for the Future, of the Strategic Visions Art Garcia best practices, and strategic Committee USLA planning tips Joe McManus 48
Florida’s Emergency Medical Services Strategic Plan July 2010 - June 2012
Bureau of Emergency Medical Services 4052 Bald Cypress Way, Bin C - 18 Tallahassee, FL 32399-1738