What follows is a list of resources mentioned during various session at this year’s NAEMSP Annual Meeting. This conference represents the best of the science of EMS. So as to not overtly violate the ethics of conference attendance (and therefore conference fees), all information was found on the web during the various sessions. I try to refrain from interpretation, but if you have any questions regarding the context of a resource please feel free to email me at ccounts@tulane.edu.
– Catherine R. Counts
I had the unique opportunity of writing for EMS1 during my time in San Diego, these articles elaborate on two of the sessions I found most valuable during the meeting.
- If your EMS agency isn’t innovating, then it’s already behind
- Experts weigh in on community paramedicine implementation
Saturday, January 16
Top Innovations for 2016
- Speaker – Brent Myers
- Active Assailant
- FBI – Active Shooter Incidents from 2000-2013
- Reform for Real
- Burwell 2015 – Setting Value-Based Payment Goals — HHS Efforts to Improve U.S. Health Care
- Bundled Payments
- Hospital Compare
- Carlton 2015 – A novel diagnostic protocol to identify patients suitable for discharge after a single high-sensitivity troponin
- Narcotic Epidemic
- Business Insider – Overdose deaths from a type of legal drug hit record numbers
- CDC MMWR – Increases in Drug and Opioid Overdose Deaths — United States, 2000–2014
- Advocacy Changes
- HR 4365 – Protecting Patient Access to Emergency Medications Act of 2016
- International Outreach
I have to Start Carrying What on My Ambulance?
- Speaker – Craig Cooley
- CARES Foundation
EMS Compass Initiative & The Latest in Performance Measures
- Speaker – Alex Garza
- EMS Compass
- NY Times – Think the E.R. Is Expensive? Look at How Much It Costs to Get There
- Health Affairs – Medicare Hospital Readmissions Reduction Program
Successes & Challenges in Developing, Implementing, & Studying Prehospital Evidence-Based Guidelines
EMS DEA Update
- Speaker – Ritu Sahni
- H.R. 4365 – Protecting Patient Access to Emergency Medications Act of 2016
- Read EMS1 summary of legislation here.
Not Carved in Stone: The 2015 AHA Guidelines for CPR & ECC – Update for EMS
- Speaker – Michael R. Sayre
- AHA 2015 Guidelines
- ED ECMO
Top 5 Articles that Should Change your Practice
- Speakers –Blair Bigham, Michael Millin, Jon Rittenberger
- Newgard et al. 2016 – Improving early identification of the high-risk elderly trauma patient by emergency medical services
- Guyette et al. 2015 – A comparison of prehospital lactate and systolic blood pressure for predicting the need for resuscitative care in trauma transported by ground.
- Berkhemer et al. 2015 – A Randomized Trial of Intraarterial Treatment for Acute Ischemic Stroke
- Modern Healthcare – Specialized ambulances expedite stroke treatment
- Ross et al. 2015 – Assessment of the safety and effectiveness of emergency department STEMI bypass by defibrillation-only emergency medical technicians/primary care paramedics.
- Prekker et al. 2016 – Pediatric Intubation by Paramedics in a Large Emergency Medical Services System: Process, Challenges, and Outcomes
- Gausche et al. 2000 – Effect of Out-of-Hospital Pediatric Endotracheal Intubation on Survival and Neurological Outcome: A Controlled Clinical Trial
- Nichol et al. 2015 – Trial of Continuous or Interrupted Chest Compressions during CPR
Friday, January 15
Promoting Innovation in EMS
- Speakers – Noah Smith, Jim Dunford, Kevin Munjal
- Read EMS1 summary here.
- NHTSA White Paper – Innovation Opportunities for EMS
- EMS Innovations – Open for public comment
- Burwell 2015 – Setting Value-Based Payment Goals — HHS Efforts to Improve U.S. Health Care
- California EMS Core Quality Measures Project
- San Diego Health Connect
- San Diego EMS – AHRQ Innovations Exchange Profile
- Accountable Care Communities
Electronic Dance Music, Designer Drugs & Teen Death
- Speakers – Kathleen FitzGibbon, Benjamin J. Lawner, Matthew J. Levy, Kevin G. Seaman
- New York City 2013 – CDC Report
- Los Angles 2010 – CDC Report
- Veld Music Festival – Toronto – August 2014
- Electric Daisy Carnival – Las Vegas, NV
- Mad Decent Block Party – Washington DC – 2014
- Moonrise Festival – Baltimore 2015
Thursday, January 14
President’s Address – Jane Brice
- NAEMSP has a bill (HR 4365) in Congress – read more here
- PEC Podcasts are a great resource
- Next year’s conference will be in New Orleans, so if you feel like learning why I love the Big Easy, plan on attending!
Identifying Human Trafficking in America
- Speaker – Rebecca Bender
- Read EMS1 summary here.
- Shared Hope International
- Red Flag Brochure has list of warning signs for human trafficking
- Power of Coercion explains tactics that are used by traffickers
- One-pager for healthcare providers on human trafficking
- One-pager for mental health providers on human trafficking
Measuring Up to IOM’s Recommendations for Cardiac Resuscitation
- Speaker – Bentley J. Bobrow
- Download the report for free here
- Examining the Health Disparities Research Plan of the National Institutes of Health: Unfinished Business
- Ornato et al. 2010 – Cardiac Arrest and Resuscitation: An Opportunity to Align Research Prioritization and Public Health Need
EMS Mythbusters
- Speakers – John Lyng & John Gallagher
- Read EMS1 summary here.
Resuscitation Outcomes Consortium: Recapping Its Impact & Successes
- Speaker – Mohamud Daya
- Read EMS1 summary here.
- Resuscitation Outcomes Consortium – ROC is a clinical trial network focusing on research in the area of prehospital cardiopulmonary arrest and severe traumatic injury.
Wednesday, January 13
Mobile Integrated Healthcare/Community Paramedicine Workshop
Read EMS1 summary here.
Historical Background and Proof of Concept Studies: Kevin Munjal
- NAEMT MIH / CP Survey
- Mason et al. 2007 – Effectiveness of paramedic practitioners in attending 999 calls from elderly people in the community: cluster randomized controlled trial.
- Logan et al. 2010 – Community falls prevention for people who call an emergency ambulance after a fall: randomized controlled trial
- Dixon et al. 2009 – Is it cost effective to introduce paramedic practitioners for older people to the ambulance service? Results of a cluster randomized controlled trial.
- Bigham et al. 2013 – Expanding Paramedic Scope of Practice in the Community: A Systematic Review of the Literature
- Jones et al. 2015 – Acceptability of Alternatives to Traditional Emergency Care: Patient Characteristics, Alternate Transport Modes, and Alternate Destinations
- EMS: Agenda for the Future
- A National Agenda for Community Paramedicine Research
Data & Metrics:
- Brenda Staffan – STRIP CMS Innovation Award
- One page strategic plan – Slide 7
- Focus on IHI Triple Aim
- Using Donabedian Model – Structure, Process, Balancing Measures, and Outcomes
- Defining hotspotters
- Million Dollar Murray – Malcolm Gladwell
- Preliminary Results – estimated savings of $7.2 million
- Savings greatest with nurse health line
- Dan Swayze – Center of Emergency Medicine of Western Pennsylvania
- Evidence-Based Medicine Resources Pyramid
- Case-Control Studies – Today
- Cohort Studies – Next few years
- Randomized Controlled Trials – Five years out
- Advocates for using a variety of MIH/CP outcome metrics developed over last few years
- Tobacco smoke enema used to be at the forefront of medicine, things change
- Evidence-Based Medicine Resources Pyramid
- Brent Myers – CMO at Evolution Health
- Hospital Compare – Includes hospital value based metrics that impact reimbursement
- 30-day death and readmission measures
- Bundled Payments for Care Improvement (BPCI) Initiative
Regulations & Policy:
- William Snoke – Director of External Affairs Allina Health EMS
- Law passed – SF 119 – Community paramedics
- Law passed – SF 1543 – Medicaid payments
- Mdewakanton Sioux Health Services Pilot
- Carol Cunningham – State Medical Director for Ohio Department of Public Safety Division of EMS
- Old law restricted MIH/CP
- New law is allows MIH/CP, but still a bit restrictive
- MIHCP White Paper
- A Guidance Resource for Ohio EMS
- NASEMSO my / CP Committee
- Shaughn Maxwell – Deputy Chief of Snohomish Fire District 1
- Reached out to researcher at County Human Services for help with data
- Have seen reduction in 911 calls as well as expanded programs
- Using Quadruple Aim in Washington Healthcare Innovation Plan
Medical Direction for Community Paramedics: Michael Wilcox
- Medical Director should observe via ride alongs
- Huddles are a great tool
Finance & Sustainability:
- Brent Myers – CMO at Evolution Health
- Burwell 2015 – Setting Value-Based Payment Goals — HHS Efforts to Improve U.S. Health Care
- More states are enacting MIH/CP legislation
- Hospital Compare
- States with Medicaid expansion have a population that has already been treated by EMS prior to insurance, meaning EMS already has data on this group
- Medicaid MCOs and Accountable Care Organizations haven’t been around long enough to have substantive data
- Brenda Staffan – STRIP CMS Innovation Award
- Don Berwick 2008 – The Triple Aim: Care, Health, And Cost
- Republicans call it Pay for Performance and Democrats call it Value Based Purchasing
- 25 states are participating in CMS Innovation Models Inititative
- Use a uniform outcome measurement set
- Progression of Payment Reform from CMS
- Don Berwick 2015 – Change from the Inside Out: Health care Leaders Taking the Helm
- Community support is important, news articles help – Rena Gazette, USA Today, Kaiser
- David Schoenwetter – Medical Director Geisinger EMS and Life Flight
EMS Compass
- The goal of EMS Compass is to help EMS systems measure and improve the quality of care at the local, regional, state and national levels.
- Read EMSWorld article on HarvardX-IHI here.
Flirting with Adrenaline 