The EMS System
Guide to Interfacility Patient Transfer
The transfer of patients from one medical facility to another has become an ongoing issue for EMS. Patient transfers between facilities or between facilities and a specialty care resource have increased as a result of regionalization, specialization, and facility designation by payers. The emergence of specialty centers (e.g., cardiac centers, stroke centers) often determines the ultimate destination of patients rather than proximity of facility. Transfer may be necessary if payers provide reimbursement only for specific facilities within their own plans.
Interfacility transfer (IFT) is provided by a variety of levels and types of personnel and agencies. Key issues include the IFT infrastructure, including the qualifications of those delivering the care. Meeting patient needs and maintaining continuity of care are only two of the many issues related to IFT. The national EMS community determined that consensus guidelines for interfacility patient transfer would be very useful to promote consistent high-quality patient care while allowing variation to meet specific local needs. This document is currently near completion and will be posted on the NHTSA EMS Web site in 2006. For more information please contact Laurie Flaherty.
Statewide EMS Technical Assessments
Does EMS in your State have a system for identifying its strengths, weaknesses, and opportunities for improvement? Does it have a method for long range planning or strategies for generating support? The answer is yes. Technical assistance like that described above is available to all State and territorial EMS programs through NHTSA’s Statewide EMS Technical Assessment Program.
This process has been used since 1988, when NHTSA developed a Technical Assistance Team (TAT) approach to support the evaluation of existing and proposed emergency medical services programs. In the TAT approach, a team of outside experts conducts a comprehensive assessment of the Statewide EMS program using an organized, objective approach and well-defined procedures that:
- provide an overview of the program’s current status in comparison to pre-established standards;
- note the program’s strengths and weaknesses;
- provide recommendations for improvement.
The program is a tool for States to use in evaluating their statewide EMS programs.
Although States must provide the funding for these State EMS Technical Assessments, almost all States and Territories have used the NHTSA State EMS Assessment process to identify system development needs and strategies. NHTSA is currently accepting reassessment requests from States that have previously conducted an assessment and are interested in measuring their subsequent progress. The reassessment standards are based on an evaluation of the EMS technical assessment process and by incorporating concepts from the EMS Agenda for the Future. To request a reassessment, make a joint request to your State Highway Safety Office and your NHTSA Regional Office. For specific information about the process, please contact Susan McHenry.
“First There, First Care” Program
Have you ever had friends or family members ask you what to do if they witness a car crash or a motorcycle crash? Many people want to help but have reservations about knowing exactly how to help. Ordinary people who are trained to use simple actions can save lives. The challenge is to overcome the fear of “not doing it right” and the attitude of “not wanting to get involved.” The First There, First Care program is designed to give simple but life-saving information to the public, build awareness, and empower people to take action. The goal of First There, First Care is to give motorists information, training, and confidence to provide life-saving bystander care at the scene of a crash, increasing the chance of survival for crash victims.
What can you do to get started? If you are an EMS provider and would like to teach First There, First Care, you need the First There, First Care Instructor Preparation Package (item # 3P0116). This kit contains all the materials necessary to complete a one-hour self-paced lesson which prepares medical professionals for teaching First There, First Care to lay motorists. The package includes the First There, First Care for the Injured Awareness Kit, the First There, First Care Train-the-Trainer CD-ROM, the First There, First Care training video, and the First There, First Care Instructor Guide.
Once you’ve completed First There, First Care instructor preparation, and need materials to conduct to conduct First There, First Care training, you need the First There, First Care Student Materials (English-language kit - item # 3P0124, Spanish-language kit - item # 3P0125). This kit contains all the necessary pamphlets and brochures for up to 30 students participating in a First There, First Care training. All materials are FREE and can be obtained by visiting the NHTSA Web site at www.nhtsa.dot.gov and clicking on “Traffic Safety Materials & Publications” on the “Quick Links” drop-down menu, or faxing an order to 301-386-2194. For more information on the First There, First Care program, contact Laurie Flaherty.
Technology and EMS Projects
Technology is producing more gadgets and making more information available every day. Some of it could be very useful in EMS; some are just gadgets. How can you tell the difference? More important, how can you tell if new technology makes a difference? Many new technologies have great potential for their application to emergency medicine and the improvement of emergency care. But there is no coordinated method for determining the clinical utility or the effectiveness of new technologies before they are deployed in EMS – at least not today.
But the National Association of EMS Physicians (NAEMSP), through an agreement with NHTSA EMS, is looking to increase national medical and emergency care community involvement in the planning and implementation of technology in EMS. Through a multi-disciplinary oversight committee, the NAEMSP is managing a project designed to develop a template and a process for assessing the medical utility of various forms of technology and their potential for improving patient care. This two-year project will provide a focal point and sounding board for future national technological issues and for helping to assure medical community involvement before technology is deployed in EMS. For more information on the Technology and EMS project, contact Laurie Flaherty.