![]() ![]() In 2012, Mecklenburg EMS Agency (a.k.a, Medic), serving the Charlotte-Mecklenburg County (N.C.) metro area, embarked on an ambitious initiative. Although this includes the direct customer experience, it also incorporates dimensions of healthcare performance identified in the Institute of Medicine (IOM) Crossing the Quality Chasm report, which included: safety, effectiveness, patient-centeredness, timeliness, efficiency and equity.1 Ambulance services have worked on one or more of these dimensions, but few as a whole system. The end result will be a change package that can be brought to any community to improve the quality and reliability of paramedic care in specific clinical areas.Ī paradigm shift for many in reform is the emphasis on patient experience and system designs that enhance value for the patient. Their improvement collaborative mirrors IHI’s Breakthrough Series Collaborative model and uses methods from improvement science to test change concepts, implement reliable care processes and spread innovations. Based on the Esther Project in Sweden, the initiative brings AMR communities from across the country together to collaborate on improving several areas of ambulance care that are believed to make a clinical difference, including sudden cardiac arrest, pain and suffering, stroke, respiratory distress and ST-elevation myocardial infarction (STEMI) identification. (AMR) developed a nationwide program called Caring for Maria. Today, we benefit from 40-plus years of knowledge, best practice and published research that demonstrates EMS can make a difference in core care areas. EMS systems were originally designed to focus on emergency care, specifically trauma and sudden cardiac arrest. Each branch of the healthcare system typically has key care areas where targeted intervention and reliable care delivery can save lives. Making a measurable and sustainable difference in the lives of patients requires focused action. Let’s look at how three EMS organizations are doing work today in these dimensions. IHI’s Triple Aim–which heavily influenced the framework of the Centers for Medicare and Medicaid Services (CMS) Innovation grants–optimizes the health system by focusing in on three dimensions: the health of a defined population, the experience of an individual and the reduction in per-capita healthcare cost. One area of healthcare reform that offers some exciting hope is the work focused on innovation, much of which has evolved from an initiative started by the Institute for Healthcare Improvement (IHI). ![]() The EMS industry is late to the game and it’s time to get to work. In the prehospital environment, there have been small pilot examples of innovative thinking (e.g., community health paramedic programs), but most organizations have not begun the process of preparing to meet the needs of the transforming system. In-hospital, leaders are crunching the numbers, making plans and piloting innovations that target improved quality and reduced costs. Unequal access, variable quality and allocated health costs as a percentage GDP at nearly twice our peer countries is no longer sustainable or acceptable. healthcare system is broken and needs to be fixed. Although cable news fixates on a few attributes that keep the left and the right pundits in a frenzy, the folks on the frontline have known for a long time that the U.S. The Patient Protection and Affordable Care Act was a key trigger, but momentum in the industry was already causing changes. For more information and sample articles and issues, visit Healthcare as we know it is experiencing a transformation. Editor’s note: This article originally appeared in the March 2013 issue of EMS Insider, the must-have resource for EMS leaders, including supervisors and managers, chiefs and administrators. ![]()
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