System design, delivery systems, SOP, Education, Occ health Flashcards
Pro all ALS
All response types covered
Response time may improve
Incremental cost for established ALS agency is minimal
Pro BLS with some ALS
Concentrates procedures for ALS (less skill dilution)
ALS may not have major benefit over ALS most of the time
Public utility model features
- Single ambulance service designated
- Governmental unit does billing
- Government unit owns capital equipment
Medical director preferable to be appointed by third party
What is queuing analysis
How many units are required for a given hour
Medical director voice regarding performance standards
Voice of the likely effect of response of interval performance
Medical equipment
Certification levels on clinical outcomes
Largest cost to EMS systems
75 % Labor
25% infrastructure
3 axis of essential system measures
- Clinical sophistication
- Response time reliability
- Economic efficiency
4 feature of effective medical oversight
- External (vs internal)
- Authoritative (vs advisory)
- Broad scope of authority (vs narrow)
- Funded (vs volunteer)
Features of high performance systems
- Sole provider
- Controls center operations
- Accountability
- Maximizes revenue
- Flexible production strategy
- Systems status management
What is system status management
Ambulance deployment model based on anticipation of need
EMS assessment system
Bladrige healthcare criteria for performance excellence
EMS at crossroads 2007 said what about Air EMS
Growth primarily money driven
Needs to be actually clinical beneficial
Needs to be safe
First HEMS program
Dr Crowly and Shock Trauma with Maryland state police
1970
First hospital based HEMS
1972 - St Anthonys in Denver CO
% of population that needs HEMS to get to trauma center
27%
What act increased CMS reimbursement for HEMS transport
1997: Balanced budget act
Airline deregulation act
States have no jurisdiction over aviation aspects of air EMS programs (stays with FAA) or economics of providing services
Title 14 of federal code
FAA responsible for all aviation specific issues: safety inspections, helicopter licensure, air traffic control