JULY 19, 2018
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PROJECT WORKGROUP UPDATE: MENTAL HEALTH PROTOCOLS
what other mental resources are available in Mecklenburg County.
GENERAL DESCRIPTION This project will result in a mutually supported change in the treatment and transport of patients experiencing a behavioral health emergency. Through coordinated effort with our law enforcement partners, we will develop a protocol and policy change to improve the alignment of patient need with care provided by both agencies. Additionally, the limitations and abilities of each agency to intervene within the confines of the law and patients’ rights will be understood.
BUSINESS CASE • The degree to which this project will reduce responses or transports will not be clear until the protocols are defined. It is likely that there will be indirect reduction in billable services, but the degree to which that will influence revenue is unknown. • NC Senate Bill 383 would establish Medicaid reimbursement for ambulance transports for Medicaid recipients in behavioral health crisis to behavioral health clinics or alternative appropriate care locations. If passed, this bill would reduce the degree to which loss of revenue would impact our budget.
REASON FOR THE EFFORT • Tension across agencies on scene of behavioral health calls often creates frustration for the patient in addition to Medic crews and allied responder partners. Establishing appropriate and supported procedures and policy is expected to increase cooperation and reduce on-scene tension. Success in improving our working relationships may reduce the need for escalation of force, use of restraints, and prevent harm to both providers and patient. It may also have a positive effect on patient satisfaction and outcomes, as well as employee satisfaction. • During a recent CIT collaborative staffing meeting, it became apparent that agency protocols and principles used when addressing behavioral health patients are inconsistent and often contradictory. Identified disparities include: when should a patient be transported by Medic, appropriate destination for a mental health patient, tools and methods used when managing these patients, and the issue of restraining a patient. • While mental health patients represent 6% of total patients transports a year, Medic continuing education has contained 1 hour of training for psychiatric emergencies since June 2015. This suggests that there is an opportunity to discuss how to manage patients, how to form a team approach with other agencies, and
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WHERE ARE THEY NOW??? Still in the inception stage, this project’s aim is to align care of behavioral health patients across Medic and Allied Agencies by 1/31/2019. The team has met several times and has set (5) primary objectives: 1. Identification of subpopulations – Draw down which specific patients would benefit from a realignment of alternative options for treatment 2. Interagency Collaboration – Work with identified stakeholders (police, fire, emergency departments, behavioral health, etc.), on the front end, to assist in this change concept. 3. Development of intervention strategies – Design treatment/transportation options for these specific patients (new protocols). 4. Testing Strategies – Test and evaluate these strategies in real case scenarios. 5. Implementation – Once testing has been completed and an adequate amount of data has been collected, the next and final step would be establishing the necessary training and communication to all stakeholders. For more information email Tony Pattillo at antoniop@medic911.com
PERIOD 1 (7/1/18 - 10/31/18) WEEKLY RESULTS THRU’ 7/13/18
EST. PAYOUT : $1000 FINANCIAL STANDING VS. BUDGET (GOAL: > 0.25%)
QUALIFYING CRITERIA Budget, Patient Satisfaction and Total Task Time goals must be met to turn on Performance Pay. If one of these three goals is not met, Performance Pay will not be paid.
ON TARGET
PATIENT SATISFACTION RATED AS “EXCELLENT” 67%
(GOAL: > 50%; LOW: 50%-59%; MID:60%-64%; HI: > 65%)
TOTAL TASK TIME
66:14
(GOAL: < 70:00; LOW: 69:00-70:00; MID: 68:01-68:59; HI: < 68:00)
$0
$150 $300
$0
$150 $300
AGENCY DRIVER SAFETY SCORING AVERAGE (GOAL: > 8%) 9
PERFORMANCE CRITERIA ($100 EA.)
CMED MPDS HIGH COMPLIANCE (GOAL: > 70%) 79%
RESPONSE TIMES P1: 97.08%/P2: 96.87% (GOAL: P1, P2: > 90%; P3: > 85%) P3: 94.40%
P1 TRAUMA SCENE TIMES (GOAL: < 10:00) 8:12
*Pat Sat through 6/22/18
The latest Performance Pay Tracking Period began on July 1. We are striving to meet the Patient Satisfaction goal of a ≥ 50% rating (experience as “Excellent”). In order to create a comfortable margin of performance, while continuing to improve the patient experience, we would like to share some feedback from recent patient focus groups. The two areas that patients value the most are: 1. Communication from the treating crew: “Explain treatment options and procedures” “Provide reassurance and compassionate communication with the patient” 2. Setting clear expectations: “Set transport length expectation” “Set a triage level expectation before arriving at the hospital”
SEPTEMBER 2014
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Every month, Medic provides a written Agency update to key stakeholders including the Board of County Commissioners, the County Manager’s office and the Agency’s Board of Commissioners; it is referred to as the Board Bulletin. This one page communication is comprised of six charts representing key performance indicators specifically chosen for this audience coupled with a brief narrative aimed at conveying Medic related news.
Following is Medic’s Board Bulletin for the month of June. This month’s narrative is focused on MEDIC’s contribution to the EMS industry-wide effort to improve ambulance safety standards and our recent designation by Charlotte Business Journal as one of the healthiest employers in the local area. Enjoy! If you have any questions, email PR@medic911.com
MEDIC HELPING DRIVE SAFETY STANDARDS FOR AMBULANCES Medic recently hosted a meeting of EMS industry leaders from across the country who are working to improve ambulance safety standards. The focus of this meeting was on patient care modules being remounted onto new vehicle chassis. The majority of the team’s participants represent Agencies that have met the stringent operating requirements established by the Commission on Accreditation of Ambulance Services (CAAS), which is a distinction Medic also holds. Remounting patient care modules onto a new chassis is a cost effective way to replace ambulance chassis that have reached their end of life and preserve investments made in the module. The downside to this practice is that new safety features for the module are often overlooked. The new standard is intended to ensure that appropriate safety requirements for ambulance remounts are clearly established and available for adoption by ambulance fabricators, EMS providers and state regulators. This work has been ongoing for nearly a year and a proposed draft is under review. Medic already adheres to the CAAS safety standard for new ambulances and will adopt the remount standard once it is finalized. MEDIC RECOGNIZED AGAIN AS HEALTHY EMPLOYER The Charlotte Business Journal has recognized Medic as one of the area’s healthiest employers for the sixth year running. The award is based upon programs and benefits available to employees to help them strike a healthy work/life balance. Medic’s efforts begin with the Agency’s wellness committee, a team that has been engaged in helping create a healthier work environment for the past eight years. Agency employees also enjoy benefits such as an onsite workout facility, an annual wellness fair that includes free health risk assessments, flu shots, and discounts on healthy snack options at the Agency’s onsite food market. In addition to helping the Agency with ongoing recruitment efforts, this commitment to wellness is critical to providing existing employees with the support system necessary to achieve a long, healthy career at Medic.
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CONTEXT FOR KEY PERFORMANCE INDICATORS The data on the following page is presented in control charts. Each dot represents a monthly average, count or proportion. The middle green line is the average performance for the displayed periods, while the red lines are the upper and lower control limits. • Response time compliance performance goal is 90%. • Cardiac arrest survival is measured for patients that meet a nationally standardized case definition. • Patient satisfaction is determined using a random telephone survey of up to 200 transported patients per month. This results in a proportion which rated their overall quality of care as excellent. The target is > 65% excellent. • County cost per transport is based off of the total number of transports in a month divided by the monthly subsidy provided to Medic.
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COMPLIANCE CLASS TRAINING In order to successfully complete this LMS training, please be aware of the following: Passwords and Login It is your responsibility to ensure that you have access to the Success Factors Learning Management System (LMS). You will need to log into the LMS to complete your compliance training and to set up your fit testing/TB test, if applicable. If you have never logged into the LMS then you will do the following: • Go to: https://medic911.plateau.com • User ID: Employee ID number with preceding zeros if applicable • Default Temporary Password is: ‘medic911’ If you have forgotten your password please use the “forgot password” function. If that fails then contact Medical Services at eqs@medic911,.com. Password resets will only occur during business hours. • You must be sure that you have your correct login information before attempting to complete work in the lab
For complete instructions, visit https://www.medic911.com/extranet/my-medic/corporate-compliance.If you have Corporate Compliance content questions, contact Pam Jackson at pamelaj@medic911.com. For technical questions, contact Medical Services at eqs@medic911.com ATTENDEES Elizabeth Ansley-Fisona, Anna Baldwin, Scott Bodien, Tabitha Byers, Brent Cail, Michael Carter, Nicholas Chase, Ed Clay, Hunter Cromwell, Janine Curlee, Jeffrey Davidson, David Dombo, Kyesha Dula, Jim Emerson, Marisa Epps, Michael George, Robert Harford, Shaun Heptinstall, Matthew Hestwood, Nicole Hogan, Aaron Hopping, Kelleigh Jackson, Cathy Jordan, Jeffrey Karll, Irina Kerusenko, Eric Koelbl, Jackson Langevoort, Shellye Ledbetter, Kaitlin Lewis, Ron Martin, Casey Miller, Jacob Miller, Rebecca Mullis, Beth Pethel, Patrick Pfund, Ian Priola, Gary Rizzo, Tyler Smith, Matthew Soria, Jason Swick, Claudia Tetenbaum, Benjamin Thackston, Christopher Weber and Sterlynn White.
August 2018
• Calendar week starts on Monday. Monday
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NO IN-SERVICE IN AUGUST – SIMULATION ONLY. IN-SERVICE WILL RESUME IN SEPTEMBER.
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SCOPE OF PRACTICE
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SAFETY MEETING
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1300 - 1500
This October, Medic turns 40. In order to make this year’s event a success, PR needs your assistance by telling us your Medic story. “Our People” is an important part of Medic’s rich history. Because of the role you play, we’d like to highlight Medic employees and their favorite Medic moments. To submit a story, visit https://www.medic911.com/extranet/ home/40th-employee-stories and answer a few, short questions. Story submission deadline is Monday, August 6. For more information, email PR@medic911.com
MARVLIS Updated mapping software makes it easier to navigate roadways For smaller EMS agencies, mapping solutions may be an iPhone, a radio, or a third-party app like Active 911. Though these methods are inexpensive and effective, the size of Mecklenburg County’s population requires a much more complex system such as our current software, Marvlis. Thanks to the innovative thinking of Scott Bodien and the input of crew members, Marvlis has been completely overhauled over the course of the last four years. Before the update, the system used simple labeled street center lines with no other context. Today Marvlis provides details crucial to response times and patient outcomes. Imagine responding to a cardiac arrest call and getting lost down an unknown, poorly-lit street late at night. Our Marvlis system makes it possible for Medic’s over 480 field crew members to avoid such situations and navigate the roadways with incredible efficiency while also providing a high standard of care. New Marvlis features include: • Routable streets outside Mecklenburg County • Private driveways • Parking lots • Tax parcel lines
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Building footprints Parks Golf courses Blocked roads Speed bumps
• Stoplights • Streams • Half a million address points in Mecklenburg County2014 SEPTEMBER
For more information, email Scott Bodien at Scott.Bodien@medic911.com
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AUGUST BIRTHDAYS Scott, Derek A. 2 Martin, Ronald D. 3 Overcash, Donald E. 3 Hackett, Christopher C. 4 Jackson, Kelleigh D. 4 Kersey, Shawn A. 5 Godbey, Noah C. 6 Betancourt, Sabrina M. 7 Sheehan, Kyle P. 7 Kiger, Madison P. 8 Phillips, David L. 9 Robertson, Daniel W. 9 Bell, Douglas E. 10 Berger, Andrew, P. 10 Headen, Jasmin N. 10 Sherriff, Michael W. 10 Smith, Tyler 10 Furphy, Kathryn J. 11 Hajjar, Mohamad A. 13 Infinger, Allison E. 13 Lucas, Jessica M. 13 Murray, Kenneth J. 13 Truesdell, Gregory M. 13 Soria, Matthew T. 14 Lewis, Matthew S. 15 Miller, Jacob W. 15 Mohr, Matthew W. 15 Robertson, Sydney E. 15 Berry, Terran S. 16 Brown, Landrel T. 16 Hayes, Isabella L. 16 McGaha, Gabriel R. 16 Mudd-Tyson, Nicole A. 16 Thornton, Barry G. 16 Crane, Patrick M. 17 Gomez, Rogelio D. 17 McNally, Christopher G. 18 Pentland, Anne L. 18 Ciccone, Michael A. 19 Kennedy, Elizabeth A. 20 Marshburn, Timothy A. 20 Shametaj, Yvone 20 Urekew, Jeremy R. 21 Gray, Keir D. 22 Jones, Trueman K. 23 Anaya, Dakota A. 24 West, Jessica H. 24
Hamilton, Raymond B. Muhammad, Thomas Martin, Tracy M. Knowlden, Jamaar Z. Gerig, David B. Giuliano, Amanda G. Graser, Daniel D. Walser, Sarah C. Harrison, Ethan J.
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