Missouri Department of Health and Senior Services

Paula AdkisonDeborah Markenson

10/29/08

Regional EMS Committees

“The purpose of the council is to make recommendations to the governor, the general assembly, and the department [DHSS]

on policies, plans, procedures and proposed regulations

on how to improve the statewide emergency medical services system.

The council shall advise the governor, the general assembly and the department on all aspects of the emergency medical services system.”

State Advisory Council on Emergency Medical Services

(SAC) (RSMo 190.101)

SAC-EMS

(RSMo 190.101)

http://www.dhss.mo.gov/EMS/Council.html

16 members—appointed by Governor

Lynthia B. Andrews, DO., ChairChair of Emergency MedicineHeartland Regional Medical CenterSt Joseph, MO

Chair may appoint subcommittees that include noncouncil members

DHSS-Bureau of EMS supports SACMeet monthly with minutes posted

on DHSS website

PURPOSE: TO MAKE RECOMMENDATIONS TO THE REGION AND DHSS ON:

1. Coordination of emergency resources in the region;2. Improvement of public and professional education;3. Cooperative research endeavors;4. Development of standards, protocols and policies; and 5. Voluntary multiagency quality improvement committee and

process.

Regional EMS Advisory Committees

RSMo 190.102

Regional EMS Advisory Committees

(RSMo 190.102)

http://www.dhss.mo.gov/EMS/Committees.html

• DHSS designates through regulation EMS regions and committees.

• DHSS Director appoints based on recommendations from recognized professional organizations.

• Appointments for 4 years with individuals serving until reappointed or replaced.

Missouri’s Regional Committee Territories

•19 CSR 30-40.302—State regulations define counties in each region.

http://www.dhss.mo.gov/EMS/Committees.html

1. REVIEW BY FUNCTION

2. BARRIERS

3. RECOMMENDATIONS

1. Supports2. Functions

Regional CommitteeDiscussion 9/18/08

Review by Function (9/18/08 discussion)

(1) Coordination of emergency resources in the region

Working: Sharing mutual aid agreements Integration of EMS out-of-hospital servicesAdditional functions: Work on triage and transport for region Work on role of small hospitals Enhance network development

Review by Function (9/18/08 discussion)

(2) Improvement of public and professional educationWorking:• Sharing information and

educational opportunities• Sharing protocols

Additional functions:• Conduct additional education with focus on regulatory

requirements• Share best practices• Coordinate prevention education on a regional basis

Review by Function (9/18/08 discussion)

(3) Cooperative research endeavors

No issues identified on 9/18/08

Review by Function (9/18/08 discussion)

(4) Development of standards, protocols and policies

Additional FunctionsShare best practicesReview regional practices based

on ACS trauma criteriaReview and approve protocols

for care

Review by Function (9/18/08 discussion)

(5) Voluntary multiagency quality improvement committee and process

Additional FunctionsImprove quality improvement functions

with benchmarks for facilty/region/stateAddress lack of EMS peer protection so

can share data for QI

Barriers

StateCommittee appointment

delaysLimited data, limited or no

feedback or data reports from registry data

Lack of timely communication and updates

RegionLack of understanding of

committee functionsLack of participation by

medical directors

Both•Resource and manpower shortage

•Inadequate funding, limited funding opportunities or notices•Lack of EMS peer protection for QI functions

General Support Recommendations Regional Committees-State

Track regional committee appointments and make timely replacements.

Increase diversity of membershipProvide orientation for new committee members.Describe purpose and benefits of regional committees and compile

strategies to promote committee value to increase involvement. Improve data support for QI functions. Provide regular updates & establish accessible website. Increase support for regional committees and functions. Post Regional Committee Member listing.

General Support Recommendations-Region & Both

RegionIncrease involvement of medical directors.Host regional committee meetings with other stakeholder

groups.Establish standard meeting time.

Both• Increase involvement of medical directors.• Explore and use technology for meetings and communication to

decrease travel time and improve information availability.

Recommendations for Regional Committee

Functions

OK

Modify

Delete

Identify ways to enhance network development.

Define and maintain role for small hospitals.

Conduct additional education, focus on regulatory requirements.

Share best practices.

RecommendationsCont. for Regional Committee

Functions

OK

Modify

Delete

Review regional practices based on ACS trauma criteria.

Review and approve protocols for care within region.

Formalize quality improvement (QI) functions with benchmarks for facility/region/state.

Recommendations Cont. for Regional Committee

Functions

OK

Modify

Delete

Additions

Address lack of EMS peer protection so can share data for QI.

Coordinate prevention education on a regional basis.