Arizona’s Premier EMS Agency Program March 6, 2019 Dr. David J. Harden, JD, NREMT Strategic Planning & Communications Section Chief Bureau of EMS & Trauma System
What is the Premier EMS Agency Program (PEAP) The PEAP was established in 2009 as an EMS patient care performance improvement initiative by the Bureau of EMS and Trauma System (Bureau) within the Arizona Department of Health Services (ADHS). The PEAP is administered by the Bureau’s Services Section. EMS agency participation is voluntary . PEAP Goal: To further improve patient outcomes in Arizona through implementing evidence-based, highly coordinated and standardized, prehospital care.
What is the Premier EMS Agency Program (PEAP) • Devised by Bentley Bobrow, MD, Bureau of EMS and Trauma System Medical Director, as an evidence-based performance improvement initiative, and launched in May 2009. • The PEAP facilitates statewide measurable improvements in EMS and trauma patient outcomes using evidence-based and standardized patient care for the following identified public health emergencies: − Suspected Opioid Overdose − Out-of-Hospital Cardiac Arrest (OHCA) − ST-Elevation Myocardial Infarction (STEMI) − Acute Stroke − Major Trauma − Pediatric Resuscitation ( criteria in development via a TEPI workgroup, and starting PEAP Year 2 – Date TBD After 9/27/19 )
Why These Six Emergencies? Suspected Opioid Overdose, OHCA, STEMI, Acute Stroke, Major Trauma, Pediatric Resuscitation An integrated EMS and trauma system can have measurable impacts on patient outcomes, resource deployment/utilization, and costs. These six emergencies are: Opioid Overdose, OHCA, STEMI, Stroke, Major Trauma, and Pediatric Resuscitation are major causes of death and disability, are time-sensitive, and are responsive to acute treatments and regionalized systems of care. • A Major Causes of Death & Disability • Time-Sensitive • Responsive to Acute Treatments • Responsive to Regionalized Systems of Care
What are the PEAP Recognition Criteria? To receive Premier EMS Agency recognition, EMS agencies MUST: • Have an electronic patient care report (ePCR) system that submits all incidents/patient contacts to the Arizona Prehospital Information and EMS Registry System (AZ-PIERS) consistent with current data submission guidelines. • Attestation of a committed and empowered quality assurance team that reviews 100% of incidents/patient contacts associated with the six time-sensitive emergencies (previous slide) • Attestation of commitment to use data for optimizing patient care, including a process/system using ePCR data to develop training, education, and policies that enhance patient care. • Agency annually updates the Bureau Automated Online Services portal with an accurate list of agency affiliated EMCTs, medical directors, EMS coordinators, and other associated personnel. • CON holders only : Attestation of having a policy in compliance with the Safe Transport of Children by EMS interim guidance.
PEAP Attributes PEAP is Voluntary: • Participation is voluntary and not a requirement established in statute or rule. Non-Punitive: • PEAP is a performance improvement initiative that DOES NOT cross over into the Bureau’s regulatory responsibilities under statute or rule. Inclusive: • Participation is open to all Arizona EMS agencies (transport and non-transport agencies). Commitment/Participation Requirements: • ADHS is committed to the PEAP as a mechanism to improve patient outcomes • ADHS requires commitment by EMS agencies’ leadership to PEAP standards to ensure the PEAP core principles are maintained. Contribution: • Success depends upon individual and collective contributions of EMS agencies.
Confidentiality • Data submitted to AZ-PIERS is part of the Bureau’s quality improvement/assurance process, and therefore, is protected from subpoena and civil discovery. • Data considered protected health information (PHI) that could identify the patient , the patient’s family , the health care provider, or the Agency are protected from civil discoverability and subpoena.
Benefits of Premier EMS Agency Recognition • Premier recognition demonstrates an EMS agency’s commitment to quality, cost-effective, and responsive patient care/customer service. • Premier recognition requires EMS agencies to establish evidence-based processes for performance measurement, setting performance improvement targets, staff integration, customer service improvement, inter-agency/provider collaboration, and operational efficiency. • Premier EMS agencies receive Bureau assistance with examples of QA/PI plans, an overview of the Plan-Do-Check-Act (PDCA) process improvement cycle, determining performance baselines, benchmarks, and gap analyses for the six TSEs, and receipt of performance-based agency and statewide aggregate data reports.
New PEAP Application
Application Content Description Section I. Agency Information Contains the EMS agency’s legal name, business address/phone number, and URL homepage. Section II. Agency Service Information Contains the EMS Agency’s service level. Section III. Agency Administration Contains contact information of the EMS agency’s senior management and key staff responsible for ensuring the EMS agency meetings PEAP standards. Section IV. Data Collection/Reporting Information Confirms the EMS agency’s ePCR system is consistent with AZ-PIERS’ data submission standards. Section V. Performance Improvement/Quality Assurance Information Informs the Bureau that the EMS agency is requesting assistance with their QA/PI process. Section VI. Senior Management Attestation Requires the EMS agency’s CEO/Fire Chief to attest to PEAP criteria. Section VII. Attachments Contains copies of the EMS agency’s QA/PI process.
Application Process • EMS agencies interested in receiving Premier EMS Agency recognition can visit the Bureau’s PEAP W ebpage to download the handbook and application: PEAP Handbook PEAP Fillable Application • All PEAP applications must include required attachments. • Submit PEAP applications directly to Dr. David Harden, JD, NREMT, at david.james.harden@azdhs.gov.
Application Process • Section VII of the PEAP Application requires senior management to attest that their EMS agency’s organization account on the Bureau’s Online Services Portal contains current entries for • EMS Coordinator • Medical Director • EMCT Assignments. • The next several slides include pages in sequence of the Online Service Portal and steps to confirm your agency’s organization account is current:
Step 1: Click the Online Services Tab
Step 2: Click the Login Tab at the Top of the Screen:
Step 3: Enter Your Login Credentials:
Step 4: Click the “Organizations” Tab in Left Margin:
Step 5: Enter Your Agency’s Name:
Step 6: Click the “Medical Director”: If the name listed is not current, the EMS agency’s administrator emails the name of the new Medical Director to David Harden, who will confirm the physician’s listing in the Bureau’s database
Step 7: Click the “Coordinator” Tab: If the name listed is not current, the EMS agency’s administrator emails a Provider User Account Request Form to the Bureau
Step 8: Click the EMCT Assignments Tab: The EMS agency’s administrator can export the Assignments to an Excel spreadsheet to update and email to David Harden
PLEASE CONTACT ME FOR ANY QUESTIONS OR ASSISTANCE WITH YOUR APPLICATION Dr. David Harden, JD,NREMT hardend@azdhs.gov | 602-364-3188 Bureau of EMS & Trauma System Arizona Department of Health Services azhealth.gov
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