Quality Change Programs Old Necessities/New Bearings.

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Quality Change Programs Old Necessities/New Bearings New York State Crisis Medicinal Administrations Board State Crisis Therapeutic Admonitory Council Branch of Wellbeing - Department of Crisis Restorative Administrations SEMSCO/SEMAC DOH BEMS
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Quality Improvement Programs Old Requirements/New Directions New York State Emergency Medical Services Council State Emergency Medical Advisory Committee Department of Health - Bureau of Emergency Medical Services

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SEMSCO/SEMAC DOH BEMS Evaluation/QI Committee accused of re-composing the NY State QI Manual Provide Guidance to Services, Program Agencies, REMSCOs and REMACs on creating and keeping up QI Programs taking into account entrenched standards and new procedures Create an outlook change in the way we approach the QI process here in NY State

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Table of Contents Introduction The Paradigm Shift in the QI Process in NY State Glossary of Key Terms Chapter 1 How to Establish a QI Committee/“The Nuts & Bolts of the Organization.” Chapter 2 EMS/“At the Crossroads of Public Safety, Public Health, and the Community Health Care System.” Chapter 3 Steps for Monitoring, Evaluating & Improving Organizational Efficiency/“From Data Collection to Performance Enhancements.”

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Table of Contents Chapter 4 Customer Service/“For It is The Customer, That We Exist.” Appendices Article 30, Section 3006 Part 800.21 (q) (r) QI Process Flow Charts Sample Audit Tools

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CQI - It’s Not the Blame Game!!!

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Organizational Efficiency Customer Service Benchmarking PCR Audits Technician – particular Behavior

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EMS The “S” in EMS remains for the word Service (sur-vis) supplying administrations as opposed to an item or merchandise; The sorted out exercises of contraption, apparatuses and representatives for supplying some settlement needed by the general population; The execution of any obligations or work for another

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“... administration individuals are the most imperative ones in the association. Without them there is no item, no deal, and no benefit. Surely, they are the product.” J.W. Marriott, Jr. Director of the Board and President Marriott Corporation

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“Everyone in an administration arranged association has an administration part, even the individuals who never see the customers.” Researchers Karl Albrecht and Ron Zemke

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EMS System Goals The general objective of an EMS System is to diminish passing and inability from wounds and restorative crises. The fundamental presumption in social insurance is that the arrangement of consideration and the people inside of it can enhance and try to a higher standard of consideration.

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SYSTEM is the agent word A mind boggling solidarity framed of numerous frequently assorted parts subject to a typical arrangement or filling a typical need.

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The Birth and Development of an EMS SYSTEM 1966 “Accidental Death & Disability: The Neglected Disease of Modern Society.” National Highway Safety Act 1972 Robert Wood Johnson Grant Funding 1973 EMS Systems Act 1998 NY State EMS Plan 2006 ACEP Report Card on the State of Emergency Medicine in the U.S. 2006 Institute Of Medicine – The Future of Emergency Care in the U.S. Medicinal services System

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Manpower Training Communications Transportation Hospitals Critical/Specialty Care Public Safety Agencies Consumer Participation Access to Emergency Care Patient Transfer Standardized Recordkeeping Public Information & Education System Review & Evaluation Disaster Management Mutual Aid 15 Components of an EMS System

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Benchmarking 101 On-going and precise procedure for measuring and looking at the work procedure of one association to those of another, by conveying an outer center to interior exercises capacities or operations. The objective is to furnish arrangement creators with a standard for measuring the quality and expense of inward exercises and to help distinguish where open doors for development may dwell.

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Benchmarking 101 How well would we say we are doing contrasted with others? How great would we like to be? Who is doing it the best? How would they isn\'t that right? In what manner would we be able to adjust what they do in our association? By what means would we be able to be superior to anything the best?

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Who are the Customers ? The Patient The Patient’s Family Taxpayers Managed Care Organizations/Insurance Companies Physicians, Nurses, Hospitals Health Care Organizations REMSCO, REMAC, SEMSCO, SEMAC, TRAUMA COUNCIL’S, ETC City Council, Town Board Police/Fire, Public Health Personnel Others ?????

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Authority Command Yeah..I got a Chief’s auto! I am in Charge People will need to hear me out now Responsibility Accountability To the patients To the individuals To the citizens Agency Leadership & Management Test

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Dangerous Attitudes…… “ We’re just volunteers, we do the best we can.” “We are 911! Who else you going to call.” “It’s my region, and I am in control, and we are the main amusement in town.”

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Is This Your Service? More than 100 years of tradition…. ….not blocked by a solitary day’s progress!

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Words not to live by…. “We’ve constantly done it like that….” “That’ll never work here…..” “’Cause I’m the supervisor - that’s why….”

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Or…Is This? overflow work: the joint activity by a gathering of individuals, in which individual hobbies are subordinate to the group’s solidarity and productivity

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Management 101: Accentuating the Positive Compliment your representatives at whatever point conceivable - and fitting Although it’s less demanding to concentrate on the negative – don’t do it! Regular little affirmations exceed uncommon extensive ones Praise out in the open - discipline in private

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CQI & The Strategic Planning Process Leaders & Managers must be successful strategists if the association is to satisfy its central goal, meet its commands, and fulfill its constituents in the years ahead

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Strategic Planning Development of compelling techniques to adapt to changing circumstances Set of ideas, methodology and apparatuses intended to help pioneers & chiefs with an assortment of errands Disciplined push to deliver key choices and activities that guide what an association is, the thing that it does, and how it does it

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Data Collection/Analysis And The Strategy Change Cycle Setting the organization’s bearing Formulating wide approaches Making interior/outside appraisals Pay thoughtfulness regarding needs of key partners Identify key issues Develop methodologies to manage every issue Implement strategies Continually screen and survey results

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From Philosophical to Operational in 5 Easy Steps What are commonsense choices, dreams and dreams you may seek after? What are the obstructions to understanding those options, dreams and dreams? What recommendations may you seek after to conquer those hindrances? What steps are expected to execute those recommendations? Why should dependable actualize these proposition?

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Plan-Do-Check-Act This is a ceaseless procedure without end.

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What is Continuous Quality Improvement?

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What Is Quality Improvement? QI is a project of systemic assessment to guarantee incredibleness. QI is a judgment in the matter of what is inadequate and connected to a framework to impact positive change. QI is recognizable proof of positive activities by EMS Providers and associations.

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It’s likewise the LAW……… Most states have a segment of their EMS statute or code that orders at any rate some type of QI project

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QI Laws and Regulations Article 30 prerequisite (Section 3006) PHL Rules and Regulations of NYS Part 800 Article 28 PHL - Part 405.19 (healing center regs.) Part 80 - Controlled Substances JCAHO Federal Regulations - HIPAA

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QI is a Continuous Activity From a Service Perspective Reinforces incredibleness Helps the administration archive its consideration Provides useful input to partners Identifies insufficiencies Improves execution through training

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QI is a Continuous Activity From a Medical-Legal Perspective Reduces hazard by strengthening the conveyance of fitting consideration From a Patient Perspective Reduces demise and handicap Ensures proper EMS activity for the community’s wellbeing and prosperity

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Traditional Approach Retrospective investigation – Review of agency’s procedures after they happen React to issues after they happen Weak additionally most surely understood PCR reviews Medical debriefings Incident reports React to warning occurrences

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Quality Assurance (QA) Total Quality Management (TQM) Continuous Quality Improvement The Baldridge System Six Sigma

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Modern View Concurrent Methods - Review of exercises that are nearby and on-going On-line (direct) therapeutic control Comparison of EMS discoveries and E.D. determination Field perception of EMS faculty by M.D.s, senior educators, clinical preceptors, and so forth. All parts of authoritative productivity

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Modern View Prospective Methods - measuring future occasions against foreordained guidelines. Achieved through: Development & utilization of conventions Establishment of time measures Minimal levels of essential preparing Requirements for proceeding with training

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QI Guidelines for EMS Services Providing Prehospital Care

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Select a QI Coordinator The administration Medical Director Hospital’s EMS QI Coordinator The framework Medical Director E.D. doctor Senior prehospital supplier

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Duties of a QI Coordinator Build a QI Team Communicate with healing center EMS Coordinator Interface with Medical Director & field bosses Review PCRs Review existing conventions & principles Develop CME educational module Review purchaser correspondences

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Resources for QI Co

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