CONFERENCES TO DEVELOP THE FRAMEWORK
The project leadership consolidated the lessons from these two regional conferences into conference proceedings documents and continued to analyze the data from the previous stages of information gathering. In consultation with the steering committee, the original five themes were reorganized into the seven themes that ultimately formed the basis of the current chapters within this document. The themes identified were legal, financial, medical direction, interdisciplinary collaboration, regional EMS coordination, education, and data and telecommunications. Despite the segmenting into chapters, it was recognized that there are complex inter-relationships between the issues discussed in various chapters. The project team wrestled with the idea of including a chapter on “quality” for quite some time but ultimately decided that since quality was the goal that required addressing barriers across all areas and not a distinct category of barriers, it would not be organized into a chapter. Instead, the reader will find strategies to improve quality throughout the document. The steering committee organized itself into small workgroups for each of the seven themes and met to discuss both the recommendations offered by the regional conference attendees as well as the qualitative analysis performed of all interview transcriptions and survey submissions. The steering committee itself then went about the task of writing the next iteration of recommendations and began vetting the emerging draft national framework document. At the midpoint of the project, a national steering committee meeting was held in our nation’s capital to allow for discussion and debate of the key issues identified and advanced by the efforts of Mount Sinai and UCSD. At that national meeting, 77 attendees both in person and via web, heard presentations from the project leadership and
Regional meetings were held in New York and California to advance local efforts to promote innovations in EMS by coming up with local solutions to local challenges. Breaking into small workgroups across the original five themes helped subject matter experts with varied experiences come together to address the same problem. The ideas generated, while intentionally focused on the nuances of the local region, were found to be broadly applicable to other jurisdictions and became the earliest iteration of proposed recommendations to be considered by the steering committee. An example of the discussion can be seen in the following results from a survey of conference attendees:
FIGURE 5A AND 5B: RESULTS OF SURVEY OF REGIONAL CONFERENCE ATTENDEES
Choose 3 issues from below that you feel most impede your innovation project or vision?
27% SCOPE OF PRACTICE (SKILLS, INTERVENTIONS) 26% PROTOCOLS (PROCESS REQUIRED TO CHANGE OR APPROVE) 17% LACK OF LIABILITY/QA PROTECTIONS 11% HIPAA 9% CERTIFICATE OF NEED OF PRIMARY SERVICE AREA 6% PORTABILITY OF CERTIFICATION 4% EMTALA
11%
27%
26%
9%
4%
6%
17%
What is most impeding data integration between EMS and hospital? (Multiple Choice)
26% UNWILLINGNESS OF HOSPITAL LEADERSHIP 22% UNCLEAR RETURN ON INVESTMENT 22% TECHNOLOGICAL LIMITATIONS 19% UNWILLINGNESS OF HOSPITAL EMR’S 6% UNWILLINGNESS OF ePCR COMPANIES 5% UNWILLINGNESS OF EMS AGENCIES
22%
22%
5%
6%
26%
19%
14
CHAPTER 1
MOUNT SINAI HEALTH SYSTEM | UNIVERSITY OF CALIFORNIA, SAN DIEGO
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