Saturday, April 19, 2014
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PRECIS OF PRESENTATIONS
SKIP KIRKWOOD, M.S., J.D., EMT-P, EFO, CMO

IS EMS IN CRITICAL CONDITION?
WHAT DO OUR BOSSES THINK?
60-90 minutes, lecture discussion.

In EMS, we spend a lot of time talking to ourselves about policy issues, but we don’t spend much time talking with our bosses – our elected and appointed officials. What do THEY know about EMS and contemporary EMS issues? Do they know an EMS system from an ambulance service? What are they talking about at their conferences and professional development seminars? What are our gurus telling them?


MEASURING WHAT MATTERS – EVIDENCE-BASED PERFORMANCE MEASURES FOR EMS AGENCIES
60-90 min, lecture-discussion.

Most EMS agencies exist in a data-rich environment, but there is often precious little useful information available to guide clinical and operational decisions. This session will discuss what matters in EMS, what evidence there is to support the measure, and present tactics and strategies for EMS agencies to focus their performance improvement efforts on things that matter, clinically and to the citizens they serve. Participants will be able to:

 

1. Identify five clinical issues where evidence supports the notion of advanced life support making a difference to the service’s patients
2. Describe the concept of “treatment bundles” and “number needed to treat” and their relevance to clinical QI.

3. Discuss the concept of a balanced scorecard and its application to EMS agency performance improvement.


LEADERSHIP DEVELOPMENT – UP THROUGH THE RANKS
60-90 min, lecture-discussion.

You can’t teach someone to be a leader, but you can teach them ABOUT leadership and give them tools to develop their individual capabilities. This session, intended for field EMS personnel interested in moving up through the ranks, will address the traits and attributes of successful leaders, and will present ideas and options for individuals to develop their individual leadership capacity. Participants will be able to:

1. Distinguish between leadership skills and management skills.
2. Identify the most common flaws in promotional preparation and testing processes.
3. Discuss five areas that should be developed by those desiring to advance to leadership roles in their EMS careers.


CHIEF OFFICER SURVIVAL – CRISIS COMMUNICATIONS - WHAT TO DO WHEN SOMETHING BAD HAPPENS IN A GOOD EMS AGENCY
60-90 min, lecture-discussion.

Your agency has a great reputation in your community, right? Except that you live one unfortunate occurrence, or one dumb move by one employee, from a media nightmare. This presentation will discuss how to prepare for the near-certainty of a crisis, and steps to take when that nightmare occurs that will minimize the negative impact on you or your agency. Participants will be able to:

1. Discuss the identification of a crisis management team and how to prepare for “the bad one.”
2. Describe techniques for dealing with the media that minimize the possibility of public blunders.
3. Describe an example of an agency head effectively addressing the community in a crisis situation.

 

EMS LEADERSHIP – WHAT WE CAN LEARN FROM THE MARINE CORPS
60-90 min, lecture-discussion.

No organization has studied leadership and leadership development like the United States Marine Corps. Leadership is the very essence of their existence, and they have distilled the concepts down to a few simple rules. This presentation will describe the leadership traits and attributes as defined by the Marines, and discuss their application to the EMS environment. Participants will be able to:

1. List the eleven leadership principles of the US Marine Corps
2. List the fourteen traits of a Marine Corps leader
3. Discuss the application of selected principles and traits to leaders in EMS organizations

 

EMS AND HEALTH CARE REFORM – WHAT ARE THEY GOING TO ASK OF US?
60-90 min, lecture-discussion.

The days of “transport everybody to the hospital” are likely coming to an end. What will the future of EMS look like as “universal health care coverage” (UHCC) moves across America? The improved health care system will expect more of EMS in terms of assessment, triage, treatment, destination selection, and evidence based care. Participants will be able to:

1. Explain why paramedics today have a poor track record concerning the need for evaluation at a hospital.
2. Explain why the ED is the only viable destination today, and what might become possible with UHHC.
3. Identify one tool that will assist paramedics in performing enhanced, destination-based triage in the future.


 

COMMUNITY PARAMEDICINE, ADVANCED PRACTICE PARAMEDICS, AND OTHER PROACTIVE APPROACHES TO EMS AND COMMUNITY HEALTH
60-90 min, lecture-discussion.

Progressive EMS systems around the country are experimenting with non-traditional approaches to pre-hospital challenges – high-risk refusals, alternative destinations, mental health crises, intoxicated patients, and medical clearance, as well as ways to reduce the demand for less acute EMS responses. This session will describe the Wake County Advanced Practice Paramedic program, the training of APPs, their daily work, and the services they provide in the community. Participants will be able to:

1. Describe the “3Rs” of the Wake County APP program
2. Describe the Wake County approach to high-risk refusals and the results of this approach.
3. Describe the didactic and clinical training of the Wake County APPs.

 

EMS-FTEP: Developing and Managing the Emergency Medical Services Field Training and Evaluation Program
16-hour pre-conference

OVERVIEW: This course is intended for EMS supervisors, educators, managers and executives who want to develop a sound, legally-defensible field training and evaluation program (FTEP) to smoothly and effectively integrate new employees in to their agencies, or to strengthen and solidify an existing field training program. The EMS-FTEP is based on the “San Jose Model” field training and evaluation program, ubiquitous in the law enforcement community, and is utilized in numerous EMS agencies across the United States. This course is not intended for individual paramedics selected to or seeking to become EMS Field Training Officers.

Many senior EMS officers believe that once a new paramedic completes pre-service training they should be ready to "hit the street" and function as a productive member of a two-person ambulance crew. In many agencies, this new paramedic will be expected to “lead” an EMT partner and to provide first-line advanced life support to critical patients. In today’s EMS environment, and given changes in paramedic education over the last 20 years, this approach is no longer viable. EMS agencies must fill in the gaps in cognitive, psychomotor, and affective performance for new personnel to be successful in the field. Liability is something every senior officer must be aware of and to guard against it, and professional, valid, documented training is the key to liability mitigation. The new medic’s street performance reflects directly on your agency and the training he/she received prior to being released to practice or credentialed in your EMS system.

OBJECTIVES: Upon completion of this program, using tools, techniques and concepts provided in this course, the participant will be able to implement the EMS Field Training and Evaluation Program (EMS-FTEP) in his or her EMS agency. The participant will be able to:

1. Describe the history and rationale for the development of FTEP in the law enforcement community.
2. Describe the process that led to the adoption and modification of LE-FTEP for the EMS community.
3. Identify and discuss the legal issues associated with employment and field training; describe the difference between direct and vicarious liability of employers, list and discuss at least five theories of employer liability for employment decisions.
4. Describe historical and contemporary issues related to field training and evaluation of new employees.
5. Identify and describe the three fundamental elements of a complete field training and evaluation program.
6. Adapt a model set of Standardized Evaluation Guidelines to the standards and practices of his or her agency.
7. Adapt a model Daily Observation Report to the standards and practices of his or her agency.
8. Develop a recruit training manual (phase guide) to specify and document the competencies required of a new employee.
9. Adapt additional FTEP forms and processes to the needs of the agency.
10. Describe the FTO program responsibilities of first line supervisors, program managers, and agency executives.
11. Discuss issues related to placement of the FTEP in the organizational structure.
12. Discuss issues related to FTO selection, retention, evaluation and incentives.
13. Discuss issues related to FTO burnout, continuing education, and performance.
14. Describe and discuss the various meetings and conferences required for a successful FTEP.
15. Discuss FTEP program issues and methods for trouble shooting your field training and evaluation program.

COURSE LENGTH: 16 hours (usually two working days).


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