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Leading the way in EMS Coordination

October 28, 2009

Premier has always valued its relationships with the EMS agencies located in the communities where we provide ED staffing and management for the local hospitals. We recognize that the EMS providers are our partners in caring for the patients that we both see. In some communities, EMS providers are paid, and in others they are volunteers. We also see a wide array of qualifications, ranging from basic EMTs to paramedic providers. Every EMS system is unique and different and requires specific guidance and oversight to provide the best team approach to the emergency patient.

Premier also appoints its best individuals to provide physician oversight to the EMS agencies it works with. Since we see these providers routinely when they bring in patients to the Emergency Departments that we staff, it makes sense that we should have the responsibility of providing them with the best education, protocol development, quality assurance, and other aspects of their overall EMS system operations. We do not feel that we should abdicate that responsibility onto another physician in the community who may not fully understand the complicated issues involved in providing EMS care. So, many of our ED Medical Directors also serve as local EMS Medical Directors in the communities they work in.

One example of how this works well is in Delaware, Ohio, at Grady Memorial Hospital where Dr. Dave Watson is the ED Medical Director, Dr. Khan Thai is the EMS Medical Director, and Scott Kravitz PA-C is the EMS liaison. All three individuals are Premier providers.

Scott Kravitz describes his position: “My role within EMS in Delaware County is to provide a communication link, physical presence, and operational assistance to the EMS Medical Director Dr. Khanh Thai. As the EMS Medical Liaison, I work on the operational side of the Medical Director role. This position allows face-to-face interaction with crews at the stations, taking runs, and participating in the ongoing quality assurance and education of the EMS providers. One of the most important issues that concerns EMS is the ‘physical presence of the Medical Director.’”

In Delaware County, Premier has split the role of the EMS Medical Director into two parts:

1) Administrative—Dr. Thai serves as the Medical Director, serving EMS in the physician role with approving protocol and medications. He has direct interaction with the Fire and EMS Chiefs, as well as 911 Directors at the administrative level regarding changes in the departments. He also provides direct quality assurance and medical review for patient care and signing of legal documents that only the physician can approve or disapprove.

2) Operational—Scott Kravitz serves as the EMS Medical Liaison working directly with the crews at the stations. He has the ability to respond to and provide care on emergency runs and perform “real-time” run reviews with the crews. He also provides a direct communication link between EMS and the Medical Director and vice versa and can offer educational/CME opportunities while working with the training officers within the departments. This allows for a physical presence of the Medical Director at the crew level.

Delaware County EMS and Delaware City Fire Department are the two primary departments where Dr. Thai serves as EMS Medical Director. Scott Kravitz says, “It has been an honor and a pleasure to work with these departments. They have embraced our involvement as the EMS Medical Direction Team and have been professional and enthusiastic regarding the introduction of the physician/physician extender model of the role of the EMS Medical Director. This model allows for the physician to extend himself/herself into the EMS patient care environment in a more efficient, cost effective, and EMS-friendly manner.”

Rob Farmer, who is the Chief for Delaware County EMS, states; “Premier Health Care Services has taken Medical Direction to a completely new level in its relationship with Delaware County EMS. The addition of a Physician Assistant in the role of EMS Medical Director Liaison has bridged the gap between the Physician Medical Director and the street level crews. No longer is Medical Direction simply a signature of licenses and protocols, or a looming fear of criticism! The teamwork of Physician to Department Administration and Physician Assistant to Paramedics creates a seamless transition of information, eliminating the intimidation of medical direction!”

Premier is also extensively involved in EMS education and course certification. Frank Giampetro, who handles this responsibility for Premier, has certified individuals in the following EMS CME courses in 2009:

ACLS-35
PALS-10
Geriatrics-33
Pediatrics-8
Other courses-21
Protocol testing- 9

Frank gave 107 presentations in 18 counties. The smallest class was 2 and the largest was 250. The only charges for any of the classes are those that require additional instructors, books, and/or provider cards. Only 5 of the 18 counties are locations where Premier staffs the local hospital Emergency Department. Premier is interested in the education of EMS personnel in all regions, whether they are Premier clients or not.

This is only one example of how Premier provides excellent physician and physician extender coverage of the Emergency Departments in which they staff and manage. We also extend that care into the EMS arena when we strive to make the local EMS system the best that it can be. By sharing ideas and innovations between our Medical Directors, who work in both large and small population locales, we work to integrate the best EMS system practices into every community that we serve.

The results foster a team approach from the moment a 911 call is made all the way through the admission of the patient to the hospital. The community benefits because they get an up-to-date EMS system that has quality Continuing Medical Education (CME) along with the oversight of the local ED physicians who are aware of the strengths and weaknesses of the EMS system. This benefit sometimes goes unnoticed by the hospital administration and needs to be highlighted as a real plus that Premier provides as a bonus to providing the professional provider coverage to the hospital ED.

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Dayton, OH 45459
800-726-3627