1 State Partnership Performance Measures Looking at the horizon Tasmeen Singh, MPH, NREMTP Executive Director Tasmeen EMSC Singh National Weik, MPH, Resource NREMTP Center Director EMSC National Pediatric Resource Research Center Workshop Children s National Medical Center Child Health NAEMSP Advocacy Annual Institute Meeting Washington DC January 2007
2 Overview of State Partnership Grants 47 will be in submitting a competing continuation in the Fall of will be in non competing continuation and submit in the Fall of 2008 California Delaware Kentucky Missouri Nebraska New Mexico Rhode Island Virginia Wyoming
3 Implementation Manual Change Process 2007 Review of EHB data and assessment of data collection efforts (August 2007) Feedback from grantees (ongoing) Changes to manual (2007 Edition) Changed definitions Added exemption from data collection Standardized data collection options Use of NEDARC for data collection Feedback from NASEMSO pediatric committee Revised implementation manual 4 month roll out Enhanced technical assistance from NRC and NEDARC
4 Implementation Manual Change Process Feedback from grantees (ongoing) Performance Measures Advisory Committee (April 2008) Grantee meeting feedback on PMAC recommendations (June 2008) Consultation with National Partnership for Children Stakeholder Group (June 2008) Report of Grantee and Stakeholder Feedback sent to all grantees (August 2008) HRSA Approval of EHB Changes (September 2008) Finalization of EHB Changes (October 2008)
5 Implementation Manual Changes will go into effect March 1, 2009 for all SP grantees Draft manual will be released in early Oct. Final manual will be released February Comments are welcome during the Draft release period.
6 Implementation Manual Changes Disclaimer: The following changes are still considered draft and are subject to HRSA approval. Further changes may occur.
7 Implementation Manual Changes Performance Measures All grantees have to work on the following performance measures 66a online and offline medical direction 66b pediatric equipment on patient care units 66c hospital recognition for trauma 68a EMSC advisory with 8 required members and 4 meetings per year 68b pediatric representation on EMS board 68c full time EMSC manager 68d integration of priorities into statutes, rules and regulations
8 Implementation Manual Changes Performance Measures Grantees are encouraged to work on the following measures but only need to do so if they have the resources in their State. 66c hospital recognition for medical emergencies 66d interfacility transfer agreements 66e interfacility transfer guidelines
9 Implementation Manual Changes Performance Measures All grantees will need to report data in EHB for all measures. For 66d/e, grantees can report previously collected data each year All grantees will need to finish collecting data for all performance measures before being able to stop working on 66d/e
10 Performance Measures What it means to meet a measure Target for most measures is 90% compliance E.g. Online and offline medical direction available to 90% of agencies. Example: State X conducted a survey for PM 66a in and achieved a 82% response rate. Analysis of the survey showed that 95% of agencies have online AND offline medical direction. Result: State has met the performance measure!
11 Performance Measures What it means to meet a measure Example: State X conducted a survey for PM 66a in and achieved a 76% response rate. Analysis of the survey showed that 95% of agencies have online AND offline medical direction. Result: State needs to continue collecting data until 80% response rate is achieved.
12 Performance Measures What it means to meet a measure Example: State X conducted a survey for PM 66a in and achieved a 76% response rate. Analysis of the survey showed that 95% of agencies have online AND offline medical direction. Result: State needs to continue collecting data until 80% response rate is achieved.
13 Performance Measures What it means to meet a measure If you feel you have met a measure, please get a letter from the Federal Project Officers (Dan or Tina) confirming they agree.
14 Data Collection Requirement Data collection required only for 66a online and offline medical direction 66b pediatric equipment on patient care units 66d interfacility transfer agreements 66e interfacility transfer guidelines Once data collection is complete, grantee does not need to collect data until the grant year. 80% response rate on surveys 80% of inspection reports reviewed Exemption from data collection Check letter
15 Data Collection Requirement NEDARC will provide survey template to be used If requesting to use your own survey, contact Federal Project Officer (PO) Exemption from data collection If requesting an exemption from data collection, contact the Federal PO
16 66a: medical direction On-line pediatric medical direction: An individual is available 24/7 to EMS providers who need on-line medical direction when providing care to a pediatric patient.. This person must be a medical professional (e.g., nurse, physician, physician assistant [PA], nurse practitioner or EMT-P) and must have a higher level of pediatric training/expertise than the EMS provider to whom he/she is providing medical direction.
17 EHB Entry Numerator and Denominator numbers will be asked for each subcomponent: Online for BLS Offline for BLS Online for ALS Offline for BLS Numerator=number of agencies that have component Denominator=number of agencies responding to survey EHB will calculate percentage Note: Targets are 2011 targets.
18 66a: EHB Entry
19 66b: Pediatric equipment Patient Care Unit: A patient care unit is defined as a vehicle staffed with EMS providers (BLS and/or ALS) dispatched in response to a 911 or similar emergency call AND responsible for transporting a patient to the hospital. Examples include an ambulance, or other type of transporting unit. This definition excludes non-transport vehicles (such as chase cars) to provide additional personnel resources, air ambulances, exclusively defined specialty care units, water ambulances/units.
20 66b: Pediatric equipment New equipment list is currently in final draft and being sent to national organizations for endorsement Anticipated release date is December-March Current data collection will continue under 1996 list. New equipment list will include essential and optional items. Essential items will require 100% compliance at patient care unit level.
21 66b: Pediatric equipment Exemption from data collection: The State/Territory must have an inspection process that verifies a 1:1 match with the national list (for all equipment and supply sizes; excluding out-of-scope equipment/supply). Remember to verify with the NRC if a piece of equipment can be legitimately considered out of-scope. The inspection process must be regular (as defined by the State/Territory; this typically occurs every year or every two years) and must cover all patient care units in the State/Territory in the given inspection cycle. A documented enforcement process (as defined by the State/Territory) to ensure that missing equipment will be replaced.
22 EHB Entry Numerator and Denominator numbers will be asked for each subcomponent: BLS ALS Numerator=number of agencies that have equipment Denominator=number of agencies responding to survey EHB will calculate percentage Note: Targets are 2011 targets.
23 66b: EHB Entry
24 66c: Hospital Recognition EHB entry change to delineate medical and trauma
25 66c: EHB entry
26 66d: Interfacility guidelines Deleted: Process for return transfer of the pediatric patient to the referring facility as appropriate. There are now only 5 guideline requirements.
27 EHB Entry Numerator and Denominator numbers will be asked for each of the 5 guidelines Numerator=number of hospitals that have component Denominator=number of hospitals responding to survey EHB will calculate percentage Note: Targets are 2011 targets.
28 66d: EHB entry
29 66e: Interfacility agreements All hospitals in the State/Territory should have at least one agreement to transfer to a tertiary care center capable of taking care of pediatric patients regardless of whether the care center is out of the State/Territory. Tertiary Care Facilities should have transfer agreements in place to facilitate movement of patients in the need of a mass casualty event and need to increase surge capacity The following was deleted Tertiary care centers capable of taking care of pediatric patients do not need to have agreements for transferring the patient out of their facility unless they do not have the specialty resources required to provide care for all diagnoses (e.g. burn care).
30 EHB Entry Numerator and Denominator numbers will be asked Numerator=number of hospitals that have agreements Denominator=number of hospitals responding to survey EHB will calculate percentage Note: Targets are 2011 targets.
31 66e: EHB entry
32 PM 66 EHB will automatically calculate whether 66 has been met in total Requires 90% for: 66a: all 4 subcomponents 66b: all 2 sub components 66c: all 2 subcomponents 66d: all 5 subcomponents 66e
33 67: Pediatric education Updated EHB
34 67: EHB Entry
35 67: EHB Entry
36 67: EHB Entry
37 68a: Advisory Committee EHB will allow entries to be changed each year Measure requires annual compliance 8 members 4 meetings a year (telephone or face to face)
38 68a: EHB Entry
39 68b: Pediatric Rep EMS Board EMS Board: The EMS Board within the State/Territory refers to the State/Territory governing entity or body that provides oversight for emergency medical services and that has the primary responsibility and authority of advising on EMS issues in the State/Territory, which ultimately affects the decisionmaking process. The EMS Board may have different names in different States/Territories. The structure of EMS oversight could be referred to as an EMS advisory committee or similar reference. If the State/Territory does not have an EMS Board, please consult the NRC.
40 68b: EHB Entry
41 68c: Full time EMSC manager State/Territory, Federal, and/or other-funded: State/Territory-funded refers to any funds provided by State/Territorial government organizations or the State/Territory legislature (e.g., line item in the State/Territory budget) to support the EMSC manager position. Federal funding refers to any funding received from a Federal governmental agency. Other funding refers to any funding received from other sources, such as professional, private, and/or philanthropic groups (e.g., foundations, non-profits). Solely: The EMSC manager is to dedicate 100% of his/her effort to the EMSC Program, EMSC activities, or other EMSC-related projects. The EMSC manager could have other responsibilities from the performance measures, but they should be EMSC-related priorities. Grantees need one individual that is designated as the FTE for EMSC and responsible for the program. If the position is split between multiple individuals, it is easy for EMSC activities to be prioritized lower than other activities.
42 68c: EHB Entry
43 68d: Integration of Priorities Please note the integration and meeting this measure is defined as having in mandate all of the following priorities: On-line and off-line pediatric medical direction BLS and ALS patient care units have the essential pediatric equipment Existence of a statewide, territorial, or regional standardized system that recognizes hospitals able to stabilize and or manage pediatric medical emergencies and trauma. Hospitals in the State/Territory have written pediatric inter-facility transfer guidelines that include the 5 components of transfer. Hospitals in the State/Territory have written pediatric inter-facility transfer agreements. The adoption of requirements by the State/Territory EMSC for pediatric emergency education for the license/certification renewal of BLS and ALS providers.
44 68d: Integration of Priorities New section on how strategic planning and how to write legislative language
45 68d: EHB Entry
46 PM 68 EHB will automatically calculate whether 68 has been met in total Requires 90% for: 68a 68b: have a mandated position 68c 68d: all 5 priorities
47 Overall EHB EHB will calculate overall meeting all 3 performance measures Note: it s important to show progress in each measure.
48 FAQs Can I work on programs other than performance measures? Can only be proposed if: Core performance measures have been met States can work on performance measures and other activities Activities should be relevant to EMSC strategic plan What about survey changes? NEDARC is working on it
49 Looking forward The current measures expire in 2011 PMAC will be engaged to develop new measures What role can the EMSC council play? Technical Assistance Resources PM Best Practices Conference calls NRC Town Halls See and click on Events
50 EMSC Grantee Meeting! Save the Date! June 9-12, Alexandria, VA June 9 1P-6P new coordinator orientation 6P-9P FAN reception June (full days) June 12 (half day) Don t forget to nominate someone for a Heroes Award! Suggestions for grantee meeting events or sessions should be ed to
51 Federal Project Officer Contacts Dan Kavanaugh State Partnership Grants for: AK, AS, AZ, CA, CO, GU, HI, ID, IL,, IA, KS, CNMI, MI, MN, MO, MT, NE, NV, ND, OH, OR, SD, UT, WA, WI, WY (26) PECARN (5) EMSC National Resource Center (1) Tina Turgel State Partnership Grants for: AL, AR, CT, DE, DC, Fl, GA, KY, LA, ME, MD, MA, MS, NH, NM, NJ, NY, NC, OK, PA, PR, RI, SC, TN, TX, VT, VI, VA, (28) Targeted Issues (13) National EMSC Data Analysis Resource Center (1)
52 NRC Contacts
53 Contacts EMSC National Resource Center Main Line Tasmeen Singh NEW Website:
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