Innovative EMS Services, Where Are You?

[kevkei]

Wait... I thought you were asking specifically for INNOVATIVE services, not just services doing things differently.

Isn't that kind of like the same thing except that innovative sounds a little more sexy?

These were only some limited examples, but I would like to hear what anyone has to offer, whatever it may be. Call it what you want, different, creative, innovative, etc.

Something outside of they typical call progression of: person calling 911 -> EMS responds -> transports them to the hospital.

[FormerEMSLT297]

I have heard that BOSTON EMS is the greatest place to work. I heard that it is inovative and progressive and all the other words you can you to describe EMS Heaven if there is such a place.

Question: Anyone here from BOSTON EMS.??????

Can you shed some light on this. I understand that medics work BLS for years just to get a medic spot in Boston.

Someone please explain to me, and I'm not trying to be obnoxious, smart-a**ed or anything else,, but why is Boston EMS such a great place to work ??????????

Educate me please.

Maybe we can start a new thread/post about Boston, EMS Heaven.

[paramaniac]

Hello mate,

Hope this is of interest,

Any questions PM me.

Accidental heroes: training emergency care practitioners to handle non-critical conditions could save the NHS £51m a year.

The challenge

Calls to emergency control rooms continue to rise by between 7% and 15% each year, and each call-out costs the ambulance service £120. Many 999 calls are not true medical emergencies, coming from patients with relatively minor medical problems or with social needs.

The solution

To meet the increase in call-outs, Skills for Health has introduced a new role to support Primary Care Trust (PCT) emergency response teams.

Emergency care practitioners (ECPs) were introduced to the NHS in 2004. There are now nearly 650 working in 41 PCTs throughout the UK, delivering care and treatment within pre-hospital, primary and acute care settings. They provide rapid response to minor injuries in different environments: in general practice, minor injuries units, out-of-hours services, rapid response, walk-in centres, and busy accident and emergency (A&E) departments.

The Career Framework Team in Skills for Health has developed the role of the ECP to cover competencies that include providing emergency assessment, diagnosis, treatment and aftercare.

ECPs complete 1,000 hours of designated study time, of which a minimum of 300 hours is designated as theory learning (delivered at a minimum standard of degree level) and 700 are clinical learning hours in appropriate clinical settings. This enables them to practice as part of the clinical team, within a range of primary and secondary healthcare settings.

Employer benefits

Sending an ECP to respond to a call costs £80, saving the NHS £40 per call-out. It is also hoped that by using ECPs, 70% to 80% of patient visits to A&E could be treated elsewhere, saving the NHS a further £75 per patient. The use of ECPs also means the ambulance service should be more responsive to those patients with acute or life-threatening needs.

The future

Within the next five years, there will be between 2,000 and 3,000 ECPs in the UK, rising to 5,000 in 10 years. Currently, the Department of Health (DoH) is rewriting its Urgent Care Policy for England and other areas, and further development of the ECP role will depend on how emergency patient care is structured in this policy. In the meantime, ECPs will continue to provide essential support to emergency teams and generate cost savings for the NHS.

ECPs are currently being recruited from nursing, paramedic or other regulated healthcare professionals who have completed the competency-based education programme developed by the NHS Modernisation Agency's Changing Workforce Programme in partnership with Skills for Health.

There are now 215 ECPs undertaking programmes at 17 higher education institutions and, in two years, it is envisaged that there will be a direct entry available for school-leavers.

Hundreds of nationally qualified clinicians will emerge with the knowledge, skills and professional behaviours to function as an ECP and the personal and intellectual attributes necessary for life-long professional development.

Employer involvement

Hull PCT, facing a shortfall in GPs due to the high number of single-handed GPs approaching retirement, has employed ECPs in its area since November 2004. Nursing and residential care homes now contact ECPs directly for patient assessment to medical interventions, such as X-ray requests and stitching wounds. The ECPs also support custody nurses in police charge cells and healthcare staff in prisons.

Other parties involved in promoting the use of ECPs include the NHS Modernisation Agency, the DoH, 22 higher education institutions, 12 ambulance services, 11 strategic health authorities and associated PCTs.

Key facts

1 In Avon, using ECPs has saved the county's employers and associated health communities more than £84,000 per ECP, which is more than twice their employment costs.

2 If all ECPs deliver this level of benefit, it would equate to national efficiency savings of £51m based on last year's costs.

3 In Hull, only 309 patients out of 1,614 seen by ECPs between January and July 2006 were referred to Hull Royal Infirmary's A&E, paediatric or acute assessment units.

Employer view

"ECPs are not only carrying out a valuable service in helping to look after the community, but have taken the strain off the NHS. It is an example of what can be achieved with common sense, assessing what's needed and giving people the opportunity to use their skills and knowledge outside the box."

[kevkei]

I have heard that BOSTON EMS is the greatest place to work. I heard that it is inovative and progressive and all the other words you can you to describe EMS Heaven if there is such a place.

Great place to work is different than being innovative and progressive. If they are innovative, how and why? They have nothing on their website that says that they are like this.

[paramaniac]

A very interesting article from the BMJ on the role of "Emergency care practitioners"

http://emj.bmj.com/cgi/content/full/21/5/614

[kevkei]

Hello mate,

Hope this is of interest,

Any questions PM me.

Accidental heroes: training emergency care practitioners to handle non-critical conditions could save the NHS £51m a year.

Paramaniac,

thanks for the references. For this one that you included above, can you refer to the source of the article so that I can obtain a copy?

We are also well versed in th DH document "Taking Healthcare to the Patient, Transforming NHS Ambulance Services".

Out of curiosity, are you involved as an ECP? As well, which trust are you working in and if you don't mind me asking, which municipality?

Cheers

[paramaniac]

Here's the link

www.personneltoday.com/Articles/2007/01/02/38687/nhs-trains-emergency-care-practitioners-to-ease-pressure-

I was involved in trialling the Community Paramedic scheme (GP surgery based) in the East of England

I no longer work in primary care, now back on the Truck.

[runsoversquirrels]

Here in N.H. the teaching hospital of Dartmouth has a DHART bus.

It is like an OR on wheels. They staff it with medics or RNs or DRs depending on the call.

This is not an emergencey response vehicle per say although they will if it is called for and approved.

Mostly they handle transfers to their hospital that need the extra staff or whatever.

I have not experienced this first hand, just talked to staff and looked through the truck a couple of times.

This is pay through the nose country for medical care and if you die, it's because you didn't do enough to stay healthy even though your HMO won't pay for it.

Very few of us have any say in what levels may be created or deleted. (NH is deleting the 1st responder level)

This level was very helpful in the volunteer departments around these here rural areas where it can be 30 mins. or more til the ambulance gets in town. More time if they are already on a call (I've fallen and can't get up). I live in such a town and most of the surrounding towns only have 'Rescues'

and may not even have basics on the fire depart. These towns contract with private ambulances to come in and transport.

There is talk every now and then about of advanced levels, expanding scope but yes it gets shot down.[/font:569dd8c393]

[FormerEMSLT297]

Great place to work is different than being innovative and progressive. If they are innovative, how and why? They have nothing on their website that says that they are like this.

This is what I was told: "great place to work innovative and progressive." I don't know I've been to Boston once. so I dunno, I was just told by some friends who have visited the system and have other friends that work there .... I thought maybe someone from Boston could shed some light.

[RescueOne]

http://www.bostonems.com

I've looked the website over. Maybe not sexy, but definitely arousing!

No, seriously. Their website doesn't really say much, except that they're an Urban EMS Agency