County emergency medical plan being prepared

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Bruce Barton, director of Riverside County’s Emergency Medical Service Agency, opened the EMS strategic planning meeting in Riverside with the promise that the draft strategic plan would be available for the July meeting and a final plan within 90 days.

The group has been working on a strategic plan for nearly a year. Until February, it was in parallel with the evaluation of the county’s ambulance contract, which, in February, the Board of Supervisors decided to extend.

The group has been preparing a list of the strengths, weaknesses, opportunities and threats to the current system. In June, a survey was conducted to identify priorities and rankings for each category. Respondents were asked to select their top five for each category. For example, the reliability of the current EMS system was considered the top strength and was followed by the collaboration among the stakeholders in the system. Ten strengths were identified.

The worst weakness considered was delays, which ambulance crews encounter at local hospitals, commonly referred to as “wait time.” The next problem was lack of contemporary mental health resources. The lack of alternative destination programs, such as mental health, and overall funding were very close to the top.

Filling the gaps in the local healthcare systems, such as the mental health resources, was considered the top opportunity. Learning lessons from experience and problems as well as identifying cost savings and new funding were the next two opportunities.

Nearly 80 percent of the respondents considered the unknowns associated with implementation of the Affordable Care Act as far the most serious threat to the current EMS system.

At the June 25 meeting, the group heard from Jan Ogar, clinical services manager for San Mateo County. She discussed the origin and operation of the San Mateo Mental Health Assessment and Response Team. This program has done a good job reducing the number of patients ferried to emergency rooms or kept in mental health clinics for days.

It requires close integration with the law enforcement agency and costs about $800,000 annually. The program has been operating in the field since early 2006.

Past speakers have included Anne M. Jensen, Resource Access Program coordinator for San Diego County and Brenda Staffan, project director, Health Care Innovation Award, for Nevada’s REMSA.

The San Diego program focus is on frequent users of the 911 program and how to divert them to appropriate services without taxing the emergency rooms. Staffan discussed how to incorporate community health-care resources into the emergency medical program, including ambulance transport alternatives.

As the meeting ended, Barton stressed that the strategic plan will focus on patient care or patient outcomes. “This will be the number one priority,” he assured the group of EMS professionals.

 

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