Key Performance Indicators (KPIs) and Checklist Training

Transcription

1 Key Performance Indicators (KPIs) and Checklist Training

2 Raynor Baker Raynor has been an EMT for 13 years. He is currently a volunteer Lieutenant with CCFD5 and works full-time for Lake Chelan Community Hospital EMS. He is an EMS Evaluator and SEI. Raynor also coordinates the BLS training programs for both CCFD 5 and LCCH EMS. Linda Nunez Linda has been an EMT for 22 years. She currently volunteers for CCFD5 and works as an MA for Lake Chelan Community Hospital and Clinics. She is an EMS Evaluator and SEI candidate. Linda participates on the regional training & ed committee and is vice-chair on the regional council.

3 Training Objectives Define what Checklist s and KPI s are. Educate patient care goals Know why Key Performance Indicators (KPI s) are important Understand the importance of checklists in meeting KPI s Provide hands-on training scenarios

4 Chest Pain Scenario

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6 Checklists Checklist were first used by the aviation industry. On October 30 th 1935 the Boeing B-17 flying fortress crashed after takeoff of its test flight. The B-17 was the most sophisticated airplane in aviation history. It was determined that the plane was too complex to fly. An investigation found the flight crew had simply forgot to release the flight control gust locks. Thus causing the plane to nose dive and crash. After the crash a CHECKLIST was introduced by Boeing as a permanent and mandatory tool. After the checklist the B-17 was sold to the US Army Air Corps, where it flew for year without incident.

7 Key Performance Indicators (KPI) A KPI is a measurable value that demonstrates how effectively an organization is achieving objective. They are used to evaluate success at reaching targets. In EMS these objectives are set for us by the state and county in the form of Patient Care Goals.

8 Patient Care Goals Does everyone remember our 30/2 CPR and when we use to load cardiac arrest patients in the back of the ambulance and transport? This had a success rate of 24%. With High- Performance CPR we now have a success rate of around 50%. We may not have known it but we used patient care goals and KPI s to accomplish this feat. Now we are expanding from cardiac arrest to other patients we can greatly affect. KPI s ensure key steps aren t missed. As EMS providers we respond to a wide variety of emergencies and provide split second decisions. KPI s ensure we are safe and more effective with our care and that we don t miss key steps. KPI s will increase our effectiveness and teamwork for these critical patients.

9 Patient Care Goals We have taken the states KPI s and added to them in a few areas. Dr. Jobe and the Greater Wenatchee EMS council have outlined four areas to focus on for the greatest benefit to our patients. Cardiac Arrest Chest Pain High Performance Trauma Management (HPTM) Stroke By simply meeting the KPI s we can improve patient care, reduce mortality and improve outcomes. If we as a county set goals, track outcomes and provide trainings we are able to better the care for our patients. Red were KPI s outlined by the state and Black were KPI s from Dr. Jobe

10 KPI- Cardiac Arrest 7. Cardiac Arrest Patient Management (Cardiac Arrest Checklist) 7.1 Percent of non-traumatic cardiac arrest patients who received bystander CPR. 7.2 Percent of patients (in cardiac arrest before EMS arrival) in an initially shockable rhythm with time from 911 call receipt at fire/ems dispatch until first defibrillation <8 minutes. 7.3 Percent of patients (in cardiac arrest before EMS arrival) with a witnessed collapse, in an initially shockable rhythm, with survival to discharge from an acute care hospital. (Suspected cardiac caused- Utstein) 7.4 Percent of overall non-traumatic cardiac arrest patients with survival to discharge from an acute care hospital. 7.5 Percent of patients in cardiac arrest who received CPR fraction of 95% of total time or greater 7.6 Percent of patients in cardiac arrest who received chest compression rate of at least 110 per minute 90% of total time or greater. 7.7 Percent of patients in cardiac arrest who received chest compression depth of at least 2 inches, 90% of total time or greater. 7.8 Percent of patients in cardiac arrest who received defibrillation with peri-shock time of no more than 2 seconds (no more than 4 seconds total pauses per shock) 7.9 Percent of non-traumatic cardiac arrest patients who received dispatch- assisted bystander CPR instructions

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13 KPI- Chest Pain 5. ACS/ Chest Pain Patient Management (Chest pain Checklist) 5.1 Percent of patients 35 years old or older with suspected cardiac chest pain/discomfort or other ACS symptoms who received aspirin from EMS or had the aspirin protocol documented 5.2 Percent of patients 35 years old or older with suspected cardiac chest pain/discomfort or other ACS symptoms with a 12-Lead ECG acquired by EMS.

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16 KPI- Stroke 6. Stroke/TIA Patient Management (Stroke Checklist) 6.1 Percent of suspected CVA/TIA patients with FAST exam (i.e. neuro-screening) performed and all elements documented or documentation of why an exam could not be completed. 6.6 Percent of suspected CVA/TIA patients who have a FAST exam score who have a Lams Stroke Scale Assessment completed and documented or documented of why an assessment could not be completed.

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19 KPI- Trauma 1. Critical Trauma Patient Management (HP Trauma Management checklist) 1.1 Percent of Step 1 & 2 trauma patients with an EMS scene time <10 minutes (arrivalto-departure of ambulance)

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22 Data Collection & Feedback Collection: EMS transporting agencies will document KPI s inside patient care report Pre-hospital provider will delivers a copy of the Patient Care Report and DATA Form to the labeled box for Trauma, ACS or Stroke at CWH. CWH (Trauma, Cardiac, Stroke) coordinators will retrieve PCR s and DATA Forms, analyze the reports and develop a quarterly report to share with Dr. Jobe, the GWEMS Council QI officer, and the Region QI committee. Feedback: QI officer will send a simple formatted letter to providers with KPI success.

23 Data Collection Jay Bretz- Trauma Coordinator Teri McIntyre- Stoke Coordinator Jennifer Brown- Cath Lab Coordinator These individuals will compile the data and give a quarterly report to Dr. Jobe, The GWEMS Council QI officer and the Regional QI committee.

24 Data Collection Criteria Chest Pain: Any patient 35 years of age or older with ACS symptoms equal to or greater than 10 minutes but less than or equal to 12 hours Stroke: Any FAST positive patient no matter last time seen normal Trauma: Any person who meets Step 1 or Step 2 trauma triage

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27 CHW ER This box is located behind the Unit Secretaries' desk in the ED. Even if the patient is not transported a copy of the PCR and DATA Form needs to be left in the box.

28 New EMS Data Procedure Goal Oriented Care: Saves LIVES CHELAN & DOUGLAS COUNTIES GO LIVE DATE: July 1, 2018

29 Patient Scenarios