The Rural

1
The Rural Frontier EMS Agenda for the Future

• Chris Tilden Ph.D.,
• Director, KDHE Office of Local Rural Health
• and
• Rural Specialist
• Rural EMS/Trauma Technical
• Assistance Center

2
Rural/Frontier EMS Agenda

• History
• Themes
• Whats happened since?

3
History

• EMS Agenda for the Future
• National Organization of State Offices of Rural
  Health (NOSORH)
• 2000 EMS Task Force (Park City, Utah)
• NOSORH/National Association of State EMS
  Officials
• 2002 Joint Priorities on Rural EMS
• 2003 Office of Rural Health Policy (ORHP)
  Funding

4
History (cont.)

• National Association of Rural Health (fiscal
  agent)
• Writer Kevin McGinnis
• Steering Committee
• Writing Team
• Editorial Board

5
History (cont.)

• First Draft Developed (2003-2004)
• Comment Period (Jan-June 2004)
• Review Conference (May 26, 2004)
• Released October, 2004
• Park City, Utah (NASEMSO)

6
Themes

• Community Assessment and Planning
• Integration and Regionalization
• Quality Performance Improvement

7
Themes

• Community Assessment and Planning
• Despite the last 30 years of experience and
  intense media profile, EMS remains mostly a
  mystery to the public. They know we will show up
  when they call 9-1-1, but the public knows very
  little about who we are, how we are organized and
  funded, and quality in the system.
• Tom Judge, CCT-P, Executive Director
• Lifeflight of Maine

8
Themes

• Community Assessment and Planning
• Quality Through Collaboration
• In rural areas interventions should expand beyond
  the health and public health systems, to ensure
  optimal allocate of scarce resources. Rural EMS
  operations must be integrated into local networks
  and other activities.

9
Themes

• Community Assessment and Planning
• Future of Emergency Care
• Citizen engagement in prehospital care is
  important, particularly in rural, resource-poor
  communities that cannot afford costly or
  sophisticated EMS systems. This could produce
  numerous benefits.possibly more rational use of
  emergency departments and EMS assets.

10
Themes

• Community Assessment and Planning
• Population 485 Meeting Your Neighbors One
  Siren at a Time (Michael Perry)
• You try to act accordingly. To meet the
  expectations. To simplyhelp. You wont always
  live up to the hype. What were going to do I
  was saying, when the woman interrupted me. Oh,
  I know. Ive seen Paramedics. This is like
  telling your Little Leaguer you expect him to
  yank a Randy Johnson fastball over the left-field
  wall.we have skills, but they are basic.

11
Themes

• Community Assessment and Planning
• Population 485 Meeting Your Neighbors One
  Siren at a Time (Michael Perry)
• Among my fellow volunteers are a pair of
  butchers, two truckers, a farmer, a carpenter, a
  mailman, and a mother of four. I guy like me
  ends up on the fire department for two reasons
  (a) I have a pulse, and (b) I am frequently home
  during the day.my primary qualifications remain
  availability and a valid drivers license.

12
Themes

• Integration and Regionalization
• Inclusive trauma system
• ALS intercepts
• Collaborative multidisciplinary protocol
  development (prehospital to stabilization to
  definitive source of care)
• EMS response networks

13
Themes

• Integration and Regionalization
• Protocol development
• Minneapolis Heart Hospital heart attack protocol
  has made improvements along the entire continuum
  of care from prehospital to stablizing facilities
  to cardiac department in tertiary care center.

14
Themes

• Integration and Regionalization
• EMS Response Networks
• Kansas MERGe voluntary network of ambulance
  services to enhance regional emergency response.

15
Rural Frontier EMSWhat has happened since?

• The Institute of Medicine Quality Through
  Collaboration The Future of Rural Health
• The Institute of Medicine Emergency Medical
  Services at the Crossroads (Future of Emergency
  Care Series)
• Rural EMS Benchmarking Project (North Central EMS
  Institute, Rural Health Resource Center, Rural
  EMS Trauma Technical Assistance Center,
  American Ambulance Association, National EMS
  Management Association, National Rural Health
  Association)
• National Rural Hospital Association EMS Interest
  Group

16
Rural EMS

• I drove the ambulance up a long back road
  where a woman was having a stroke. Her adult
  granddaughter rode with us to the hospital.
  Three days later, in the grocery store, I exited
  the fruit-juice isle and came face-to-face with
  the granddaughter, all made up and wearing a
  discreet black dress. I inquired after Grandma.
• We just came from the funeral mass, she said.
• And yet she was kind, praising my brother and me
  for the gentle way we had handled Grandma, for
  the way we had accomodated the family.
• -Michael Perry, Population 485

17
Rural EMS

• Whoevers out there needing help, theyre
  getting me, for better or for worse. Me, and a
  handful of my neighbors. Well do what we can.
  There was this old man, we used to get a call to
  his apartment almost on a weekly basisI remember
  walking in his bedroomtoward the end there, and
  seeing this little man looking up at us with such
  trust, and I thought one day I will be the little
  old man on the bed. And I hope my neighbors come
  when I call.
• -Michael Perry, Population 485

18
Rural EMS

• I used to say I would trust the Silver Star
  crew with my life, but not with my sister.
• -Michael Perry, Population 485

19
Questions and Comments

• Chris Tilden, Ph.D.
• Director, Office of Local Rural Health
• Kansas Department of Health Environment
• 1000 SW Jackson, Suite 340
• Topeka, KS 66612
• [phone]
• Ctilden_at_kdhe.state.ks.us