Establishing Relationships in the ED
EMS personnel play a critical role in the medical trauma experience. From being the first on the scene of an accident to rushing through the emergency department (ED) doors, EMS personnel are critical resources that quickly assess and stabilize patients. As an important part of the care spectrum, their responsiveness often makes the difference in the ability to save a life and deliver great healthcare outcomes.
Building an environment of open communication that promotes learning, as well as process improvement with EMS providers, is important to improving medical care in the community. Establishing and maintaining a positive working environment with EMS personnel is the responsibility of all Emergency Department leadership. Here are several strategies to better support EMS providers and foster greater collaboration while providing the highest quality service in a patients’ greatest time of need:
Hospital and Community Outreach
Joint Provider BLS, ACLS, PALS, ITLS Training
An integrated training program for keeping up-to-date on required emergency services will help introduce your ED staff to EMS personnel and build critical bridges. Joint training reinforces a mutual respect of services that all providers bring to the chain of patient care.
Fostering Team Dynamics
We encourage ED providers to go outside and help EMS as they bring patients into the ED whenever possible. Meeting providers at the rig has proven beneficial in several patient care scenarios, including when patients arrest upon arrival. Seeing familiar faces in an intense situation builds a positive encounter for EMS partners. As you establish these relationships ED/EMS team members become more open to constructive feedback. Be open to educating on patient dispositions or unique cases, in real time.
Integrate ED/EMS news into the hospital newsletter. This is a public forum to highlight ED/EMS providers, patient letters, success stories and opportunities. A resource like this also helps introduce your hospital’s service relationships to the community. Distributing this to patients in the waiting room, during health fairs and nursing home visits provides a united partnership that showcases positive rapport between clinicians and EMS.
EMS Quality Improvement
Open Invitation to Hospital CME
Opening up hospital education seminars to EMS providers can provide an important avenue for professional development and expansion of the knowledge base. Learning together strengthens collaboration and patient safety.
Pre-Hospital Care Continuing Medical Education Seminars
Our ED physicians often get involved with County Fire & EMS services. Joint education in-services with EMS/ED personnel can focus on innovative treatment strategies (Acute Care of Pulmonary Edema and CHF, Advanced ECG Interpretation, etc.)
ED Feedback Mechanisms
Providing structured feedback to ED/EMS providers has been proven to decrease treatment times and increase patient and provider satisfaction. Developing a formal mechanism for this feedback is critical to seeking Chest Pain Accreditation by the AHA and is guaranteed to improve the quality of emergency care. Other areas where this feedback is critical include the care of stroke, sepsis and congestive heart failure patients. Early interventions with these patients can lead to time-dependent improvement in outcomes. As an extension of our care teams, EMS is a critical component in the care of these patients.
EMS Lounge & Documentation Area
Establish a dedicated space for EMS personnel to rest, debrief, and complete their documentation. The space can be used to post Hospital/ED QI data. It also creates the opportunity for additional collaboration with the ED providers. EMS personnel should never feel rushed to leave their patients, submit their paperwork and head back to the station with little interaction with ED team members. Designated areas build a sense of comradery and helps each team to get to know each other better. They also provide an area where teams can meet, sit down, and discuss outcomes and celebrate mutual success. Ideally these spaces are located in or adjacent to the ED’s trauma bays.
ED Staff should appoint an EMS Liaison who can serve as a single point of contact for communication between the ED and EMS personnel. This person should engage both ED and EMS providers and be a reliable contact for information, flow and scheduling events. Our EMS champions have also served to highlight cases that were successfully managed by both teams and identify opportunities for collaborative learning. Often, members of our clinical teams (physicians, advanced practice providers, and nurses) may have prior experience as an EMS provider and would be ideal candidates for this position.
As President of ApolloMD, Dr. Yogin Patel serves our health system partners and oversees practices along the East Coast in our collective mission to drive better patient care and higher quality outcomes. Dr. Patel joined ApolloMD in 2007 and has been involved with establishing new practices, new physician recruitment, clinical operations, leadership development, and strategic growth initiatives. From an operations perspective, he has driven the success of several large-volume emergency departments, by maximizing throughput, enhancing the patient experience, and improving clinical quality using strong, performance-based incentives to align providers with our health system partners. He combines his clinical and business acumen to bring creative solutions to our client’s toughest challenges. In addition to his leadership role, Dr. Patel is a practicing Emergency Physician proudly serving communities throughout the Carolinas.
Prior to joining ApolloMD, Dr. Patel received his BS with Concentration in Neuroscience from Duke University. He also completed his MD, and his MBA focused on Health Sector Management from Duke University. He completed his residency in Emergency Medicine at Oregon Health Sciences University where he was inducted into AOA and served as Chief Resident in Emergency Medicine. He also concurrently served as Legislative Advisor for the Emergency Medicine Resident’s Association and remains active within the American College of Emergency Physicians.
Nickalaus A. Goodman, MBA joined the ApolloMD team in 2015. He currently serves as a Vice President of Operations supporting the North Carolina and Virginia markets of emergency and hospital medicine. In this role, he supports the daily operations of each practice and serves as a liaison between hospital administrative teams. Nickalaus helps support initiatives related to all aspects of the practice with a keen focus on quality and flow. He leverages his clinical healthcare experience to create innovated solutions to improve patient outcomes.
Nickalaus is a Nationally Registered Paramedic and started his career 16 years ago in a rural county 911 system as a Paramedic, where he is currently a Senior Medic. He then received his Bachelors of Business Administration from Catawba College in 2009 and his Masters of Business Administration from Texas A&M – Commerce in 2013. Nickalaus has held positions in both the pre-hospital and acute care facility settings and has received additional training in the field of community paramedicine.