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(Adopted July 26, 2005)
PURPOSE
The Arizona Rural EMS Consensus Project grew out of a strategic planning group formed in the summer of 2003 during the Arizona EMS conference. The Purpose is to form a collaboration among tribal and non-tribal rural EMS groups, and the Arizona Rural Hospital Flexibility Program to agree on a rural EMS agenda for the future.
The Arizona Rural Hospital Flexibility Program (“Flex” Program) is administered by the Rural Health Office at the Mel and Enid Zuckerman College of Public Health. The Flex Program was created by Congress, under the Balanced Budget Act of 1997, in order to improve the financial viability and stability of health care in rural areas across the nation.
The purpose of the Rural EMS Agenda for the Future is to determine the most important directions for the future of rural EMS development in the state, within a three to five year time period.
The Consensus Project includes input from EMS communities and organizations throughout the state, and will be expanded, during the implementation phase, to include a broad, multidisciplinary spectrum of EMS stake-holders. This document is intended to provide guiding principles for the continued evolution of a rural EMS agenda, as well as ideas for future action.
VISION
The vision for rural EMS in the state is an integrated, efficient, caring system that respects Tribal and State sovereignty issues as well as promotes creative collaboration across borders and boundaries.
We recognize the critical importance of the “Hour of Survival” – the time between the first call for help and the first arrival at the scene. The ultimate goal of the EMS system is to prevent physical disability or premature death that could occur during the Hour of Survival. The Arizona Rural EMS Agenda for the Future will strengthen our EMS system and integrate it into the mainstream of the health care delivery system. The level of pre-hospital care will increase to effectively advance health care in rural areas of Arizona.
Echoing the National Highway Traffic Safety Administration’s National EMS Agenda for the Future, Arizona’s emergency medical services (EMS) of the future will be community-based health management that is fully integrated with the overall health care system. It will have the ability to identify and modify illness and injury risks, provide acute illness and injury care and follow-up, and contribute to treatment of chronic conditions and community health monitoring. This new entity will be developed from redistribution of existing health care resources and will be integrated with other health care providers and public health and public safety agencies. It will improve community health and result in more appropriate use of acute health care resources. EMS will remain the public’s emergency medical safety net.
Along with the rest of the nation, during the past 30 years, Arizona’s emergency medical services have experienced explosive development and growth. Yet initiatives to create a system to provide emergency medical care for the nation’s population began with limited knowledge about what constituted the most efficient processes for delivering ideal resources to the spectrum of situations encountered by contemporary EMS.
The AZ Rural EMS Agenda for the Future provides an opportunity to examine what has been learned during the past three decades and create a vision for the future. This opportunity comes at an important time, when those agencies, organizations, and individuals that affect EMS are evaluating its role in the context of a rapidly evolving health care system. EMS will be integrated with other health care providers and public health and public safety agencies. It will improve community health and result in more appropriate use of acute health care resources. EMS will remain the public’s emergency medical safety net.
To realize this vision, Arizona’s Rural EMS Agenda for the Future adopts those aspects of the National EMS Agenda for the Future which proposes continued development of 14 EMS attributes:
* Integration of Health Services
* EMS Research
* Legislation and Regulation
* System Finance
* Human Resources
* Medical Direction
* Education Systems
* Public Education
* Prevention
* Public Access
* Communication Systems
* Clinical Care
* Information Systems
* Evaluation
Mission
To promote sustainable tribal and non-tribal EMS systems in Arizona, which respects state and tribal sovereignty concerns.
Goals
1. Increase the scope of practice of EMS providers to make possible a broader range of intervention and prevention services to communities served.
2. To promote training opportunities that include the use of technology to establish rural learning centers and sites.
3. Disseminate information among providers regarding best practice models of EMS systems serving rural communities.
4. Develop a data collection system that impacts quality of care and increases EMS revenues.
Objectives
1. Establish a regional training program that contributes to increasing the scope of practice of EMS providers, and also assures retention of skills in current practice, through virtual training opportunities and regional training sites.
2. Develop best practice models, using information gained from implementing pilot models in rural Arizona and other successful models.
3. Collect EMS pre-hospital data and submit the data to the state trauma registry and other appropriate tribal and state entities.
Potential Activities
1. Training and education
a. Promote and support the design and implementation of a comprehensive needs assessment that examines the current scope of practice of EMS providers, reviews Arizona’s rural health care provider shortage dilemma, and examines alternatives to the current scope of practice that might alleviate the shortages. Implementation of the needs assessment should involve partnerships with organizations such as state and regional EMS councils, the Arizona Chapter of the American College of Emergency Physicians Arizona Group, the Arizona Ambulance Association, the national Tribal EMS Association, Arizona tribal EMS councils, the Arizona Hospital Association, the National Association of Community Health Representatives, the Arizona Association of Home Health Agencies, and the Rural Health Office at the Mel and Enid Zuckerman College of Public Health. The needs assessment should consider the differences between the tribal and state EMS systems in its design and implementation.
b. Develop a demonstration project to assist EMTs in maintaining competence in practical EMT skills, expand EMT skill bases, explore expanded scope of practice in areas such as public health and primary care. Address the need for greater flexibility in testing, licensing and continuing education requirements for volunteer EMTs, focusing on basic knowledge and practical skills demonstration vs. paper tests for re-certification.
c. Identify a training model for EMS medical directors that focus on the continuum of care integration and networking, quality, and performance improvement, and effective EMT training.
d. Provide community education in the appropriate use of the EMS system.
2. Develop best practice models:
Identify best practice models that support the formation of locally operated or regionally operated provider networks in rural areas, for potential implementation in rural Arizona.
a. Identify best practice models that integrate information technology, such as medical records, to facilitate communication among providers, and enhance patient care across the network continuum.
b. Identify best practices model(s) of EMT recruitment and retention incentives.
3. Develop Data Collection System.
a. To collect EMS pre-hospital data and submit the data to the state trauma registry and other appropriate tribal and state entities, funding will be sought to support the purchase of appropriate hardware, software, and training in data collection methods.
b. Data will be analyzed through the Regional EMS councils, and used to make recommendations regarding next steps in training design, quality improvement design, and modifying billing procedures that enhance revenues.
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