Author Archives: Kyle Gaines

SCCAD Selected to Pilot Groundbreaking ET3 Model

St. Charles County Ambulance District [SCCAD] was one of only three emergency medical service agencies in the State of Missouri selected last week by the Centers for Medicare & Medicaid Services [CMS] to take part in a groundbreaking pilot program.  The initiative is called Emergency Triage, Treat and Transport – ET3 for short.  The model provides greater flexibility for paramedics to address the unique health care needs of patients.  Announced by CMS last year, the ET3 model creates a new set of incentives for emergency transport and care, ensuring patients get convenient, appropriate treatment by a variety of providers.

Under current CMS guidelines, patients who dial 911 are typically transported to an emergency department at a hospital, which is unquestionably appropriate in the case of serious medical events such as cardiac arrest, traumatic injury or stroke.  In lower-acuity situations, however, alternative treatment options, may be more appropriate and cost-effective for patients, which is where ET3 will come into play.

 “For years, EMS agencies have been paid to transport patients to emergency rooms.  Under the ET3 framework, our team of 200+ highly-skilled clinicians will have the latitude to confer with lower-acuity patients and perhaps recommend transport to an alternative, lower-cost destination such as an urgent care that can meet their needs,” said SCCAD Assistant Chief David Lewis. “Crews also will have the ability to initiate and facilitate treatment in place by a qualified health care practitioner via telehealth with a tablet device.”

SCCAD paramedics will work with a variety of healthcare partners to facilitate a robust array of options for ET3 patients, including multiple urgent care facilities and hospitals.  Ultimately, the initiative will work to reduce avoidable transports to emergency departments and unnecessary hospitalizations.

“Though the initiative was developed with Medicare/Medicaid insurance patients in mind, SCCAD is poised for multi-payer alignment, working with several commercial insurers to deliver enhanced treatment and transport options to their patients,” said Lewis.

ET3 is the latest in a series of cutting-edge EMS initiatives to debut in St. Charles County; in the past three years alone, SCCAD paramedics have launched multiple successful programs to address critical healthcare needs in their community, including the opiate epidemic, special needs pediatric patients, behavioral health emergencies, and hospital readmission avoidance.

204 agencies throughout 36 states selected to take part in ET3 will work over the coming weeks to develop program-specific protocols, with program launch occurring this spring. 

Going for the Gold: SCCAD Recognized by Heart Assn. for STEMI Care

Next summer, residents throughout the metro area will undoubtedly be tuned in to see if American athletes bring home the gold at the 2020 Olympic Games in Tokyo.  This week, one group in our region already garnered gold status, albeit in a different form!  St. Charles County Ambulance District [SCCAD] paramedics earned the American Heart Association’s Mission: Lifeline EMS Gold Plus distinction for their continued implementation of quality measures for the treatment of patients who experience ST elevation myocardial infarction [STEMI] – a severe type of heart attack.

Each year, more than 250,000 individuals experience a STEMI, which is caused by a blockage of blood flow to the heart and requires timely treatment.  To prevent death, it is critical to restore blood flow as quickly as possible.  Unfortunately, a significant number of these patients don’t receive this prompt attention.

The correct tools, training and practices allow SCCAD paramedics to rapidly identify suspected heart attack patients and trigger an early response from the awaiting hospital personnel.  Agencies that receive the Mission: Lifeline Gold award demonstrated at least 75 percent compliance for each required achievement measure for two years.  The ‘Plus’ distinction reflects that paramedics are consistently performing a 12-lead ECG on patients within 10 minutes on chest pain calls.

“Paramedics play a vital part in the system of care for those who have heart attacks,” said James Jollis, M.D., Chair of the Mission: Lifeline Advisory Working Group.  “Since they are often the first medical point of contact, they can shave precious minutes of life-saving treatment time off by activating the emergency response system that alerts hospitals.  We applaud SCCAD for meeting evidence-based guidelines in the treatment of STEMI patients.”

SCCAD paramedics and leadership staff are elated to be recognized at this high level, but are quick to highlight that it is their collaborative relationships with area hospitals that make it possible.

“We’re working diligently with our partners at Barnes-Jewish St. Peters, Progress West, SSM Health St. Joseph Hospital St. Charles and SSM Health St. Joseph Hospital Lake St. Louis to develop processes and protocols with the goal of improving the quality of care for STEMI patients,” said John Romeo, Deputy Chief Medical Officer for SCCAD.

Cardiac care has been an area of focus for SCCAD in recent years; in 2015, the District was the first in the region to debut cardio-cerebral resuscitation [CCR] – an innovative approach to cardiac arrest management that saw a significant increase in survival to hospital discharge rates.

Board of Directors Vacancy

A vacancy has occurred in District 5 of St. Charles County Ambulance District Board of
Directors. Candidates for the office of Director must be a citizen of the United States, a qualified voter of election District 5, a resident for two years and shall be at least 24 years of age.

All interested applicants shall submit a letter of interest and resume to the Executive Assistant,
[email protected] or St Charles County Ambulance District, Attn: Tammy Dixon, 4169 Old Mill
Parkway, St Peters MO 63376 within seven (7) calendar days of the newspaper publication date (May 28, 2019).

SCCAD Receives 2019 ‘EMS Patient Safety First’ Award

The Center for Patient Safety (CPS) recently recognized the St. Charles County (MO) Ambulance District (SCCAD) for the EMS Patient Safety First Award.

CPS Executive Director Alex Christgen said district leaders have shown dedication and resilience by taking proactive steps to improve SCCAD’s patient safety culture, and the employees have shown spirited dedication in advancing the safe care of their patients. The EMS Patient Safety Award was presented to SCCAD during the East Central Region Clinical Save Banquet on April 18.

“Only one Emergency Medical Service provider in the United States is selected annually to receive this prestigious award,” Christgen said, “and I am pleased that St. Charles County Ambulance District has been selected. Their achievements are significant and deserving of this recognition.”

The award is given as part of EMS Week, set for May 19-25. Last year’s recipient was Lee County Florida Public Safety EMS. This is the second year the award has been given.
Lee Varner, director of patient safety at CPS, noted, “EMS is a high-consequence industry where organizations will be successful through a commitment to continuous improvement and effective adaption to change.”

SCCAD has developed and implemented several new practices that, Varner said, demonstrate the district’s proven leadership in the EMS field. Those practices include:
• Adopting a “just” culture to encourage recognition and reporting of near misses and medical errors so lessons can be learned from mistakes.

• Implementing the Medication Administration Cross Check (MACC) with staff to reduce medication errors. SCCAD also integrates MACC procedures while training paramedic students and utilizes the cross check during other educational events.

• Establishing a Peer Review Committee where peer clinicians review medical reports and events to ensure care is exceptional, and improvements are identified then implemented. SCCAD’s peer review model has been shared with numerous medical providers across the country.
• Developing a patient safety plan that actively involves leadership and frontline staff.
About CPS: The Center for Patient Safety is a non-profit organization whose mission is reducing preventable harm through creative and innovative patient safety solutions. CPS provides patient safety
improvement consulting, educating, and supporting services to hospitals, home care, nursing homes, EMS, ASCs, medical offices, and pharmacies across the United States. Find the Center for Patient Safety on Facebook and Twitter @PtSafetyExpert.

SCCAD Honored for Excellence in Financial Reporting

The Certificate of Achievement for Excellence in Financial Reporting has been awarded to St. Charles County Ambulance District by the Government Finance Officers Association of the United States and Canada (GFOA) for its comprehensive annual financial report (CAFR). The Certificate of Achievement is the highest form of recognition in the area of governmental accounting and financial reporting, and its attainment represents a significant accomplishment by a government and its management.

The CAFR has been judged by an impartial panel to meet the high standards of the program, which includes demonstrating a ‘spirit of full disclosure’ to clearly communicate its financial story and motivate potential users and user groups to read the CAFR.

District Begins Critical Care Transport Program

In 2018, SCCAD managed over 9,000 inter-facility transfers. The Transfer Division handles numerous patient logistics such as: hospital-to-skilled nursing facility, assisted living, independent living, or private residence. Moreover, the Division oversees transport from hospital-to-hospital for situations beginning in St. Charles County. With the inception of our Critical Care Transport program, the new service line focuses on inter-facility transfers of patients who require additional services / care outside St. Charles County and of a higher acuity. The new service line’s primary objective is to extend the same terrific care established at the point-of-origin en route to the destination facility. Often times, patients who are admitted to an area Emergency Department or Intensive Care Unit are managed with medications and / or interventions outside the scope of the Standard Paramedic Curriculum. Paramedics who undergo Critical Care education are taught similar concepts and procedures as intensive care nurses and respiratory therapists.

Critical Care Paramedics possess a national Critical Care credential. As with any new service line, special attention has been paid to a multitude of aspects such as: operations, logistics, training, quality assurance, and communication. According to Chief Taz Meyer, “Successful Critical Care Transport operations is only obtainable through effective collaboration with area Healthcare systems. We highly value our relationships with BJC and SSM. Through our partnerships, we believe our Critical Care Transport capabilities will result in favorable patient outcomes especially in those high-acuity situations. We have looked forward to this moment of launching operations of a Critical Care nature for many years and we are excited to begin offering this new level of service to the community! ” The Paramedic Critical Care Specialist will staff a quick response vehicle, which will respond simultaneously with a SCCAD Transfer Division Ambulance. The two assets will form a Critical Care Ambulance.

Assistant Chief Lewis Attains ‘Fellow’ Distinction From American College of Healthcare Executives

Like other areas of the healthcare continuum, emergency medical services [EMS] is an industry that has undergone considerable evolution in recent years, and more change undoubtedly is on the horizon.  St. Charles County Ambulance District [SCCAD] is well-positioned to develop and promote best practices to integrated community healthcare thanks to Assistant Chief David Lewis, who recently became a Fellow of the American College of Healthcare Executives [ACHE], the nation’s leading professional society for healthcare leaders.

“The healthcare management field plays a vital role in providing high-quality care to the people in our communities, which makes having a standard of excellence promoted by a professional organization critically important,” says Deborah J. Bowen, FACHE, CAE, president and CEO of ACHE.  “By becoming an ACHE Fellow and earning the distinction of board certification from ACHE, healthcare leaders demonstrate a commitment to excellence in serving their patients and community.”

Fellow status represents achievement of the highest standard of professional development.  Only 9,100 healthcare executives hold this distinction.  Candidates must fulfill multiple requirements, including passing a comprehensive exam, meeting academic and experiential criteria, and demonstrating professional/community involvement.  Fellows are also committed to ongoing professional development and undergo recertification every three years.

“Assistant Chief Lewis’s leadership, problem-solving abilities and ability to develop strategic, collaborative solutions to issues in our industry and community make him an invaluable asset to our organization,” said SCCAD Chief Taz Meyer.  “His attainment of the ACHE’s Fellow distinction points to his dedication to constant growth and improvement.”

Since his arrival at SCCAD in 2015, Lewis has been instrumental in the development of several cutting-edge initiatives that see paramedics collaborating with healthcare partners across the community to improve outcomes.  Examples include a hospital readmission avoidance program operated in collaboration with Barnes Jewish St. Peters and Progress West Hospitals, and a behavioral health telemedicine partnership with Behavioral Health Response that connects qualifying patients with masters-trained counselors as opposed to routing these individuals to an emergency department.

Lewis also spearheaded the creation of the District’s Substance Use Recovery Response Team.  Developed in early 2017 to help those affected by the opiate epidemic, the program received the American Ambulance Association’s Community Impact Award for its unique approach to linking patients with treatment, giving them a chance at recovery.

Assistant Chief David Lewis, FACHE