What began as an effort by Missouri ambulance services to protect quality review confidentiality has become an innovative program designed to improve the quality and safety of health service delivery through the collection and analysis of patient safety data, from prehospital treatment through hospital release. With a $595,165 grant from the Missouri Foundation for Health to the Missouri Center for Patient Safety, the Missouri Ambulance Association will encourage all of the state’s ambulance services to contribute their patient safety data to the Center, a patient safety organization (PSO).
PSOs were established in response to the 1999 Institute of Medicine report “To Err is Human: Building a Safer Health System.” The federal government passed the Patient Safety and Quality Improvement Act of 2005 and the Patient Safety Rule authorizing the creation of PSOs to reduce medical errors and improve safety by voluntarily collecting and sharing patient information while protecting it from the legal discovery process.
In Missouri, the PSO collects data from all of the state’s hospitals, clinics and, with the new grant, EMS services. “If you’re part of a bigger PSO, like we are, then we can attach our data to the hospital data,” said Jason White, director of compliance and government relations for Metropolitan Ambulance Services Trust (MAST), a member of the Missouri Ambulance Association board of directors and one of the organizers behind the effort to have EMS participate in PSO data collection. “Down the road, as the body of data under the PSO roof grows and we submit linkages between what’s submitted from EMS and what’s submitted from hospitals, you’ve got a clear picture of our successes and failures as a health care system.”
In related news, MAST board members voted at their regular January board meeting to make Kansas City Fire Chief Richard “Smokey” Dyer CEO of MAST following the Kansas City Council’s vote in September 2009 to make MAST part of the Kansas City Fire Department. (See Best Practices November 2009.) The vote followed a closed-door discussion, according to local press reports. The merger is scheduled to be completed April 25, and Dyer is in charge of MAST during its transition to a city agency. MAST was one of the original public utility model ambulance agencies to be developed in the 1980s and the first to be dismantled.
White said the fire department will continue to contribute EMS patient-safety information to the PSO’s data-gathering project.
Conscious of the role EMS practitioners play on the front lines of any disaster within, or attack on, the U.S., the National Association of Emergency Medical Technicians (NAEMT) has released a new position statement advocating for operational security measures and domestic preparedness and planning that would protect such workers. Taking these steps, according to the NAEMT, requires:
- Sustainable federal funding for EMS practitioners to implement domestic preparedness, situational threat awareness and operational security programs
- Including EMS system requirements in the development, implementation and use of operational security measures, including equipment and vehicles, adequate personal protective equipment and timely briefings on security issues
- EMS participation in local, regional, state and federal preparedness planning
The link to the detailed Operational Safety and Domestic Preparedness and Planning position paper is at naemt.org/advocacy/naemt_positions.aspx.
This month, a website devoted to “green” buildings and fire safety, a project of the National Association of State Fire Marshals (NASFM), launches at greenbuildingfiresafety.org. The NASFM received a $420,455 Assistance to Firefighters Fire Prevention and Safety Grant from the Department of Homeland Security to develop and share information with first responders and code-enforcement officials about building technologies and criteria employed in green building design that affect their work.
“It’s a matter of making the fire service aware, from a safety point of view, of the kinds of techniques and technologies and practices that are going on as part of the green building movement, which is obviously here to stay, and from a code enforcement point of view, being able to recognize what the green building technologies are and to make sure that fire safety is represented when they are inspecting blueprints or doing a walk-through,” said Karen Deppa of the NASFM, project manager of the Green Building Fire Safety project.
Under the terms of the grant for “Fire Safety and Green Buildings: Bridging the Gap,” the NASFM will create a working group to advise on the project and create an agenda for needed educational materials, develop an online clearinghouse for sharing information and publish guidelines for first responders and others.
