In the US, emergency medical services (EMS) systems typically respond to 911 calls in either of two ways: “scoop and run” patients to emergency departments, or “stay and treat” patients in the field. However, a number of recent developments are causing the EMS industry in the US to rethink the ways in which it typically delivers pre-hospital care. For example, the Affordable Care Act is calling for innovation and improved coordination of care among healthcare providers; the Institute for Healthcare Improvements’ Triple Aim Initiative is calling for improved patient experience, improved health of populations, and reduction in per capita cost; and the Centers for Medicare and Medicaid is growing concerned about the increasing cost of ambulance transports. All of these factors have caused the EMS industry in the US to look for ways to implement alternative care and transportation plans that integrate with healthcare systems, treat more patients in their homes, and transport patients to care delivery points that are more appropriate and less expensive than hospital emergency departments.
The client for this PRP is Austin-Travis County Emergency Medical Services (ATCEMS). ATCEMS would like us to help them think about ways they can improve their integration with local healthcare networks to support patient-centered out-of-hospital care.
The PRP will comprise four phases. In phase 1, students will come up to speed on the operations and culture of the EMS industry in general and ATCEMS in particular. This will be accomplished through a series of readings prepared by the instructor, ridealongs on ambulances with local paramedics, and time spent in the local 911 call center listening to incoming calls and observing how dispatchers prioritize and assign calls to paramedics. Once students are sufficiently up to speed, students will then identify, describe and assess the current points of contact between ATCEMS and local healthcare networks (phase 2). In phase 3, students will brainstorm alternative points of contact along with corresponding care and transportation protocols. Phase 3 will be accomplished through interviews with local healthcare experts, literature reviews, etc. Phase 4 will assess the feasibility and likely impact of the brainstormed alternatives from phase 3. Deliverables include a final report detailing findings and a final presentation to the project sponsor.