The future goal of EMS is to become a community oriented health care system that is integrated with other health care services in order to become part of the overall health care system. In order to achieve this long term goal, the EMS Agenda for the Future has introduced 14 attributes that will promote advancements and future development of EMS as a healthcare system. The agenda hopes that EMS will be able to provide healthcare alongside nurses and physicians and work with other public health and management agencies. EMS is a relatively young healthcare system and the development of it is important to public health.
The EMS Agenda for the Future was developed and published by government organizations, National Highway Traffic Safety Administration
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(NHTSA) and the Health Resources and Services Administration (HRSA) (National Highway Traffic Safety Administration [NHTSA], 1996). This report focused on the importance of emergency healthcare and how emergency care differentiates from traditional healthcare (NHTSA, 1996). Within the agenda, the 14 attributes were introduced in order to build a framework for continuing development for EMS as a healthcare system (NHTSA, 1996). The first attribute in the agenda is the integration of health care services. This attribute was established to include EMS into the overall health care system. This element’s objective is to eliminate the segregation of EMS from other healthcare services (NHTSA, 1996). It guarantees that the care provided by EMS personnel to be legitimate and part of the patient’s overall treatment and medical history (NHTSA, 1996). Integration allows patients who are treated by EMS to receive appropriate follow up medical care (NHTSA, 1996). This attribute also focuses on how EMS providers produce positive outcomes and that they should be integrated with services such as trauma centers, burn centers and pediatric centers to improve EMS care for specific demographics and patients who need specific care (NHTSA, 1996). Without this integration, patient health outcomes might not be as successful. EMS is often regarded as an extension of the ER. This means that without EMS, the emergency room will have a more difficult time in stabilizing a patient. In order for integration to occur, EMS must expand their overall role in the community. EMS systems can expand their role by cultivating relationships with not only health care providers but with social services (NHTSA, 1996). Relationships such as these will create networks and improve communication that facilitates the enhancement of patient referrals and follow-ups by other health care agencies. The EMS Agenda for the Future envisions that EMS systems will be involved in the business of community health monitoring (NHTSA, 1996). This monitoring will promote data collection and the dissemination of this data to appropriate community and health care agencies (NHTSA, 1996). The long-term effects of community health care monitoring must be documented and reported through information systems. The second attribute in the agenda is EMS research. Research is important to understand the foundation and to build upon a certain a topic. Through effective research, society can gain a deeper understanding of the topic at hand. One of the main purposes of EMS is to advance medical care and the distribution of resources (NHTSA, 1996). As stated earlier, EMS is a relatively a young field. Research is a vital aspect in improving the capabilities of EMS as a resource. However, research within EMS is a difficult task. Given the number of variables, it is difficult to test and find solutions during real-time emergencies. Due to complexities, most of the research in EMS has been generated by researchers at a small number of medical schools (NHTSA, 1996). This allows for a controlled environment. The only way to conduct research is within EMS is to establish integration between other health services. Developing relationships between EMS and physicians at medical schools, academic institutions and private practices (NHTSA, 1996). By this integration, EMS can publish more research in order to enhance EMS as a healthcare service. The third attribute is legislation and regulation.
This attribute is important because it affects several aspects of EMS. Legislation and regulations can affect government funding, research, personnel credentials and their scope of practice (NHTSA, 1996). Within EMS systems, there is a lead federal agency as well a state level agencies. The federal leads nationwide EMS development, serves as a central source for federal EMS research and oversees development of national guidelines (NHTSA, 1996). State lead agencies oversee the statewide EMS system (NHTSA, 1996). According to the EMS Agenda, all states have laws that establish a statutory basis for EMS activities and programs (NHTSA, 1996). Legislation and regulation of EMS vary greatly between states. This makes it difficult for providers to practice in multiple areas. For example, the national protocol may differ from state law when regarding the administration of a medication. This means that EMS personnel are taught to practice one way but may contradict their local protocols. In order to improve EMS legislation and regulation, states governments must pass legislation that supports EMS advancements, integration of health services and EMS funding (NHTSA, 1996). This will enable the EMS to grow and become a more efficient health care
service. The fourth attribute is system finance. There must be a well a strong financial foundation in order to efficiently and effectively run an EMS system. There are many different costs associated with the structure of an EMS system. Within an EMS system, there are communications systems, apparatus, maintenance, personnel, education, emergency operations, medical direction, drugs, and equipment. EMS systems are funded both publically and privately (NHTSA, 1996). This is why legislation and regulation are such an important attribute because it can greatly influence governmental subsidies via tax dollars (NHTSA, 1996). For private EMS such a volunteer organization, they rely on personally funding and community fundraising. These organizations often hold events such as carnivals to raise funds.
De Tar Hospital should ensure that EMTALA compliance is monitored regularly through internal auditing of emergency department records. Issues identified should be examined against existing policies and procedures to determine whether the problem is an isolated error which may be corrected through education and discipline, or if there is a more systemic problem that calls for major modification of existing policies and procedures. For example transfer records executed by Dr. Burditt and other physicians should be reviewed see if there is a pattern of inappropriate transfers by other physicians or if this is just an isolated incident. Such a proactive approach to addressing EMTALA compliance issues should significantly reduce the hospital’s liability for violation.
Medicare and Medi-Cal insures about fifty percent of patients EMC treats in the ED and because of that large number of patients it exposes the hospital to low-reimbursement rates the hospital receives back from those programs for providing care. Federally funded programs r...
Determined healthcare systems routinely examine their environments internally and externally to locate significant trends and forces in the present and for the future which will have an effect on their performance goals and mission efforts. These healthcare systems understand who their stakeholders are, their needs and how best to meet those expectations and needs. These systems give attention to specific efforts on accomplishing goals that acquire opportunities in the whole environment while they continue to adjust their internal structures and functions. Precise aims are dealt with by uninterrupted sequences for performance improvements. Strategic directions for systems originate from the mission and directives. Strategic directions are identified by observing key stakeholders, addressing their interests and being proactive about responding to current, as well as, future shifts and trends in the systems’ entire environment (Skinner, 2001).
The health care organization with which I am familiar and involved is Kaiser Permanente where I work as an Emergency Room Registered Nurse and later promoted to management. Kaiser Permanente was founded in 1945, is the nation’s largest not-for-profit health plan, serving 9.1 million members, with headquarters in Oakland, California. At Kaiser Permanente, physicians are responsible for medical decisions, continuously developing and refining medical practices to ensure that care is delivered in the most effective manner possible. Kaiser Permanente combines a nonprofit insurance plan with its own hospitals and clinics, is the kind of holistic health system that President Obama’s health care law encourages. It still operates in a half-dozen states from Maryland to Hawaii and is looking to expand...
There are pros and cons. Some medical people believe that the EMTALA legislation creates some problems for hospitals. Knowing that hospitals must take care of every person, people may use the ED for routine doctor visit situations. These people believe this contributes to the sometime overcrowding of ED’s. Another problem is that EMTALA legislation mandates caring for everyone no matter what. The hospital therefore, may not get paid. “According to the American College of Emergency Physicians, 55 percent of emergency care goes
The federal government has taken a stance to standardized care by creating incentive programs that are mandated under the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009. This act encourages healthcare providers and healthcare institutions to adopt Meaningful use in order to receive incentives from Medicare and Medicaid. Meaningful use is the adoption of a certified health record system that acquires or obtains specified objectives about a patient. The objectives or measures are considered gold standard practices with the EHR system. Examples of the measures include data entry of vital signs, demographics, allergies, entering medical orders, providing patients with electronic copies of their records, and many more pertinent information regarding the patient (Friedman et al, 2013, p.1560).
While the outcomes of the effects of newer efforts are unclear, the assessments address specific issues that stand in the way of Honor Health’s mission. Honor Health is effectively using its vision statement to fulfill its mission; to an extent, as its mission and vision are so vague. By identifying data and socioeconomic barriers to care in each individual community it serves; each community is identified by zip codes that surround each hospital and health clinic in the organization, it can purpose and implement initiatives to address specific needs (Honor Health, 2015). While the vision statement is vague, it does provide a broad goal for the organization that can allow a variety of strategies, allowing operational flexibility and room for leadership to implement a diverse definition of organizational mission
To be considered meaningful users of the EMR, the qualified applicant must use clinical content that is consistent and standardized across systems and healthcare settings, use decision support tools such as alerts and reminders, have the ability to collect and store raw data from documentation that can be used for reporting purposes, collect and report data to the state. Reporting of data will help to improve public health and awareness and provide sharing of information between systems (Tripathi,
Congress addressed growing public concern about privacy and security of personal health data, and in 1996 passed “The Health Insurance Portability and Accountability Act” (HIPAA). HIPAA sets the national standard for electronic transfers of health data. Before HIPAA, each state set their own standards. Now states must abide by the minimum standards set by HIPAA. States can enact laws to incorporate and/or strengthen the basic rights given by HIPAA.
Ambulances started affecting modern day health care, after the Civil war ended in 1865. The first civilian ambulance started in 1865, in Cincinnati, Ohio. The EMS, emergency medical services, first started to grow, in 1950. The EMS started as one of the five branches created in 1950, which include towing operator, police/fire departments, hospitals, medical equipment companies, and funeral homes. Then, 300 EMS systems were established in 1973, through the EMS Systems Act. A lot has changed since the start of EMS. The EMT is now acknowledged as a true member of modern day health care; the NREMT now plays an active part in the continuing process of improving the EMS; national standards have also been established.
State and local public health departments throughout the country have the responsibility for improving health in workplaces, schools, and communities through identifying top health problems within society and developing a plan to improve. Barriers the public health system has encountered over the years include: changes in the overall health system that support cost containment and improved health, and an increase in the number of individuals with insurance coverage for direct preventive services; reduction of qualified public health professional and funding at all levels of government; increasing focus on accountability, with higher expectations for demonstrating a return on investment in terms of cost and health improvement (Trust, 2013). In the near future, health departments ...
In 2005, Congress reauthorized the legislation for the NHTSA. Under the Safe, Accountable, Flexible, Efficient Transportation Equality Act: A Legacy for Users or SAFETEA-LU, Congress then created the Federal Interagency Committee on Emergency Medical Services. The EMS system today is still a serious career that is competitive to get into. Medical Assistance is integrated into Law Enforcement, Fire Fighters, and anyone in public safety because it’s an honorable career and works to improve the safety of the community in which we live in.
...e crucial change needed in health services delivery, with the aim of transforming the current deteriorated system into a true “health care” system. (ANA, 2010)
With regard to the healthcare organization, it is essential to develop a strategic plan and a clear vision so that the patient focused care will be at par with the organizational process that is conducted operationally and on a daily basis. SSM Health Care has its call letters for meetings standardized at all their sites as part of its protocol. Its values and missions are attached to its call letter for meetings as constant reminders for their staff. Indirectly, this approach helps in translating our vision on how people should behave at SSM Health Care.
As a future healthcare leader, I will start by collecting data on the health of the community that my organization serves. I will develop a five-step program to contribute to public health efforts within my organization. My five-step program towards public health will involve monitoring, diagnosing and investigating, informing and educating, partnering, and researching. I will monitor the health indicators of my community and be aware of health needs and disparities. I will seek to identify hazards through research and analysis and diagnose root causes. Once root causes are recognized, improvement is possible. It is