Improving hospital relationship with EMS

[Doczilla]

It was recently asked of me to come up with some ideas to improve our hospital's relationship with EMS. I'm fairly sure that printed coffee mugs don't quite cut it. I was hoping that the learned folks here would have some good thoughts on this.

Currently our flight service here does training sessions "on the road" in some of the surrounding areas. They offer great classes by solid instructors. The hospital takes paramedic students for clinical time but does not have its own paramedic program. We have a full time EMS coordinator who is very proactive. We'd like to offer something that has some actual value, not something like the usual junk handed out on EMS Week.

One idea that has been floated is creating a mobile training center with high fidelity patient simulators that can be taken to various squads for offering continuing ed. Another is to offer clinical time (which is available for EMS students but not to EMTs/medics who are not in a training program. This can be done on an individual basis with physicians, but there is no real "system" to do it.).

Anyone care to share some ideas?

'zilla

[Christopher.Collins]

If you dont mind my asking, how is the relationship between both agencies as of now? Decent, could be better, some tension, etc? What if anything could be causing a need for improvement?

For hospital to EMS relations, do you guys celebrate EMS week? One thing alot of hospitals in my area do; is take at least this one week a year to show their appreciation for us. They have cold cut sandwiches and other food and cold drinks in bulk all day every day during the week in the EMS lounges. Some make up t-shirts, mugs and gift bags... (these would be handed out by staff to make sure any indavidual isnt abusing it though), thank you banners hanging over the ambulance ED entrance. Things like that. It really does make us feel like a team, and like we are appreciated.

As far as EMS to hospital relations... alot of times, especially on the night shift, my partner and I would pick up coffee and food for the ER nurses and staff. This of course is if time permits as one never knows what the Dispatch Gods have waiting for you. But regardless its always helped.

At the end of my night shift rotation (we rotated 3 nights on, 3 off, 3 days on)... my crew would go for breakfast. And we'd invite whoever was working in the ER that shift.

Training together as you say is deffinatley a good idea as well. Our flight service (LifeStar) is sponsored by Hartford Hospital and based there as well as Bakus Hospital (Norwich, CT). They offer an observer program for medically certified personel. Only requirments are to be currently affiliated with an agency that can offer a letter of reccomendation, weigh under 200lbs, and be certified as a first responder minumum. Your there for a whole shift, and fly with them... but beware you may be booted on a scene for various reasons, but someone will always be willing to help get you back. You may assist the crew (1 RN and 1 RRT) if asked which is usually if CPR is needed.

[p3medic]

Con-ed would be a great place to start. One of the teaching hospitals here has a multi-million dollar sim lab, obviously not every facility can justfify that, but it is a great tool. OR time for airway management con-ed, OB/GYN, ED rotations for a few medics at time and weekly EMS rounds would also be a nice "peace offering".

[katbemeEMT-B]

The service that I work for is actually hospital owned. We are not based at the hospital, but we do spend time there. When we are in the ED, we help out where ever we can. We also train with the hospital staff and invite them into CE classes that are EMS specific, as they do the same. While there are always those that like to fuel the fire, we pretty much get along great and work as a whole to provide better patient care. They depend on EMS to provide them information from the scene that will benefit patient care and we depend on them to direct us as to what information we need to gather. Oh yeah, we also fill their big butt candy drawer.

As far as other hospitals we transport to, we have a pretty good relationship with them also. I think it comes down to getting to know the staff and allowing them to get to know your service.

[streetsurgeon]

i agree with the fact of getting to know the hospital staff. and "open continuing ed. is a great idea.. both hands need to know what the other is doing.. same as pre hospital and hospital ed.. we try to do that very thing for our county ran ems ,but the major issue is attendace, as i am sure it is for others..

[itku2er]

Offering con-ed at a discount might be helpful cause those classes do cost alot of cash when its out of pocket. Why not have an "open house' allowing all EMS and ER staff to get aquantied like a bbq or something. Even getting the Floor personell would be good too that way communications can be opened. The free stuff is good too. Might even try a monthly "community meeting" for ems and hospital workers so that if there has a problem in the month that it can be addressed in a timely manner and not allowed to brew. Just some suggestions.

[Richard B the EMT]

In the strings on EMS week, having food set out for the crews has been mentioned. The usual complaint is, by the time the midnight to daylight crews get there, either all the food's been consumed, or has gone stale, and the "mid-nighters" usually end up cleaning up the food's wreckage left by the Dawn to dusk, and the dusk to witching hour crews.

[letmesleep]

Something that our director is attempting to put in place is some monthly sit downs with EMS. Just showing some interest goes a long way. With that he has talked about joint training (con-ed) as well as establishing some ride-a-long time in both directions. He has even tried to find money to be able to pay his nurses for this, thus making it somewhat mandatory (for lack of a better word). I knew a director that would just show up to a station, and sit down with the "guys", drink some coffee, and talk shop. He was able to make changes to protocols based off of the one-on-one interaction with the crews, and the level of respect was raised to a higher level.

Training is always going to be a good thing, but getting to know those that you regulate on a one-on-one basis will rock your world Doc.

[CBEMT]

If it doesn't already exist, establish a procedure for EMS to request feedback/outcome information on select patients brought to your facility. Obviously this shouldn't be every sniffle and stubbed toe, but that should be fairly self-explanatory.

[Just Plain Ruff]

Great suggestion CB often times I've wondered what happened to that guy who got hit by the train, then attacked by the rabid possum and then who fell in the water and we had a cold water drowning, you know those types of patients.

Also if you are going to provide food for an entire day make sure that you have set aside enough for the night shift crews as they always get the left-overs which if left out there can be some real bad side effects of food left out.

continuing education - Topics related to EMS

Offer a meet and greet and how about a tips and tricks from the ER that you wish that the ems crews would know.

One thing your ER might want to offer is Gowns for the patients. As a former ER worker getting a patient in a gown after two iv's were started it's kind of a obstacle course. But EMS workers, don't let getting a patient in a gown distract you from patient care though.

Sponsor a EMS/ER day where whoever can come can get together at a local park or community center for a get to know lunch and activities.

Ride-alongs for nurses and docs. ER-alongs for paramedics and Emt's so each group sees what the other group does on a daily basis. It might just change your outlook on why the nurses get so pissed when you bring a really soiled patient to them or why you actually brought that soiled patient to them. (EMS sometimes cannot clean them up)

Free stuff is good but it's gotta run both ways. If the ER gives free pens or coffee cups or whatever out then the EMS system needs to reciprocate and give a t-shirt with their logo on it away. A couple of years or giveaways from the ER with no reciprocation from EMS will end that practice real soon.

If the hospital does ACLS or PALS and does not have EMS staff helping in the instruction then might want to re-think that policy.

Free beer would be good but not required.