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Post by Admin on Apr 29, 2016 17:47:09 GMT
These are the standard categories used by two different EMS agencies to get you started thinking about the standard categories we want here in Fairfax County
Wake County, NC
APPEARANCE / PREPARDNESS / CONDITION 1 Punctuality / Shift Change Procedures 2 General Appearance 3 Physical Skill 4 Radio Usage 5 Equipment Readiness 6 Non-Emergent Driving Skills 7 Emergent Driving Skills 8 Mapping and Navigation 9 Appropriate Utilization of Downtime
SAFETY / ASSESSMENTS / DOCUMENTATION 1 Provider Safety 2 Patient Safety 3 Command Presence 4 Decision Making Skills 5 Patient Assessment 6 Patient History 7 Report Writing: ECR Content 8 Report Writing: Appropriate Time Utilization Comments:
ATTITUDE / RELATIONSHIPS / DEMEANOR 1 Acceptance of Feedback 2 Attitude towards EMS Work 3 Attitude with Patients and Citizens 4 Attitude with Co-workers / Public Safety / Healthcare Providers
KNOWLEDGE / APPLICATION 1 Departmental Policy 2 Cardiac Protocols 3 Trauma Protocols 4 Medical Protocols 5 Pharmacology (BLS) 6 Pharmacology (ALS) 7 Pediatrics 8 Field Performance SKILLS / PERFORMANCE / ABILITY 1 BLS Skills 2 ALS Skills 3 IV, IM, IN, IO skills 4 ECG Monitoring & 12-Lead Interpretation 5 Advanced Airway Management 6 Electrical Therapy 7 CPAP
Reed College
Categories: Professionalism 1. Appearance 2. Attitude Knowledge 3. Procedures 4. Department Directives 5. College Policies 6. State Laws 7. Campus Geography 8. Off-Campus Geography 9. Master Keys 10. Alarm Panel Locations 11. Emergency Phone Locations Performance 12. Self-Initiated Activity 13. Driving Skill 14. Field Performance, Non-Stress 15. Field Performance, High-Stress 16. Problem Solving/ Decision Making 17. Investigative Skills 18. Radio Use Written Work 19. Report Writing 20. Citations 21. Shift Summary Interactions/ Communication 22. Students 23. Faculty/ Staff 24. CS Department Members 25. Non-Reed Community Members
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Post by provow on Apr 29, 2016 18:06:03 GMT
Duane,
Just a quick observation, these are all standards for an EMS organizations, we need to add topics on Fire related topics (i.e. responsibilities if first unit to arrive at vehicle accident, fire, etc.) Also recommend actual training on CAD so they learn all the ins and outs of the CAD and its capabilities and FIRE RMS for reports. Class on problem resolution would probably be a good topic also since there is the potential if the process changes that the new medics will be much junior to those driving them.
Eric
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Post by Admin on Apr 29, 2016 18:07:10 GMT
And here is the current evaluation standard catergories we are using here in Fairfax County
· Basic Patient Assessment
· Use of Diagnostic Adjuncts
· Therapeutic Interventions
· Fairfax County Protocols
· Communication with Providers and Hospital
· Communication with Patient and/or Family
· Documentation of Care Provided
· Progress towards Lead Provider
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Post by Admin on Apr 29, 2016 19:09:05 GMT
Here is one from Southside Emergency Crew here in Va that use the FTEP model
1) General Appearance Evaluates physical appearance, dress, and hygiene as outlined by agency policies and procedures.
2) Acceptance of Feedback Evaluates the way the EMT receives feedback and how it is applied to further the learning process and improve performance.
3) Attitude Towards EMS Work Evaluates the EMT’s behavior of EMS in terms of motivation, goals, acceptance of roles and responsibilities, and overall performance.
4) Self-Initiated Field Study Utilizes time for further familiarization with local protocols, procedures, equipment, and geography. Other examples may include vehicle orientation, journal reading, etc.
5) BLS Skills Performance of Basic Life Support skills per the SVEC and ODEMSA Patient Treatment Protocols.
6) Knowledge of Agency Policies and Procedures Demonstrates knowledge of agency policies and procedures.
7) Knowledge of SVEC and ODEMSA protocols Demonstrates knowledge and field application of EMS protocols for all patients.
8) Knowledge of Equipment Demonstrates a thorough knowledge of all equipment found on ambulance and in kits.
9) Emergency Vehicle Driving Operates emergency vehicles safely during both emergent and non-emergent response modes.
10) Orientation, Mapping, Routes, Navigation Utilizes maps and map books to navigate response routes and to choose the most efficient route to the scene of an emergency incident in a timely fashion. Knows the location and several driving routes to area hospitals. Knows major thoroughfares. Understands layout of district and hospitals. Knows landmarks and corresponding response areas. Communicates routes effectively.
11) Documentation Completes appropriate documentation for every patient in a timely manner. Calls are posted in a reasonable time and calls are logged appropriately. Narrative is organized, and reflective of patient presentation, assessment, treatment, and response to treatment. Ensures all demographic and billing information is complete and accurate. Maintains 100% signature and HIPAA compliance.
12) Field Performance – Non Stress Conditions Under routine, non-stressful conditions, properly assesses situations and is able to implement an action plan.
13) Field Performance – Stress conditions Under stressful conditions, controls scene, assesses situations and implements an action plan.
14) Safety Works in a safe manner and is aware of safety in all operations. Observes standard precautions. Uses appropriate PPE. Follows safety procedures in agency policies and procedures.
15) Radio procedures Understands operation of radio equipment and frequencies. Listens and comprehends radio traffic. Transmissions are clear, concise, and complete. Hospital consultations and reports are timely, appropriate, and succinct.
16) Relationships with patients, citizens, coworkers, and other agencies Communicates and interacts with patients, citizens, coworkers, and other agencies in an appropriate, effective, and professional manner.
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Post by Admin on Apr 29, 2016 19:12:22 GMT
Northern Virginia EMS Council list of standards
Safety (awareness/compliance)
Routes of travel (geography/access knowledge)
Patient assessment skills
Professionalism
Teamwork (attitude towards EMS work)
Treatment skills
Complex problem solving; Scene control
ALS Protocol multi-tasking
Radio communication
Documentation
Interaction with the patient
Interaction with coworkers/other agencies
Equipment/Supplies use; Restocking
Acceptance of feedback
Self-initiated field study
Non self-initiated field study
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Post by Admin on May 4, 2016 11:53:53 GMT
Here are the categories I think we should use here in Fairfax. Please respond with a yes, no, or need to add, we don’t need. Thanks
1) Safety
2) Professionalism
3) Diagnostic Equipment
4) Patient Assessment
5) Decision Making Skills under stress (on calls)
6) Decision Making Skills under non-stress (not on calls)
7) Therapeutic Interventions
8) Fairfax County Protocols
9) Non-EMS specific equipment used on medic units
10) Communication with patients and public
11) Communication with Co-Workers and Hospital
12) Orientation to surrounding area
13) Documentation of Patient Care
14) Self Initiated study and Improvement
15) Affective Domain - Acceptance of Feedback - Attitude towards EMS work - Attitude towards Public (patients and citizens) - Attitude towards co-workers
Remember we are not defining these standards yet just trying to make sure we have all the categories we want covered that is needed to make someone a lead provider
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Post by M@ Moon on May 4, 2016 18:02:53 GMT
Finally have down time and will be writing some things out tonight. I'm conflicted with number of categories vs sub categories and then prioritization of our most relevant job set skills.
I know i'm a "millennial" but still need to write things down and visualize them.
Be back on later this evening.
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Post by Coston on May 4, 2016 19:02:35 GMT
I agree 100% with Provow. For a brand new provider, it can be overwhelming putting them in the front seat to give a size up of an incident and initial actions. While ALS skills, hospital communication, report writing, ect. are equally as important, it seems as though we leave out what to do when your first on scene of a house fire or entrapment. Many times (including today) you hear "Fairfax from BC404, I see Medic _____ on scene, do they have a report?". We need to put size up skills and initial first responder actions into a category.
In terms of categories, I like the way Wake County's flows. Instead of using "professionalism" which can mean a multitude of things, they use appearance/preparedness/condition. The less amount of "interpretation" we have by both the intern and preceptor, the better.
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Post by Adam Willemssen on May 4, 2016 22:10:26 GMT
Here are the categories I think we should use here in Fairfax. Please respond with a yes, no, or need to add, we don’t need. Thanks 1) Safety 2) Professionalism 3) Diagnostic Equipment 4) Patient Assessment 5) Decision Making Skills under stress (on calls) 6) Decision Making Skills under non-stress (not on calls) 7) Therapeutic Interventions 8) Fairfax County Protocols 9) Non-EMS specific equipment used on medic units 10) Communication with patients and public 11) Communication with Co-Workers and Hospital 12) Orientation to surrounding area 13) Documentation of Patient Care 14) Self Initiated study and Improvement 15) Affective Domain - Acceptance of Feedback - Attitude towards EMS work - Attitude towards Public (patients and citizens) - Attitude towards co-workers Remember we are not defining these standards yet just trying to make sure we have all the categories we want covered that is needed to make someone a lead provider Generally speaking, I agree with all of these. I can appreciate how these categories all lean toward the affective domain and help guide the training on how a field provider should act/behave. Assuming, of course, the majority of the cognitive and psychomotor components of the "Medic Apprentice" have already been assessed by this point in their training. I look forward to future discussions on potential sub-categories and/or further definition of these standards. I do think we should add a category for readiness/preparedness - one that would address medic unit cleanliness/supply management. Although, one could make a case for fitting that in under Safety, Professionalism or Equipment. Are they maintaining a clean, safe and properly stocked work environment? Are they checking drugs and critical supplies prior to line-up or are they waiting until after line-up/breakfast? I also echo the comments by others about needing to include an EMS Operations area. I don’t think this topic area is trained well enough. I’m thinking things like: Size-up (fire/MCI/MVC), positioning, rehab procedures, Fairfax 1, SWAT Operations, mutual aid communications procedures, etc. I’m trying to think of how we best create a well-rounded lead provider – not just one who might know how to operate a station 2 but one that knows how to operate at 10 an 39 as well.
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Post by Miranda on May 5, 2016 0:25:51 GMT
If we are operating under the assumption that the intern is well-versed with our protocols and are (somewhat) comfortable with their skills, I also believe that a significant part of the focus needs to be on creating a well rounded lead provider. There should be a General Operations category. Including: scene size up, scene management, vehicle positioning on accidents and suppression incidents, on scene reports, rehab, mutual aid, EMS reporting/narrative writing, MCT/CAD ops, logistical procedures, Target Solutions, IPAD/SIOC, portable radios, exposure reporting, bariatric equipment, hospital familiarization, and I'm sure another 30 topics I can not think of at this time. But they all fall under General Operations.
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Post by M@ Moon on May 5, 2016 13:14:37 GMT
Duane, in response to your suggestions; 5+6 and be combined to "Decision making Capability" with stress/non-stress as sub-categories. 10+11 can be combined to "Interaction" or "Teamwork" with FRD, Hospital, OLMD, other healthcare, citizens, etc as sub-categories. "Communication(s)" is more pertinent to use of MCT/CAD, iNet, radios.
Can I get some clarity on what 9 and 14 are referencing?
Yes to Affective domain and documentation.
Lastly, will safety include PPE, universal precautions, infection control topics or is that solely for scene/provider? If so, I think we should have something for use of gloves, safety glasses, PIC kit.
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Post by Kordalski on May 5, 2016 13:29:51 GMT
Ok so I think are good, we do not need to break everything out to the lowest common denominator since not all preceptors will teach the same way. I do like your last post that had simple categories. We can break these down a bit more.
1) Safety
2) Professionalism
3) Diagnostic Equipment
4) Patient Assessment
5) Decision Making Skills under stress (on calls)
6) Decision Making Skills under non-stress (not on calls)
7) Therapeutic Interventions
8) Fairfax County Protocols
9) Non-EMS specific equipment used on medic units
10) Communication with patients and public
11) Communication with Co-Workers and Hospital
12) Orientation to surrounding area
13) Documentation of Patient Care
14) Self Initiated study and Improvement
15) Affective Domain - Acceptance of Feedback - Attitude towards EMS work - Attitude towards Public (patients and citizens) - Attitude towards co-workers
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Post by Miranda on May 5, 2016 17:07:23 GMT
OK, I am confused.. We are trying to design a new internship program (mostly) for people who are coming straight out recruit school correct? They have never worked for our county and we're expecting them to ride as leads in 6 months, but yet we are not adding an "Operations" category? Soo, how will they know where to park on a fire? Or what to do when an exposure occurs? Or how to find the radio police channel on certain incidents? Etc, etc... Also, I do think we need to break things down to the lowest common denominator ( or very close to it), because quite a few preceptors at this point are still fairly new and if we're not thorough, the interns are not set up for succes. The BLS workbook for new BLS providers is VERY detailed.. As annoying as it may be for the preceptor, I think they're going to miss quite a few points if we're not laying it out very detailed and specifically
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Post by Admin on May 5, 2016 18:02:29 GMT
Thanks for all the great responses. There will be two parts to this project and the standards is just part 1. The standards are the everyday evaluation that the intern will be graded on. That mean that the categories should be a little broad and when the evaluator grades them the remarks as to why the qualify for a particular mark need to be documented. I think a broad category of overall “operations” as a standard to be evaluated may be valid to have.
Breaking it down into where to park on scene, how to work this piece of equipment and various tasks will be included in the second part of the project “the task book” that will have a specific set of training to become a lead provider. Currently it is a set of objectives to completed each tour. That part of the project will begin July 1 and I will be asking for help again with portion as well. Currently we are finishing up the task book for the next 4 month internship, it has been updated and is awaiting final approval from the intern committee before being published.
Here is an example of Tour One to give you a preview of the task book and how it will be separate from the standards
Tour 1
Tasks:
Adult Protocol Review: Acute Coronary Syndrome, Cardiac Arrest, Cardiac Dysrhythmias
Protocol Review: Team Work & Decision Making, When a person Becomes a patient, Decision-Making Capacity
Protocol Review: Cardiac Medications Discuss with your preceptor the common medications used for cardiac patients and the strategy, tactics, and roles for a cardiac arrest call
Equipment Familiarization: Philips MRx monitor 1. Demonstrate proper safe storage of unit and securing during transport 2. Demonstrate performing operational check and troubleshooting common problems such as a battery change-out, AC power connection, battery rotation policy, changing paper 3. Demonstrate proper cleaning techniques and accessory storage 4. Demonstrate proper 4- and 12-lead placement and acquisition 5. Demonstrate proper defibrillation pad placement and use of AED mode
Equipment Familiarization: Philips MRx Operation 1. Demonstrate the proper sequence to set up and initiate pacing and the difference between fixed and demand pacing 2. Demonstrate the proper sequence to perform Defibrillation and Cardioversion 3. Discuss the benefits of and demonstrate how to obtain a 15-Lead EKG 4. Prepare an in-station drill to give to your shift next week on the basic operation of the MRx and assisting with 12-Lead acquisition
Area Familiarization: Receiving Facilities Using your favorite online mapping program, find the three closest hospitals to your station and the best route of travel. 1. Name: Miles from station: 2. Name: Miles from station: 3. Name: Miles from station:
Target Solutions: Take Tour 1 Quiz by last day of Tour.
Information Technology: MCT & CAD 1. Demonstrate using the unit roster to add personnel and assign the portable radio 2. Demonstrate how to obtain medic “unit history”, last incident number and times from the vehicle MCT and station CAD terminals 3. Explain the concept of a “Julian Date”
Equipment Familiarization: Perform a full inventory inspection utilizing FRD-209-A
Station Orientation: EMS Resupply 1. Locate the EMS supply closet(s) and explain the station security policy to keep ALS items locked and secure 2. Locate the battery charges and spare batteries for all items on your unit (radios, suction unit, heart monitor, pulse ox, laryngoscope, power cot, etc)
Administrative: Chain of Command Identify the three shift leaders at your station. Discuss the relationship between a Captain I and Captain II at the station level.
This book will need to updated to include everything we think a lead provider should be able to do at the end of 6 months. Whereas the Standard Evaluation Guide is how the function with-in our department on a day-to-day basis.
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Post by Adam Willemssen on May 6, 2016 0:45:25 GMT
Great inputs! I think we'll have a lot to discuss tomorrow. I just want to add that the more detailed the program the less reliant we need to be on the preceptor side. What I mean by that is if an apprentice gets stuck with a less than motivated preceptor they will have prompts for the information they need to seek out.
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