Perspectives from Pinnacle: A Real-Time Look at the System

In EMS we’re pretty good at analysis after the fact. We review patient charts and assemble AARs on critical events. But that’s a tough way to promote change. Telling Joe Paramedic to do something differently weeks or months after he did it is far less effective than correcting him within moments of the act.

Dashboards—visualized displays of real-time data that let leaders monitor key performance indicators as things happen—shrink that interval.

“With EMS people, if you catch us while something is fresh in our minds, what you tell us will resonate,” says Todd Stout, founder and president of FirstWatch, which helps agencies marshal data for situational awareness, operations and clinical improvement. “What the real-time dashboards do is let us make changes right after or as things are happening and really affect how people function, rather than try to intellectually tell them, ‘If you get that kind of call again, do it this way.’ They might not get that call again for days!”

Stout provided some examples at Pinnacle that included a dashboard for Priority Dispatch’s ProQA dispatch system. That might show you, for example, a call-taker who takes longer than expected to handle a certain call. Leaders can investigate that in near-real time, and if that call-taker is doing something wrong, bosses can remediate them now, before it becomes habitual or harmful.

By the same token, notes Stout, “There are thousands of agencies that use ProQA. And if people can figure out who’s good at this, who does it well, then we have the opportunity to learn from those people too.”

This can have some large financial implications. Looking at call volume for one California client, Stout said, FirstWatch found something interesting: Transient increases in call volume didn’t mean volume would stay high. However, decreases in volume below a statistical level almost always meant volume would stay lower than normal for the next 6-8 hours. If a boss knows something like that, they can send crews home early or not fill empty slots, better matching supply to demand and reducing labor costs.

In Sedgwick Co., KS, they’re using dashboards toward clinical goals. One example is patients with severe respiratory distress. Leaders want the SpO₂ levels of these patients above a certain threshold by the time they reach the ED. Thus they look in real time at relevant patient records using a dashboard that shows providers’ percentage compliance with that SpO₂ goal. If a provider isn’t getting those saturations up, it can be promptly addressed.

“People always say, ‘Oh, in EMS we only measure response times, and those don’t matter!’” says Stout. “Well, you don’t have to just do that. You just have to pick something else and start working on it. Doing that in real time—seeing which medics do what, which kinds of calls we can improve on—can really change a lot.”

For more: www.firstwatch.net.

The 2014 Pinnacle EMS Leadership Forum will be held July 21–25 at the Westin Kierland Resort, Scottsdale, AZ. Get conference updates at https://pinnacle-ems.com.