1. Missouri Department of Health and Senior Services Paula Adkison Deborah Markenson 10/29/08 Regional EMS Committees

2. “ The purpose of the council is to make recommendations to the governor, the general assembly, and the department [DHSS] on policies, plans, procedures and proposed regulations on how to improve the statewide emergency medical services system. The council shall advise the governor, the general assembly and the department on all aspects of the emergency medical services system.” State Advisory Council on Emergency Medical Services (SAC) (RSMo 190.101)

3. SAC-EMS (RSMo 190.101) http://www.dhss.mo.go v/EMS/Council.html 16 members—appointed by Governor Lynthia B. Andrews, DO., Chair Chair of Emergency Medicine Heartland Regional Medical Center St Joseph, MO Chair may appoint subcommittees that include noncouncil members DHSS-Bureau of EMS supports SAC Meet monthly with minutes posted on DHSS website

4. PURPOSE: TO MAKE RECOMMENDATIONS TO THE REGION AND DHSS ON: 1. Coordination of emergency resources in the region; 2. Improvement of public and professional education; 3. Cooperative research endeavors; 4. Development of standards, protocols and policies; and 5. Voluntary multiagency quality improvement committee and process. Regional EMS Advisory Committees RSMo 190.102

5. Regional EMS Advisory Committees (RSMo 190.102) http://www.dhss.mo.gov/EMS/Co mmittees.html DHSS designates through regulation EMS regions and committees. DHSS Director appoints based on recommendations from recognized professional organizations. Appointments for 4 years with individuals serving until reappointed or replaced.

6. Missouri’s Regional Committee Territories 19 CSR 30-40.302—State regulations define counties in each region. http://www.dhss.mo.gov/E MS/Committees.html

7. 1. REVIEW BY FUNCTION 2. BARRIERS 3. RECOMMENDATIONS 1. Supports 2. Functions Regional Committee Discussion 9/18/08

8. Review by Function (9/18/08 discussion) (1) Coordination of emergency resources in the region Working: Sharing mutual aid agreements Integration of EMS out-of-hospital services Additional functions: Work on triage and transport for region Work on role of small hospitals Enhance network development

9. Review by Function (9/18/08 discussion) (2) Improvement of public and professional education Working: Sharing information and educational opportunities Sharing protocols Additional functions: Conduct additional education with focus on regulatory requirements Share best practices Coordinate prevention education on a regional basis

10. Review by Function (9/18/08 discussion) (3) Cooperative research endeavors No issues identified on 9/18/08

11. Review by Function (9/18/08 discussion) (4) Development of standards, protocols and policies Additional Functions Share best practices Review regional practices based on ACS trauma criteria Review and approve protocols for care

12. Review by Function (9/18/08 discussion) (5) Voluntary multiagency quality improvement committee and process Additional Functions Improve quality improvement functions with benchmarks for facilty/region/state Address lack of EMS peer protection so can share data for QI

13. Barriers State Committee appointment delays Limited data, limited or no feedback or data reports from registry data Lack of timely communication and updates Region Lack of understanding of committee functions Lack of participation by medical directors Both Resource and manpower shortage Inadequate funding, limited funding opportunities or notices Lack of EMS peer protection for QI functions

14. General Support Recommendations Regional Committees-State Track regional committee appointments and make timely replacements. Increase diversity of membership Provide orientation for new committee members. Describe purpose and benefits of regional committees and compile strategies to promote committee value to increase involvement. Improve data support for QI functions. Provide regular updates & establish accessible website. Increase support for regional committees and functions.  Post Regional Committee Member listing.

15. General Support Recommendations- Region & Both Region Increase involvement of medical directors. Host regional committee meetings with other stakeholder groups. Establish standard meeting time. Both Increase involvement of medical directors. Explore and use technology for meetings and communication to decrease travel time and improve information availability.

16. Recommendations for Regional Committee Functions  OK  Modify  Delete Identify ways to enhance network development. Define and maintain role for small hospitals. Conduct additional education, focus on regulatory requirements. Share best practices.

17. Recommendations Cont. for Regional Committee Functions  OK  Modify  Delete Review regional practices based on ACS trauma criteria. Review and approve protocols for care within region. Formalize quality improvement (QI) functions with benchmarks for facility/region/state.

18. Recommendations Cont. for Regional Committee Functions  OK  Modify  Delete  Additions Address lack of EMS peer protection so can share data for QI. Coordinate prevention education on a regional basis.