17 november 2009 fairview hotel, nairobi, kenya
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17 November 2009Fairview Hotel, Nairobi, Kenya
Emergency Medical System Development PilotStakeholders Conference
Today's agenda
TopicTopic
Welcome & Introductions
Opening and Keynote Address
Academic role Africa Collaborative for EMS
EMS Development Nairobi Pilot Project
Required Elements of an EMS System
The Call to Action
Identification of Next Steps
ObjectiveObjective
Review of: Emergency Medical System a Priority of the Ministry of Medical Systems Reforms Agenda
Review the role of universities and researchers in facilitating this process
Set the foundation for the pilot project
Review lessons learned from India’s EMRI Program
Stakeholders group discussion to align on practical action
Outline immediate next steps
Setting the foundation for action
Why are we here?
Why are you
here?
Why now?
The journey
We Share the Same Dream...
...You Have the Same Passion...
...A Window of Opportunity
Life-Long for many, a 3 year labor of love for the UCLA Team
Healthcare - The Most Basic Commitment of a Society to its Fellow Citizens
Emergency Healthcare- The Most Vulnerable Stage
Vision for today
There are risks and costs to a program of action. But they are far less than the long range risks and costs of comfortable inaction
John F. Kennedy
Let us reflect throughout today on how to create a foundation for practical and united action
Today's agenda
TopicTopic
Welcome & Introductions
Opening and Keynote Address
Academic role Africa Collaborative for EMS
EMS Development Nairobi Pilot Project
Required Elements of an EMS System
The Call to Action
Identification of Next Steps
ObjectiveObjective
Review of: Emergency Medical System a Priority of the Ministry of Medical Systems Reforms Agenda
Review the role of universities and researchers in facilitating this process
Set the foundation for the pilot project
Review lessons learned from India’s EMRI Program
Stakeholders group discussion to align on practical action
Outline immediate next steps
This section WIPThis section WIP
A new model of health care needs to be developed
Silo approach to health care has failed us
Care coordination is needed at every level and every transition point• Pre-Hospital (Emergency Care)• Hospital• Rehab• Chronic & Long-Term Care
Current system prevents comprehensive care coordination: This is a global problem
What are alternate approaches?
Sustainable change requires systems thinking and the collaboration of three groups
Academia
GovernmentPrivate
Sector & NGOs
Working together in a balanced and collaborative manner is key
Emergency medicine is a consistent challenge globally
Emergency Medical System- A Global Problem
The Continuous Improvement Challenge in Developed Nations
A “Silent Killer” in Developing Nations• Sub Saharan Africa, South America, MENA, U.S. (Underserved)
Role of academia is valuable as a facilitator and developer of insights
Relative Independence
U.S. Universities: University of California, Stanford University, (Duke, UNC, etc)
Local Universities: TBD
Multi-Level, Multi-Profession Systems Thinking• School of Medicine• School of Management• School of Nursing• School of Education
Review of pilots
Africa Pilots
Nigeria, South Africa, Kenya,
Why Kenya?
East Africa- Kenya, Tanzania, Nairobi Pilot(s):• Phase I- Initial 2 sites, Consult & Consensus- • FAST (NO WRONG DOOR)
Today's agenda
TopicTopic
Welcome & Introductions
Opening and Keynote Address
Academic role Africa Collaborative for EMS
EMS Development Nairobi Pilot Project
Required Elements of an EMS System
The Call to Action
Identification of Next Steps
ObjectiveObjective
Review of: Emergency Medical System a Priority of the Ministry of Medical Systems Reforms Agenda
Review the role of universities and researchers in facilitating this process
Set the foundation for the pilot project
Review lessons learned from India’s EMRI Program
Stakeholders group discussion to align on practical action
Outline immediate next steps
Today's agenda
TopicTopic
Welcome & Introductions
Opening and Keynote Address
Academic role Africa Collaborative for EMS
EMS Development Nairobi Pilot Project
Required Elements of an EMS System
The Call to Action
Identification of Next Steps
ObjectiveObjective
Review of: Emergency Medical System a Priority of the Ministry of Medical Systems Reforms Agenda
Review the role of universities and researchers in facilitating this process
Set the foundation for the pilot project
Review lessons learned from India’s EMRI Program
Stakeholders group discussion to align on practical action
Outline immediate next steps
International EM – A Case Study
India – GVK Emergency Management and Research Institute (EMRI) Collaboration with Stanford University, USA.• Dr. S Mahadevan, Stanford Emergency Medicine
Developed a successful Emergency Medical Services System in several states in India
Overview of this system
GVK EMRI
Started in August 2005
Not-for-profit professional organization operating in the PPP mode• Private entrepreneur funded initial startup costs• Government provided 108 emergency service and legislation
Only professional emergency service provider in India today
Handles medical, police and fire emergencies through the "1-0-8 Emergency service”
Quick Facts
Over 1900 Ambulances and 15 Prime Responder Vehicles across 9 states
Ambulance reaching in 14 minutes in urban areas and 22 minutes in rural areas
100% Virtual handholding by Paramedic and Physician in critical cases
Medical Emergencies (Vehicular Trauma 18%, Maternal Complications 22%, Suicidal attempts 6%, Cardiac 4%, etc)
46,000 + Lives saved
12,000+ Associates – Ambulance (90%), ERC (5%), Support (5%) Source: http://www.pressreleasepoint.com/node/165826/pdf
EMRI EMS Project
Emergency Medical Technician (EMT) Training program• Extensive education initially provided by Stanford, trained Indian
instructors who now train future EMTs.
Universal toll-free number
Call Center that dispatches ambulance
Provided jobs for community
EMRI EMS Project
Improves healthcare
Created public demand
When private funding reduced, public implemented policy for EMS
Now funded by Indian Government and private sources
Expanded to several other Districts
Key Points for an EMS System
Learning from India’s EMRI EMS project, sustainability is the TOP priority in design
Infrastructure• Emergency Number• Call Center• Employees (Nurses, EMT, Doctors)• Hospital Emergency Departments
Key Points for an EMS System
Education• Community Emergency education• EMT, ER Nurse, Emergency Doctor
Cooperation/Dedication• from Stakeholders
Public Health
In response to resolution WHA60.22 on emergency-care systems, adopted by the World Health Assembly, May 2007, WHO/Europe actively contributes in the following aspects:• Devising standardized tools and techniques for assessing need for pre-
hospital and facility-based capacity in trauma and emergency care• Reviewing legislation • Determining standards of essential trauma and emergency care• Providing guidance for the creation mass-casualty management systems• Encouraging research
International EM – Emerging Areas
Will Kenya have the first Comprehensive Emergency System in Sub-Saharan Africa?
A chance to be a leader amongst Sub-Saharan African nations?
Thank You
Acknowledgements (to name a few)• UCLA EMPH, Fred Hagigi DrPH, MBA, MPH• Charles Otieno, M.D., MPH, Jonathan Crisp, M.D.• Shubha Kumar, DrPH, Julie Elginer, DrPH MBA• Nanette Ramzan, Edith Omwami PhD• S. Mahadevan, M.D.• Jerome Hoffman M.D., Scott Votey M.D., Seve Rottman M.D., Marshall
Morgan M.D.• UCLA Emergency Medicine residency• Luis R. Goldfrank, M.D.
Today's agenda
TopicTopic
Welcome & Introductions
Opening and Keynote Address
Academic role - Africa Collaborative for EMS
EMS Development: Nairobi Pilot Project
Required Elements of an EMS System
The Call to Action
Identification of Next Steps
ObjectiveObjective
Set the foundation for today's conference
Review of: Emergency Medical System a Priority of the Ministry of Medical Systems Reforms Agenda
Review the role of universities and researchers in facilitating this process
Set the foundation for the pilot project
Review lessons learned from India’s EMRI Program
Stakeholders group discussion to align on practical action
Outline immediate next steps and preparation for Thursday
This section WIPThis section WIP
Today's agenda
TopicTopic
Welcome & Introductions
Opening and Keynote Address
Academic role - Africa Collaborative for EMS
EMS Development: Nairobi Pilot Project
Required Elements of an EMS System
The Call to Action
Identification of Next Steps
ObjectiveObjective
Set the foundation for today's conference
Review of: Emergency Medical System a Priority of the Ministry of Medical Systems Reforms Agenda
Review the role of universities and researchers in facilitating this process
Set the foundation for the pilot project
Review lessons learned from India’s EMRI Program
Stakeholders group discussion to align on practical action
Outline immediate next steps and preparation for Thursday
This section WIPThis section WIP
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