proposal for new emergency medical services …proposal for new emergency medical services program...

Proposal for New Emergency Medical

Services Program for Arriyadh

INTERNATIONAL TOTAL ENGINEERING CORPORATION

Adviser Dr. Tatsuro Kai : Vice President, Osaka Senri Saiseikai Hospital

Dr. Katsuhiko Sugimoto : Professor, Kokushikan University

Dr. Noriaki Aoki : Assistant Professor, University of Texas

Mr. Ryo Chida : Lecturer, University of Toyama

INTERNATIONAL TOTAL ENGINEERING CORPORATION INTERNATIONAL TOTAL ENGINEERING CORPORATION

Introduction

1

The Prince Sultan Emergency Medical Services Program for Arriyadh is

one of the special project under the patronage of His Royal Highness,

Prince Sultan bin Abdulaziz, the Crown Prince.

We received the invitation letter for a bid for the professional services for

this project on last May in 2011 by ADA (Arriyadh Developmet Authority).

And We participated in a bid for professional consulting services on last

July in 2011.

But unfortunately the project bid has been canceled. Because of all prices

of the submitted proposals are exceeded the allocated budget.


Background

2

ADA invited 2 Japanese emergency physicians, Dr. KAI and Dr.

SUGIMOTO to Riyadh in 2010.

T.KAI: Vice President of Osaka Saiseikai Senri Hospital

K.Sugimoto: Professor of Kokushikan University

They discussed current challenges in the emergency medical system in

Riyadh and some leading physicians in Saudi Arabia admired Japanese

emergency medical model to reduce the number of fatalities by traffic

accident.


Traffic Affairs in Arriyadh

Cause of Death in Arriyadh in 2009

Illness Pregnancy

Delivery

Traffic

Accidents

Other

Accidents Others Total

Male 6,220 458 1,264 475 1,481 9,898

Female 4,713 1,344 287 133 275 6,752

Total 10,933 1,802 1,551 608 1,756 16,650

Number of Death

per 100,000 pop. 187.3 30.9 26.6 10.4 30.1 28.5

3

Traffic accidents are a major concern in Arriyadh.

Compared with OECD countries, the number of death caused by

traffic accidents per 100,000 population in Arriyadh is extremely high.

OECD countries: 8.2


Current Major Challenges

The emergency system in Arriyadh is in extremely high demand.

The integrated command system is not well-developed.

4

Uneven Distribution

Of the Patients

Increasing Demand

Increasing Traffic Accidents

Population Growth

Overcrowded ER Beds

Existing Hospitals

Imbalance between

Supply and Demand

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Basic Policy

5

A new emergency care model in Arriyadh based on the

Japanese model.

The establishment of Japan Saudi Arabia Emergency

Medical Association.

Project based on Japan’s comprehensive highly

developed technology.

Our policies on this project follow the propositions below:



Japanese emergency care model①

6

Mild

Moderate

Serious

Severity

Transfer of patients

Tertiary emergency care

Secondary emergency care

Rear hospital

Home

Discharge Patients:

Emergency transport

(Ambulance etc.)

Patients: On foot etc.

Patients: Emergency transport (Doctor

Helicopter)

Primary emergency care

Transport

Transport

Transfer of patients



Japanese emergency care model②

7

Serious


Japanese traffic accident fatality

Qualifications and training for paramedics began in 20 years ago.

The traffic accident fatality has decreased by 53% in the past 20 years.

8

全国の交通事故　　年次推移（件数・死亡者）

0

100,000

200,000

300,000

400,000

500,000

600,000

700,000

800,000

900,000

1,000,000

1989

年

1990

年

1991

年

1992

年

1993

年

1994

年

1995

年

1996

年

1997

年

1998

年

1999

年

2000

年

2001

年

2002

年

2003

年

2004

年

2005

年

2006

年

2007

年

2008

年

件数

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

死亡者数

件数

死亡者

▼救急救命士法制定

Death

Cases

DeathCases

The Number of Accidents in JapanAnnual Transition (The Number of Cases and Death)

The Enactment of The Emergency Life-saving Technicians Act

89 90 91 92 93 94 95 96 97 98 99 00 01 02 03 04 05 06 07 08


Japan Saudi Arabia Emergency Medical Association

Research and survey

Exchanging Program

Holding training and educational seminars

policy-making support

Consulting services

9

JAPAN SAUDI ARABIA

EMERGENCY MEDICAL

ASSOCIATION

The Association will contribute to the

emergency medical services and education

in Arriyadh by conducting:


Japanese highly developed technology

Planning for the emergency care system

Operation and management of healthcare facilities

Construction design and engineering for healthcare facilities

IT for the integrated command system in emergency care

Management of emergency and local healthcare

Various types of outsourcing

10

Preferred Model Option (PMO) Development

Japan has many specialists in:


Concept of a new emergency care model

11

ECC

1～2

10

UCC

・・・

UCC-1 ・・・ UCC-15

2～3

Each UCC

Rehabilitation Hospitals

Home

Existing Hospitals Intensive Care

Legend

L:1 ･･ CTAS Level 1





L:3-4

L:1-2

L:1-2

L:1-2

L:5

L:3-4

L:5

Existing Hospitals

L:1-2

ICC CEMS

Instructions Call Triage

Staff Training


Developing service programs for ECC

ECC will play the central role in the emergency care system and disaster

medical care in Arriyadh.

The major functions of ECC assumed in the present stage are as follows:

12

-The Outline of the Service Programs-

Number of beds: 500

ICU and burn beds.

10 ambulances, 1 or 2 helicopters.

24 hours a day, 7 days a week.

Full range of diagnostic and support services (CT, MRI, angiography

and sonography etc.)

Length of stay: around 7 days.

Direct admission protocols (severe and critical cases of CTAS Levels 1-2)

…etc.

Detailed functions and configuration of each center shall be proposed after

conducting field surveys of the current state of emergency care in Arriyadh.


Developing service programs for UCCs

UCCs will serve as a center of triage for emergency patients.

The major functions of UCCs assumed in the present stage are as follows:

13

15 centers shall be established in Arriyadh.

Number of beds: 35

2 or 3 ambulances at each UCC

Triage by nurses before medical examination.

24 hours a day, 7 days a week.

Full range of diagnostic and support services(CT, MRI, angiography and

sonograpy etc.)

Observation: 1-3 days …etc.

Detailed functions and configuration of each center shall be proposed after

conducting field surveys of the current state of emergency care in Arriyadh.

-The Outline of the Service Programs-


14

UCC

Emergency Care Facilities

ECC

ICC (image) (Co-located with ECC)

Arriyadh Development Authority

Supervise

② Call Triage

Patient acceptance information database

Ambulance position

information database

Emergency Control Screen

Emergency Information system

Accident! 997

Hospital Information System

Medical Cloud

Decision-Making Support Algorithm

GPS

GPS

GPS

Information of patient acceptance

③ Ambulance dispatch command ④ Instructions on destination

① Accident Information

⑨ Data registration

⑦ Patient’s condition ⑧ Transport

⑤ Rush to the site

GPS position information

Developing service programs for ICC

Emergency Info. Data Bank

⑥ On-site Triage

-Conceptual Scheme of Emergency Information System-

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Developing CEMS education programs

15

-Basic Concept-

Educational Institution

CEMS

・Job Training ・Department Classes ・Graduate Schools Classes ・Specialist Training ・Number of Students: 1,000 ・Facility Area: 50,000㎡

・Indoor and Outdoor Space for Simulation

Existing Hospitals

Trainer

Trainee

Graduates

Medical

Staff

Japan

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