“Health and Wellness for all Arizonans”

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Bureau Of Emergency Medical Services & Trauma System

150 N. 18th Avenue, Suite 540 Phoenix, Arizona 85007-3248

602-364-3150

TRAUMA AND EMS PERFORMANCE IMPROVEMENT (TEPI)

STANDING COMMITTEE Date: November 16, 2017 - Time: 09:00 hrs

Location: 150 N. 18th Avenue, Conference Rooms 215A & 215B, Phoenix, AZ 85007 Via computer with call back: azgov.webex.com, meeting code 804 590 499, password TEPI2017

Via telephone: dial 240-454-0879, meeting code 804 590 499 (#)

AGENDA I. Call to Order – Bill Ashland, Vice Chair II. Roll Call – Shelley Bissell (25 Members, 13 required for quorum)

III. Chairman’s Report – Bill Ashland, Vice Chair

a. Attendance report (Attachment III.a.) b. 2018 Meeting Schedule (Attachment III.b.) c. Regional EMS and Hospital Data Integration (ESO data hub) update

IV. Bureau Report – Taylor George, Bureau Liaison

a. ASENA – 2016 Arizona Statewide Emergency Medical Services Needs Assessment (Attachment IV.a.)

b. Premier EMS Agency Standards revision update c. AZ-PIERS & ASTR Bridge d. Fall 2017 Issue of AzHEAT e. Stop The Bleed in AZ

V. Discussion and Action Items

a. Discuss, amend, and approve TEPI meeting minutes of July 20, 2017 (Attachment V.a.)

b. Discuss, amend, and approve TEPI bylaws (Attachment V.b.)

VI. Progress Reports a. EMS Registry Users Group (EMSRUG) - Robert Corbell b. Trauma Registry Users Group (TRUG) - Melissa Moyer c. Trauma Program Manager Workshops – Heather Miller

VII. Agenda items to be considered for the next meeting VIII. Call to the Public

A public body may make an open call to the public during a public meeting, subject to reasonable time, place and manner restrictions, to allow individuals to address the public

“Health and Wellness for all Arizonans”

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body on any issue within the jurisdiction of the public body. The Board may ask staff to review a matter, or may ask that a matter be put on a future agenda. Members of the public body shall not discuss or take legal action on matters raised during an open call to the public unless the matters are properly noticed for discussion and legal action. A.R.S. § 38-431.01 (G). Persons with disabilities may request reasonable accommodations such as a sign language interpreter, by Angie McNamara, Program Project Specialist II, 602-364-3156; State TDD Number 1-800-367-8939; or Voice Relay Number 711. Request should be made as early as possible to allow time to arrange accommodations.

IX. Summary of Current Events a. November 7, 2017 – Arizona Public Safety Broadband Program/FirstNet Regional Forum in

Tucson, AZ http://info.mcp911.com/arizona-public-safety-broadband-forum-0 b. November 16 - 17, 2017 - 9th Annual Southwest Trauma & Acute Care Symposium - Talking

Stick Resort, Scottsdale, Arizona c. November 29, 2017 – Arizona Public Safety Broadband Program/FirstNet Regional Forum in

Flagstaff, AZ http://info.mcp911.com/arizona-public-safety-broadband-forum-0 d. December 13, 2017 – Arizona Public Safety Broadband Program/FirstNet Regional Forum in

Chandler, AZ http://info.mcp911.com/arizona-public-safety-broadband-forum-0 e. December 14, 2017 – Arizona Public Safety Broadband Program/FirstNet Regional Forum in

Phoenix, AZ http://info.mcp911.com/arizona-public-safety-broadband-forum-0 f. January 17, 2018 - EMS for the Future 2050 - Los Angeles, California g. March 1, 2018 - EMS for the Future 2050 - Dallas, Texas h. March 12- 13, 2018 - Arizona Pediatric Symposium - Flagstaff, Arizona

X. Next Meeting

March 15, 2018 @ 09:00 hrs, Arizona Department of Health Services, 150 N. 18th Ave, Rooms 215A & B, Phoenix, AZ 85007

XI. Adjournment

Attachment III.a.

Bureau of Emergency Medical Services and Trauma System

2018 Statutory/Standing Committee Meetings

Date Time Meeting Conference Room

January 18, 2018 9:00 a.m. State Trauma Advisory Board 215A & 215B – 2nd Floor

150 Bldg

January 18, 2018 10:30 a.m. Emergency Medical Services Council 215A & 215B – 2nd Floor

150 Bldg

January 18, 2018 12:00 p.m. Medical Direction Commission 215A & 215B – 2nd Floor

150 Bldg

March 15, 2018 9:00 a.m.

Trauma and EMS Performance

Improvement (TEPI) 215A & 215B – 2nd Floor

150 Bldg

March 15, 2018 10:30 a.m. Education Committee 215A & 215B – 2nd Floor

150 Bldg

March 15, 2018 12:00 p.m.

Protocols, Medications and Devices

Committee 215A & 215B – 2nd Floor

150 Bldg

May 24, 2018 9:00 a.m. State Trauma Advisory Board 215A & 215B – 2nd Floor

150 Bldg

May 24, 2018 10:30 a.m. Emergency Medical Services Council 215A & 215B – 2nd Floor

150 Bldg

May 24, 2018 12:00 p.m. Medical Direction Commission 215A & 215B – 2nd Floor

150 Bldg

July 19, 2018 9:00 a.m.

Trauma and EMS Performance

Improvement (TEPI) 215A & 215B – 2nd Floor

150 Bldg

July 19, 2018 10:30 a.m. Education Committee 215A & 215B – 2nd Floor

150 Bldg

July 19, 2018 12:00 p.m.

Protocols, Medications and Devices

Committee 215A & 215B – 2nd Floor

150 Bldg

September 27, 2018 9:00 a.m. State Trauma Advisory Board 215A & 215B – 2nd Floor

150 Bldg

September 27, 2018 10:30 a.m. Emergency Medical Services Council 215A & 215B – 2nd Floor

150 Bldg

September 27, 2018 12:00 p.m. Medical Direction Commission 215A & 215B – 2nd Floor

150 Bldg

November 15, 2018 9:00 a.m.

Trauma and EMS Performance

Improvement (TEPI) 215A & 215B – 2nd Floor

150 Bldg

November 15, 2018 10:30 a.m. Education Committee 215A & 215B – 2nd Floor

150 Bldg

November 15, 2018 12:00 p.m.

Protocols, Medications and Devices

Committee 215A & 215B – 2nd Floor

150 Bldg

DISCLAIMER: “Meeting schedule subject to change upon the request of the Governor’s Office or the

Office of the Director. Should this occur, the Bureau will make all reasonable efforts to contact the affected

members as soon as feasible.”

9/28/2017

Attachment III.b.

ABSTRACT

Emergency Medical Services (EMS) is an institution and product of public health, health care,

and public safety that is chopped and scattered across multiple jurisdictional deployment methodologies

throughout Arizona. To fully-asses the EMS needs of the state, those jurisdictions are considered as a

whole; for it is the whole that makes a system, and a system is what truly impacts patient outcomes.

Evaluating the "whole" is the genesis and driver of the 2016 Arizona Statewide EMS Needs Assessment

(ASENA).

The primary objective of ASENA is to establish a current "snap-shot" of EMS in the state while

simultaneously identifying needs and/or areas that can be targeted for further analysis and/or

improvement as part of Population Health Management and Emergency Medical Services Integration

under the AZ Flex Grant funded by the U.S. Health Resources and Services Administration (HRSA). In

addition, the secondary objective of ASENA is to compare and contrast this current "snap-shot" with

data obtained in a more narrow needs assessment conducted in 2001, allowing comparison of changes

in Arizona's critical access EMS system over 15 years.

To accomplish this, a 105-question needs assessment survey tool was developed and distributed

to EMS agencies throughout the state. The fully-vetted survey tool collected information pertaining to

sixteen core functional sections. Eighty-six agencies fully-completed the needs assessment survey tool,

with respondents evenly distributed across the state's four EMS coordinating regions and representative

of the various service-delivery methodologies. The combined service areas of the respondents cover

over 85% of the state's population.

Arizona's statewide EMS system is well organized and positioned to deliver advanced levels of

prehospital care for the vast majority of its citizens and visitors, with some variation between urban and

rural regions. Key needs identified relate to: patient care reporting between EMS providers, emergency

departments and receiving hospitals; quality assurance activities; education and skills training programs;

dispatch system capabilities; mass casualty and public health preparedness; equipment and supplies;

and more robust use of data and analyses to inform continuous EMS system improvement.

George TA. 2016 Arizona Statewide EMS Needs Assessment. Page 9 of 286

Attachment IV.a.

TRAUMA AND EMS PERFORMANCE IMPROVEMENT (TEPI)

July 20, 2017

150 N. 18th

Ave., Conference Room 215A & 215B

DRAFT MINUTES

I. Call to Order - The meeting was called to order at 9:05 a.m. A quorum was present.

II. Roll Call – ( 25 Members, 13 required for quorum)

Present Absent

Bill Ashland

Brian Bowling

Chris Salvino, MD*

Darlene Herlinger*

Eric Merrill

Gail Bradley, MD

Garth Gemar, MD*

Jill McAdoo

Josh Gaither, MD*

Mary McDonald*

Melissa Moyer

Michelle Guadnola

Pamela Goslar*

Rebecca Haro

Robert Corbell*

Tiffiny Strever

Dale Woolridge, MD

Danielle Stello

Heather Miller

Jeffrey Schaff

Pam Noland

Paul Dabrowski, MD

Ralph Zane Kelly,MD

Summer Magoteaux

*indicates member participated electronically

III. Chairman’s Report – Bill Ashland, chaired the meeting, Chris Salvino, MD, chair

attended by conference call

a. Attendance report - included in the packet for members

IV. Bureau Report – Terry Mullins, Chief, reported that the Bureau has been reorganized

into the Services Section and the Regulatory Section. We will be launching this change

on August 1, 2017.

a. Introduction Taylor George, Services Section Chief

Terry Mullins gave background and credentials of Taylor, and described his

role in the reorganization of the Bureau.

o Taylor reported on his role as oversight of Epidemiological Data and

Quality Assurance, Strategic Planning and Recognition Programs,

Fellowship and Internship Programs, Statutory and Standing

Committees, and Time Sensitive Illness and Injury, and other duties.

b. Premier EMS Agency Standards Revision

We will be starting a taskforce to see if the standards need to be revised

and/or added and will be formerly asking Rebecca to head up this taskforce

for us.

c. V3 Transition

July 1, 2017 was the official transition date to the version 3.4 of the EMS

dataset.

d. Bylaw Review

All the statutory committee bylaws need to be revised so we will be forming

a workgroup for that purpose. The goal is try to keep them all similar.

V. Discussion and Action Items

a. Discuss, amend, approve, TEPI meeting minutes of March 16, 2017

Attachment V.a.

Rebecca Haro made a motion to approve the minutes. Dr. Gail Bradley approved

the minutes as presented and Michelle Guadnola seconded the motion.

Motion carried.

VI. Progress Reports

a. EMS Data Cube and Trauma Triage Logic Filter Workgroup

Taylor George reported that the bureau will be building this out at the state level.

The workgroup has taken a pause but will be starting back up.

b. Services Section Update

Taylor George reported that Vatsal Chikani is now the manager of the

epidemiology data and quality assurance program. Paula Brazil is now the

manager of the Time-Sensitive Illness program. Ithan Yanofsky is running the

Regulatory Section. The first issue of the new reporting structure will be going

out at the end of July. Each issue will have a main focus area.

c. EMS Registry Users Group (EMSRUG)

Robert Corbell reporting that we are no longer excepting version two data. We

are completely up to date in regards to the international standards.

d. Trauma Registry Users Group (TRUG)

Melissa Moyer reported that TRUG met yesterday, July 19th

, she stressed the

need to make sure that state submissions are done on a timely manner. There will

no longer be a grace period. HonorHealth is hosting a report writing class on

August 1 - 3, 2017. The new pathway to submit data for the NTDB and TQUIP is

going to be changing to the trauma cloud. If you have not registered please talk to

your vendor. You can no longer submit data or run reports through the NTDB.

e. Trauma Program Manager Workshops

Kimberly Boehm reported that the last workshop was in March and the next one

is tomorrow July 21, 2017 at Wickenburg Community Hospital.

VII. Agenda Items to be considered for the Next Meeting – No items were presented.

VIII. Call to the Public:

David Harden asked if updates on Naxolone administration and the opioid epidemic

data can be included as a standing agenda item. Taylor reported the data is public

record, but any further data is not available to be discussed at an open forum.

IX. Summary of Current Events

a. August 3 - 4, 2017 - 28th

Southwest Regional Trauma Conference, Tucson, AZ

b. August 17 - 18, 2017 - Trauma Conference International, Live-Simulcast, In-

Person (Toronto, Canada) - https://traumacon.org/

X. Next Meetings: November 16, 2017 @ 9:00 AM, 150 N. 18th

Ave. Rooms 215 A & B

XI. Adjourn: 9:20 am

Approved by:

Date:

BYLAWS

Standing Committee Title: Trauma and EMS Performance Improvement Standing Committee

Standing Committee Acronym: TEPI

Article I: Purpose

The Trauma and EMS Performance Improvement (TEPI) Standing Committee is formed to assist the

Statutory Councils (State Trauma Advisory Board, Emergency Medical Services Council and

Medical Direction Commission) and the Bureau in carrying out the duties described in statute and

rule relating to quality improvement of the State’s EMS and trauma system. This is accomplished by

aiding the Bureau’s Data and Quality Assurance Program in the development of guidelines, reports,

and recommendations to the Statutory Councils. Importantly, TEPI’s review of provider level data is

limited to routine system performance indicator analysis and cannot be used for regulatory purposes.

Specifically, TEPI shall:

1. Provide recommendations to the Bureau for the development of system performance

indicators relating to the emergency care system inclusive of dispatch, first response,

transport, emergency department, in-patient and rehabilitative care.

2. Review and suggest changes to Bureau developed reports based upon system performance

indicators

3. Recommend to the Statutory Councils specific system performance enhancements to the

State’s emergency care system.

4. Review and consider evidence-based research dealing with emergency care system and make

recommendations to the Statutory Councils for possible changes in system practice.

5. Periodic review and recommendations for changes in the data-sets pertaining to emergency

care system registries.

Article II: Committee Liaison

The intent of this article is to provide for the timely and appropriate exchange of information

between the Standing Committee and the three Statutory Councils. All Standing Committees shall,

therefore, have a minimum of one member from each of the three Statutory Councils in their

membership to serve as liaisons.

The Chief of the Bureau of Emergency Medical Services and Trauma System, or designee, shall also

attend and support the timely and appropriate exchange of information between the Standing

Committee and the three Statutory Councils and to provide staff support and technical support to the

Standing Committee including notification of pending actions or issues which may be within the

scope of the Standing Committees’ purpose.

Article III: Members

Section 1: Committee Membership

Membership of the TEPI shall consist of no more than 25 members from a diverse representation of

individuals from throughout the state. There will be Standing Committee members selected from

each of the four EMS Regions. The Medical Director, Standing Committee Chair and Bureau Chief,

under the advice of the Bureau Liaison, shall solicit and appoint members. The following members

are required:

Attachment V.b.

A member of the State Trauma Advisory Board

A member of the Medical Direction Commission

A member of the Emergency Medical Services Council

Section 2: Terms of Membership

There is no specific term of membership, however, the Medical Director, Standing Committee Chair

and Bureau Chief, under the advice of the Bureau Liaison, shall periodically review member

attendance (Article V, Section 4) and if necessary, remove a member due to failure to meet the

attendance requirement.

Section 3: Compensation

Standing Committee members shall not be eligible to receive compensation.

Section 4: Voting

Each member of the Standing Committee shall be entitled to one vote when present in person or via

electronic media at a meeting of the Standing Committee. No individual member shall cast more than

one vote on the Standing Committee. Voting by proxy and/or alternate voter shall not be permitted.

Section 5: Vacancies

Standing Committee vacancies shall be filled through appointment by the Medical Director, under

the advice of the Standing Committee Chair,Bureau Chief and the Bureau Liaison, with

consideration given to individuals with expertise consistent with the Standing Committee purpose.

The Bureau Liaison shall be responsible for informing the Medical Director, Standing Committee

Chair and Bureau Chief of vacancies.

Article IV: Officers

Chair: The Standing Committee Chairs shall be chosen as follows:

Education Standing Committee – EMS Council

Protocols Medications and Devices Standing Committee – MDC

Trauma and EMS Performance Improvement Standing Committee – STAB

Vice Chair: The Vice Chair of the Standing Committee shall be filled through appointment by the

Medical Director, Standing Committee Chair and Bureau Chief, under the advice of the Bureau

Liaison, and shall serve as the Standing Committee Chair in his/her absence. On resignation a new

Vice Chair shall be selected by the next regular meeting.

Article V: Meetings

Section 1: Regular Meetings:

The regular meetings of the Standing Committee shall be held, at a minimum, three times per year at

a time and place designated by the Chair and Bureau.

Section 2: Special Meetings

Special meetings and/or telephone meetings may be called by the Chair in agreement with the Bureau

Liaison, or by written request of five (5) members of the Standing Committee and must comply with

the Open Meeting laws.

Section 3: Notice of Meetings

Standing Committee members shall be notified ten (10) days in advance of all Standing Committee

meetings. A yearly schedule of regular Standing Committee meetings shall be made available to

Standing Committee members in January. Minutes of the previous meeting and an agenda for the

upcoming meeting should be available to members ten (10) days in advance of the Standing

Committee meeting.

Section 4: Attendance

Regular attendance is expected of all Committee members. If a member fails to attend two (2)

consecutive meetings, an inquiry shall be made by the Bureau Liaison of that member concerning

their continued participation on the Board, and the results of the inquiry shall be forwarded to the

Medical Director, Committee Chair, and Bureau Chief for a decision on the member's status.

Section 5: Quorum

A quorum consists of a simple majority (50% plus one) of the entire membership, whether the

position is filled or vacant, present in person or via electronic media.

Article VI: Parliamentary Authority

The rules contained in the current edition of Robert’s Rules of Order Newly Revised shall govern the

Standing Committee in all cases to which they are applicable and in which they are not inconsistent

with these bylaws.

Article VII: Open Meeting Law

The Arizona Open Meeting Law (A.R.S. 38-431-A.R.S. 38-431.09) shall apply to meetings of the

Standing Committee.

Article VIII: Minutes

Minutes of each Standing Committee Meeting will be recorded and the Standing Committee shall

have the rights of review and correction of minutes of all meetings before publication and

distribution.

Article IX: Motions

All motions passed by this Standing Committee will be forwarded to the Statutory Councils for

review and/or action at their next regularly scheduled meeting.

Article X: Amendments

These bylaws can be amended at any regular meeting of the Standing Committee by a majority vote

of the entire membership, provided that the amendment has been submitted to the members in written

form ten (10) days in advance of the meeting. Bylaws will be reviewed, at a minimum, every three

(3) years.

Approved: 02/02/11

Revised & Approved: 11/21/2013