CTEMSC Quarterly Advisory - September 22, 2020

1. Introductions

2. Intake Form – Tool to help identify target areas hospital and EMS agencies, contact

3. Family Advisory Network (FAN) – Nanfi Lubogo and Jennifer Groves Fusco serve as co-chairs.  The organization works parent to CTEMSC community to address issues that affect families with special needs children up to 26 years old. Along with FAN, Nanfi serves on the National EMS FAN and National EMS Counsel. Nanfi and Jennifer have been working with Victoria and CTEMSC on educational training and assisting with the PECC project.

4. Target Issues Grant/PECC project – Dr. Cicero shared that this is a national four-year effort being conducted in Connecticut, Rhode Island and Colorado to study:
     a. If there is improved patient care and outcomes if there is a PECC in place at that agency
     b. If there are better outcomes as a result of additional training such as simulations
     c. Family Satisfaction and developing a tool; Dr. Cicero reported that the tool has been submitted for publication to the Pre-hospital Emergency          Care Journal and it has been accepted
If any agency would be interested in conducting a simulation, we would be happy to
come out. Please contact
Victoria Barnes or Mark Cicero


5. How has COVID-19 Influenced protocols – The team has been working with physicians to study patient care and determine if and how protocols have changed during the pandemic. The study includes all patients not just pediatric. Dr. Richard Kamin is among the providers interviewed (we are grateful to Dr. Kamin for his time and willingness to meet with us). Dr. Cicero announced that a preliminary abstract has been submitted to the National Association of EMS Physicians.

6. ACEP SimBox – low fidelity manikin that comes with step-by-step guide, in collaboration with YouTube videos. The SimBox is a free resource, and readily available.

7. Hospital based work:
     a. National Pediatric Readiness Assessment was scheduled to be delivered during summer, but postponed until June 2021. 
The survey includes      pediatric policies and  procedures, PECC, supplies, annual education and staffing. In the meantime, we can work with hospitals to key everyone up.
     b. Transfer Tool - Connecticut scores tend to do quite well, but we can work to identify things that we can do to improve scores. In collaboration with  CCMC, Yale, and FAN over the next few months we will be working to help make transfers of children more smoothly. We will be using the information you shared on the Intake Survey to form a workgroup to help develop the transfer tool.

          • Creating a Guideline
                 o No written process agreement is currently in place at all Connecticut hospitals. It would be helpful to have an established guideline to help providers and staff determine when to call ambulance and when it should be escalated.
                 o Embed into EMR so that staff can easily access as opposed to searching for a document
          • Creating a Checklist – to give parent as to where to go, where to park, and other helpful information in moments that are stressful as it is.

     c. Transfer Agreement – Given the number of networks within the state, geography trumps the agreements in place, we feel it is best to postpone re-examining transfer agreements at this time.

Additional comments:
          o UCONN, who partners with CCMC on patients 16 years or younger, have access through transfer line via EMS or transport. The line works well and easily discuss what should/should not be done on patient care side.
          o CCMC’s transfer line has made process easier; trauma patients up to age 21 are now considered pediatric.
          o Jennifer Tabak welcomes any suggestions and feedback. You can contact her
          o Be mindful of young adults who families struggle as to where they should take the patients because of their age.
          o Senders and receivers should be made aware of the uniqueness of Connecticut.

8. Pediatric Emergency Care Coordinator (PECC) Defined
          o What is a PECC?
              It is a physician, nurse or clinician who will serve as a point of contact and liaison between ED leadership and CTEMSC.
          o What is a PECC responsible for?
              He/she ensures availability of equipment and supplies, helps with QI improvements and to bring education/training to the facility.
          o How much time does a PECC need to commit?
              About an hour a week, as well as attending quarterly meeting.
          o Why is having a PECC important?
              Having a PECC has shown to advance care of children, pediatric scores are higher, and mortality decreased.

9. Help Us Help You!
We would like to create working groups both for individual local topics and/or
synergizing across the state collectively on QI work. Please share your ideas and
suggestions for projects – please send an email to us. We will set up a call to work
through it together.

10. Education and Training
     a. In-person Simulations – we will be creating a Sign Up Genius to set up simulation sessions before the next quarterly and will be emailing out the link.
     b. SimBox – quick scenarios, not much time required of staff
     c. Virtual sim – facilitator from our team will be remote, while the participants can be either present or remote. Eventually, the PECCs will feel more comfortable leading the simulation and will conduct them independently. This format is more interactive.

Next Quarterly Advisory Meeting: Tuesday, December 8th at 9am EST