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Local News

Louisville Metro EMS Targets Veterans For Training

For the first time, Louisville Metro EMS is targeting veterans for its next EMT training academy.

“They’re disciplined. They understand chain of command. They understand direct order. They understand protocol and process,” said Jennifer Maupin, the personnel coordinator with LMEMS. She’s also an Army veteran.

The idea is partly a response to the EMS agency’s high turnover rate, she said. LMEMS is constantly processing new EMTs and since Maupin joined in March, paramedic positions have always been available.

LMEMS is currently in the process of hiring a small group of new-hires, but starting next month the agency is expecting to find its next cohort of trainees for its academy, and to target veterans.

“Most of the time we’re looking for people that already have the certification as an EMT or paramedic. At the academy class we’re actually going to train them to become the EMT. They are actually going to be paid while they’re in class,” Maupin said.

The idea is also a response to the high veteran unemployment rate and the idea that veterans may be familiar with EMS operations, she said. A soldier’s training and knowledge of protocols are similar to the expectations of an EMS agency, Maupin said.

“I think they would be very good EMTs and paramedics and anybody that’s been in the military or somehow tied to the military can understand that,” she said.

Maupin will attend Congressman John Yarmuth’s veteran’s jobs fair Monday to recruit interested individuals to the program.

Recruitment is expected to be formally announced next month and training would begin early next year.

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Local News

Louisville EMS Program Saves Money, Provides Better Care

Nationwide, ten percent of emergency room visits are non-urgent. People call 911 or go to the hospital for ailments that could be cured at a doctor’s office or clinic. A majority of these patients are on Medicaid or are uninsured, and their ER visits drive up healthcare costs.

That makes them the target audience for a computer program used by Louisville Metro EMS, which could save both the health care system and patients money, while providing more appropriate care.

911 calls in Louisville are route to Metro Safe. Inside it’s quiet and calm by design because on the other line it’s likely not.

Calls may require any combination of police, fire and EMS; others require none of the above and that population is the focus of the Priority Solutions Integrated Access Management program, or PSIAM, and Louisville Metro is the only EMS agency in the country that uses it.

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Local News

Merger Report Recommends Metro Government Consider In-Depth Review

The government consulting firm that released last week’s Metro Government merger report says the city may benefit from a more in-depth audit.

Public Works, LLC came into Metro Government’s $30,000 grant-funded project with an open mind, said senior consultant Marion Reitz. After 100 hours of research, the report affirmed many issues already being discussed in some Merger 2.0 Task Force subcommittees. But the report should be used as just one of the tools to direct Metro Government to areas it should study further, said Reitz.

Certain topics subcommittees discuss are not new. Fire and EMS talk about whether a merger is necessary, solid waste knows its current system allows five different waste collectors to drive all over the county in a less than efficient way. This is why Mayor Greg Fischer appointed the task force.

The report goes further to recommend the county consider merging fire and EMS, re-working its solid waste system by re-contracting and creating more competition among service providers, and keeping better city and county records.

The report should be considered a positive thing, despite recommending the consideration of a fire and EMS merger, said Jeffersontown Fire Chief Randy Lawson. And he said he hopes that the fire and EMS subcommittee can have dialog about what the data shows.

“And we can ask intelligent questions because we’ve had some time to look at it and then say, hey we really think this information is useful let’s build on it or we think this one has a flaw let’s go correct those numbers and we could use it to,” said Lawson.

It has been difficult to collect data on fire and EMS, organize it, and then determine how the two agencies can operate more efficiently. That’s the issue Lawson brings up after determining that the report should be considered one of many pieces of information used to make recommendations to the full task force and then finally to Fischer.

The report further compares Jefferson County suburban and urban fire departments and its EMS to the Nashville, Davidson County merged system, which covers a similar size population. Davidson County spends around $23 million less, the report shows. But many members of the fire and EMS subcommittee have said it’s difficult to compare counties and each should be considered independently.

Among other recommendations, the report says Metro Government should consider a “performance review”, where an outside firm could get into the weeds of how city services are operating, said Reitz.

“We go in and we challenge we what services are being provided, why, why they’re begin provided the way there are and if there are ways to do them more efficiently,” she said.

A performance review is a non-monetary audit that dissects each Metro Government service in depth by working closely with employees in certain service areas, said Reitz. Unlike the current report, there are strong reasons and data backing up recommendations from a performance review, she said.

“There’s really a blue print for what needs to happen in order to achieve the savings. In those instances we have a very high percentage of implementations of recommendations,” she said.

Performance reviews can range in cost from $200,000 to more than $1 million, but it could save Metro Government three to five percent of the general fund, said Reitz.

With less than a month before the full panel is expected to make its recommendations to Fischer, subcommittees will be trying to pull together months of information and data to show how the county has operated since its 2003 merger.

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Local News

Louisville Metro EMS Responds to Recent Activity

Louisville Metro EMS is changing the way it tracks and handles patient medications. This comes after two EMS employees were accused of mishandling drugs. Now the agency will tighten its processes in response, but will still rely on the trust of its employees.

When EMS personnel prescribe medication to a patient, employees are expected to comply with certain protocols to prevent misuse. While the ability to prescribe medication is regulated through the DEA, it’s up to the individual agencies to track and monitor these prescriptions, said Dr. Neal Richmond, director of Louisville Metro EMS.

“How we track and monitor that is an internal process. What I can say is as a result of this case, and identifying that this did indeed happen, we don’t want this to ever happen again. We’re going to make this as airtight and watertight as we can for the future,” said Richmond.

The agency will seek the help of the Louisville Metro Police Department to further regulate EMS protocols. Richmond said he met with Metro PD on Monday and the new protocols will include an extra level of security to prevent further misuse of patient medications.

Richmond wants Metro PD to help regulate the process because the agency regularly deals with discarding narcotics, he said. Metro EMS is treating the situation with urgency and an agreement is likely to be reached soon, said Richmond.

But, the new protocols will still be subject to some level of trust.

“You try the best you can to lock these things down. There’s always an element of trust. In this case there was an egregious breach of trust. It’s something we take to heart. We investigated this very aggressively (and) we’re going to continue to investigate,” said Richmond.

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Local News

Fire and EMS Continue to Look for Common Ground in Subcommittee

Louisville’s Merger 2.0 Task Force subcommittee on fire and EMS met on Tuesday. As the Oct. 1 deadline for recommendations nears, the two departments are struggling to find common ground.

The subcommittee meeting was at times contentious. Fire and EMS have different opinions on how to proceed with the conversation about possible changes to either agency.

Fire officials said they want to look at data and different models that might shed some light on how to be more efficient. EMS said the subcommittee doesn’t have the time or the information to make any major recommendations, such as a merger.

“It might be reasonable to ask an external group to come in who has got serious expertise in this. Everybody here has expertise but this is a pretty time consuming project,” said Dr. Neal Richmond, the director of Louisville Metro EMS.

Richmond said it’s a difficult project to take on with the amount of time and resources the subcommittee has.

Both departments agree that public safety and patient care is a top priority. But the logistics and decisions behind how to operate was sometimes at odds. Members from both sides did recommend improving communication and suggested offering similar technology to all departments so that accountability was consistent.

Each subcommittee member will prepare five suggestions for both fire and EMS at the next meeting on Aug. 23. They will also continue to review data and information, and search for areas where the departments can be more efficient.

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Local News

Heat Stroke Requires Emergency Assistance

After a southern-Indiana teen died of heat stroke last week, questions arose about the accusation that he was denied treatment at an immediate care center.  According to accounts, the boy’s stepfather took him to the Norton Immediate Care Center in Lyndon before calling EMS at the center’s advisement.

A Norton Spokesperson said this week that the boy was not denied care and was not actually brought into the clinic. Rather, his stepfather described his symptoms to the doctors, who referred the man to an emergency room.

State statutes do not require an urgent care center to be equipped to handle ailments like heat stroke, which can be life threatening. The Cabinet for Health and Family Services advises patients with life or limb threatening injuries to seek care at an emergency room or treatment facility.

University of Louisville professor of emergency medicine Timothy Price says patients should think of an urgent care center like a walk-in doctor’s office.

“One of these immediate care center places, you know they don’t have the ability to sort of admit a patient or observe a patient for an extended period of time,” Price says “they’re essentially like a doctor’s office, you wouldn’t expect to to go into your doctor’s and be seen and be able to stay there for four hours while you’re receiving ongoing treatment and then being discharged.”

Price says heat stroke causes disorientation beyond the exhaustion associated with minor heat-related illness, and should always be treated as an emergency.

With the extreme heat this summer, the Cabinet has also issued guidance on avoiding heat-related illness and warns of the dangers associated with them.

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Local News

Fire and EMS Discuss Efficiency and Effectiveness

The Louisville Merger 2.0 fire and EMS subcommittee met for over two hours on Monday. It began with a presentation by Louisville Metro EMS.

It highlighted the agency’s use of new technology and its increased revenue over the past few years. But the agency still relies on fire departments to be first responders, said Walter Lage, chief of Anchorage Fire and EMS.

“EMS needs help from the fire districts and the fire districts need financial help. Now can we get the two of those together I don’t know,” he said.

The subcommittee discussed how both fire and EMS could benefit by sharing technology and saving time and resources, but neither side would say what it would recommend to the mayor.

The subcommittee meets again on Aug. 9. The mayor has asked for recommendations for Merger 2.0 by Oct. 2.

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Blog Archive

Six Degrees of Health Insurance

If you heard my feature on health care costs, you heard a reference to heart catheterization teams being on call. The line turned out to have extra meaning today, making all those attempts to properly pronounce it in the recording booth worthwhile.

At a press conference about emergency care this morning, I learned that Louisville EMS teams now have the ability to transmit EKGs to hospitals where heart catheterization teams will be on call and ready to treat patients based on their EKGs.

When I got back to the newsroom, I called Norton Healthcare to find out about their potential split with Anthem Blue Cross/Blue Shield. Both entities were quoted in my health care feature, and now they’re at odds over, among other things, reimbursements for care.

This could be medical news serendipity or a reinforcement of not only the need for a 24-hour heart catheterization lab, but the necessity of funds, public or private, to pay for it.

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Local News

New EKG Devices Allows For Mobile Diagnosis

Dr. RichmondEmergency medical officials in Louisville have unveiled a new tool designed to help heart attack patients.

Ambulances are now equipped with wireless heart monitors that can send cardiograms to hospitals. Patients suffering from certain types of heart attacks can then be rushed directly to the heart catheterization lab to receive treatment.

EMS director Dr. Neal Richmond says the equipment will allow the diagnoses to be made on the way to the hospital.

“Once that diagnosis is made they will wirelessly transmit that EKG right into the emergency room,” he says. “The doctor will confirm it, they will activate the cath team, even it’s 3 in the morning and we have an agreement that people are going to show up and be in the cath lab.”

Richmond estimates that about 100 patients will benefit from the new equipment every month.

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State of Affairs

Emergency Medicine


Friday, May 8, 2009
Emergency Medicine
It makes for heartstopping TV drama: the ambulance screeching through dark streets, the patient arriving at the ER and being whisked inside under the frenzied but sure hands of doctors and nurses. In the real world, a trip to the ER is often less enthralling and can entail long wait times and lots of folks with non-urgent runny noses. Though the emergency medical system strives to be a well-oiled machine, underfunding and overcrowding can lead to mistakes & inefficiency. Join us on Friday when we’ll talk about the unique challenges of emergency medicine, and how providers overcome them. Photo by Joel Neild.

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