As an EMS executive, keeping up with the burden of requirements for contractual reasons or accountability while preparing your operation for the future has your time stretched thin. With so much of your organization geared towards collecting and reporting information to others, finding the time and responsive tools for your own internal benchmarking and performance improvement can be a challenge. Furthermore, with new national performance standards coming, combined with the pressures on your existing operation, performance improvement driven by your internal data may seem daunting. This talk looks at the potential that executives have today to harness the data in their organization and transform it into information that highlights the areas of friction in your organization. Nick Nudell will share his insights on some of the various analytical tools and methods that EMS executives can use today track their clinical, operational, and safety performance in real time today for actionable positive change in their organization.

1. #ZOLLSUMMIT
Nick Nudell, MS, NRP
Chief Data Officer
The Paramedic Foundation
#ZOLLSUMMIT
Finding the Answers that are Right Under your Feet

2. #ZOLLSUMMIT
Nick Nudell, MS, NRP
• Critical Care Paramedic
• Chief Data Officer
• Bachelors IT Management
• Master’s Information Security
• Information Systems – Analytics & Decision Science
Doctoral Student
• Systems, Evaluation, Information & Performance
Improvement Consultant
• EMS Compass architect & project manager
• http://emsnerd.com http://twitter/runmedic

3. #ZOLLSUMMIT
Navigating EMS systems challenges

4. #ZOLLSUMMIT
EMS systems are complex
Managing without information is
crazy!

5. #ZOLLSUMMIT
Where do you start?

6. #ZOLLSUMMIT

7. #ZOLLSUMMIT

8. #ZOLLSUMMIT

9. #ZOLLSUMMIT

10. #ZOLLSUMMIT

11. #ZOLLSUMMIT

12. #ZOLLSUMMIT

13. #ZOLLSUMMIT

14. #ZOLLSUMMIT

15. #ZOLLSUMMIT

16. #ZOLLSUMMIT
How do you get there? Dig deeper!

17. #ZOLLSUMMIT

18. #ZOLLSUMMIT
What about everyone else?

19. #ZOLLSUMMIT
Real time system management

20. #ZOLLSUMMIT
Dashboards

21. #ZOLLSUMMIT
Decision Aids

22. #ZOLLSUMMIT
How do you measure up?

23. #ZOLLSUMMIT

24. #ZOLLSUMMIT
Performance Measures

25. #ZOLLSUMMIT
What is a performance measure?
Measurement Domain
Clinical
Area
Topic
Family of Measures
Structure
Process
Outcome
Balancing
Measure Formula
Denominator Numerator =Score

26. #ZOLLSUMMIT
Structure
Process
Outcome Stroke Bundle of Care
For positive stroke
assessment, average
time from LKW to
arrival at stroke
center
Documentation of
LKW
Positive stroke
Assessments
transported to Stroke
Center
Blood Glucose for
Positive Prehospital
Stroke Assessment
Notification of stroke
team
Suspected Stroke
Receiving Prehospital
Stroke Assessment
Performance Measure Example:
Stroke-7 Bundle of Care*
Stroke-1 Stroke-2 Stroke-3 Stroke-4
Stroke-7
Stroke-5
Stroke-6
*For illustration only. This does not represent a final measure and may change
significantly before it becomes finalized.

27. #ZOLLSUMMIT
Stroke performance measurement

28. #ZOLLSUMMIT
Trauma performance measurement

29. #ZOLLSUMMIT
0
5
10
15
20
25
30
5/14
6/14
7/14
8/14
9/14
10/14
11/14
12/14
1/15
2/15
3/15
4/15
5/15
6/15
7/15
8/15
9/15
10/15
11/15
12/15
1/16
2/16
3/16
4/16
5/16
TotalIncidents
Month
Number of Cardiac Arrests Per Month
Total Incidents
Median

30. #ZOLLSUMMIT
Reduce variability

31. #ZOLLSUMMIT
Paramedic self-improvement

32. #ZOLLSUMMIT
Paramedic benchmarking

33. #ZOLLSUMMIT
Compliance monitoring

34. #ZOLLSUMMIT
Performance monitoring

35. #ZOLLSUMMIT
0
20
40
60
80
100
ProtocolCompliancePercentage
Month
Compliance with Cardiac Arrest Bundle
Protocol Compliance % Median
CL 0.412
0.5273
UCL
0.946
1.1315
0.0000.000
0.200
0.400
0.600
0.800
1.000
1.200
1.400
1.600
5/14
6/14
7/14
8/14
9/14
10/14
11/14
12/14
1/15
2/15
3/15
4/15
5/15
6/15
7/15
8/15
9/15
10/15
11/15
12/15
1/16
2/16
3/16
4/16
5/16
Percentage-ROSCatAnyTime
Month
ROSC at Any Time During Cardiac Arrest
CL 0.6125
UCL
1.2636
0.000
0.500
1.000
1.500
2.000
5/14
6/14
7/14
8/14
9/14
10/14
11/14
12/14
1/15
2/15
3/15
4/15
5/15
6/15
7/15
8/15
9/15
10/15
11/15
12/15
1/16
2/16
3/16
4/16
5/16
Percentage-Capnography
AfterAirway
Month
Capnography Used After Airway Placed
CL 0.8380.838 0.9939
UCL
1.5251.600
1.8235
LCL 0.1520.076 0.1644
0.000
0.500
1.000
1.500
2.000
2.500
5/14
6/14
7/14
8/14
9/14
10/14
11/14
12/14
1/15
2/15
3/15
4/15
5/15
6/15
7/15
8/15
9/15
10/15
11/15
12/15
1/16
2/16
3/16
4/16
5/16
Percentage-Monitordata
uploaded
Month
Percentage of Cardiac Arrests Where
Monitor Data Was Uploaded

36. #ZOLLSUMMIT
Daily management reports

37. #ZOLLSUMMIT
System management

38. #ZOLLSUMMIT
Delaying is costly!

39. #ZOLLSUMMIT
Delays cost!

40. #ZOLLSUMMIT
For more information please contact:
Nick Nudell
Chief Data Officer – The Paramedic Foundation
Project Manager – EMS Compass Initiative
nnudell@paramedicfoundation.org
(760) 405-6869
EMSnerd.com EMSCompass.org
https://twitter.com/RunMedic
Image Credits: ZOLL, MCHD,
FirstWatch, Google, EMSCompass