262295 Multi-sector strategic planning in public health managed Emergency Medical Services: A model for enhancing system wide quality improvement

Monday, October 29, 2012 : 9:10 AM - 9:30 AM

Iyah Romm , Bureau of Health Care Safety and Quality, Massachusetts Department of Public Health, Boston, MA
Madeleine Biondolillo, MD , Director, Bureau of Health Care Safety & Quality, Massachusetts Department of Public Health, Boston, MA
Jean McGuire, PhD , Professor of Practice, Health Sciences Department, Northeastern University, Boston, MA
Emergency medical services in Massachusetts, as in many states, has faced a decade of flat or decreasing resources, expanding obligations, and stressors created by the intersection of public safety related post-9/11 emergency preparedness developments, regional public health strategies, and rapidly changing health care organization and reimbursement mechanisms. Contemporaneous changes in national EMT registration and uniformity of training and quality standards have added to a system under duress. Isolated but significant performance issues in Massachusetts provided the impetus for the establishment of an external cross-sector Strategic Planning Task Force (SPTF) to assess incident review and risk mitigation strategies. This group became the platform for substantial program and administrative improvements.

SPTF applied quality improvement methods to build consensus across inter-related, but not always aligned, sectors such as fire, ambulance services, physicians, and universities. These methods facilitated a system-wide assessment and decision-making process leading to field practice improvement, workforce development, enhancement of state agency fiscal and organizational priorities, and utilization of national benchmarks for data driven improvement. The success of this model in driving organizational change in public health administration and regulation has facilitated an evolved and highly competitive role for a state agency.

This model for building consensus around difficult systems-shifts is replicable across settings and scenarios and is currently informing additional strategic planning efforts at the Massachusetts Department of Public Health, including: re-development of the trauma triage system; quality improvement collaboratives for facilitating pre-hospital to hospital transition for patients suffering acute cardiovascular illness; and regionalization of critical public health services.

Learning Areas:
Administer health education strategies, interventions and programs
Administration, management, leadership
Public health administration or related administration
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Public health or related public policy

Learning Objectives:
1. Identify system-wide barriers to innovative public health administration and regulation in fiscally constrained environments 2. Explain multi-sector methods of consensus building among stakeholders with conflicting interests 3. Formulate strategic approaches for quality improvement planning in rapidly changing service delivery environments

Keywords: EMS/Trauma, Public Health Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the lead facilitator of multi-sectorial strategic planning initiatives in my role as the Director of Policy, Planning, and Strategic Development at the Massachusetts Department of Public Health's Bureau of Health Care Safety & Quality. These initiatives have led to groundbreaking shifts in the operations of many of our divisions and programs, including the Office of Emergency Medical Services.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.