Loading...
HomeMy WebLinkAboutAgenda - 11-04-1993 COURT FACILITIES STUDY GROUP MEETING TIME: 12:00 NOON--2:00 P.M. (LUNCH PROVIDED) DATE: NOVEMBER 4, 1993 LOCATION: GOVERNMENT SERVICES CENTER,200 S. CAMERON ST., HILLSBOROUGH PUBLIC MEETING ROOM AGENDA I. ISSUES WHICH REQUIRE IMMEDIATE ATTENTION A. Courtroom Overcrowding 1. Assuming a third floor courtroom can be developed within the next six-eight months,what opportunities for alleviating the crisis are available in the interim? 2. What role can/should the County play in assisting Court officials to: achieve a solution for overcrowding? B. Development of Courtroom on third floor of New Courthouse; status report and discussion. II. SHORT TERM ISSUES A. Projection of need for next five years; B. Potential for development at existing site. III. LONG TERM ISSUES A. Projection of need for next 20 years; B. Location of future expansion; 1. On existing site; 2. Built separately at alternate location. a. Close proximity to Hillsborough; b. Geographically able to effectively serve both Hillsborough and Chapel Hill from a single facility. C. Functions at future site 1. Court only; 2. Court and Law Enforcement (Sheriff); 3. Court, Law Enforcement and Jail. IV. POTENTIAL FUNDING SOURCES A. Bond issue B. Grants available for court facilities C. Federal Marshal funds (if Jail service is built) INVITEES: JUDGE LOVE JUDGE BATTLE MOSES CAREY, CHAIR COUNTY COMMISISONERS STEPHEN HALKIOTIS, VICE CHAIR COUNTY COMMISSIONERS ALICE GORDON, COUNTY COMMISSIONER VERLA INSKO, COUNTY COMMISSIONER DON WILLHOIT, COUNTY COMMISSIONER JOHN LINK, COUNTY MANAGER SHERIFF PENDERGRASS SHIRLEY JAMES, CLERK OF COURT CARL FOX, DISTRICT ATTORNEY GEOFFREY GLEDHILL, COUNTY ATTORNEY ROD VISSER, ORANGE COUNTY ASSISTANT MANAGER PAM JONES, ORANGE COUNTY DIRECTOR OF PURCHASING AND CENTRAL SRVS. PAUL THAMES, ORANGE COUNTY ENGINEER WILBERT MCADOO, ORANGE COUNTY PUBLIC WORKS DIRECTOR NICK WATERS, ORANGE COUNTY EMERGENCY MANAGEMENT DIRECTOR ORANGE COUNTY COMMISSIONERS P.O. Box 8181 HILLSBOROUGI-I, N.C. 27278 Moses Carey,Jr. 732-8181 Alice M. Cordon 9684501 Stephen H. Halkiotis 688-7331 Verla C. lnsko 227-2031 Don Willhoit 644-3004 (Fax) ORANGE COUNTY BOARD OF COMMISSIONERS SPECIAL MEETING NOTICE FOR NOVEMBER 4 , 1993 AND NOVEMBER 30, 1993 • The Orange County Board of Commissioners will hold a special meeting on November 4 , 1993 at 12 : 00 noon in the Government Services Building in Hillsborough, North Carolina for the purpose of discussing court facilities with that committee. The Orange County Board of Commissioners will hold a special meeting on November 30, 1993 at 7 : 30 p.m. in the Community Room at OWASA in Carrboro, North Carolina for the purpose of meeting jointly with the Orange County Schools and the Chapel Hill-Carrboro City Schools to discuss school capital issues. Afi(U. .1 e C.rey, . , Ch/77 Board of Commission= • 10/19/93 I ' YC11T CCI17NT TN fIRANC;F CO11NTY i GS 1 MEMORANDUM TO: Board of County Commissioners FROM: Moses Carey, Jr. DATE: October 12 , 1993 RE: COURT FACILITIES Please read the attached letter from Judge Patricia Love. The Facilities Committee will meet on November 4 . I will have a report to you shortly after that meeting ou fining the work that has already been accomplished and what the committee expects to do to address the concerns raised by Judge Love. If you have an interest in attending the meeting of November 4 which will be held at 12 : 00 noon at the Government Services Center, please let Beverly know by tomorrow. If we have more than three Commissioners attending we will notice this as a special work session. If you have any questions or suggestions, please give me a call. I will be out of town the week of October 18th. Thank you. ORANGE COUNTY HILLSBOROUGH NORTH CAROLINA ✓fai &taaticized 1752 MEMORANDUM TO: JUDGE GORDON BATTLE JUDGE PATRICIA LOVE FROM: JOHN LINK 4 RE: FOLLOW UP O NOVEMBER 4, 1993 FACILITIES STUDY GROUP MEETING DATE: NOVEMBER 12, 1993 cc: Orange County Board of Commissioners I am pleased that you were both able to attend the November 4 meeting of the Facilities Study Groups, The discussion was productive in several ways, not the least being the creative solutions presented as potential ways to mitigate the overcrowding situation that seems to occur regularly on Mondays and Wednesdays. I was particularly intrigued by the concept of multiple docket calls and hardily support pursuing that idea. Please feel free to call me if there is any way in which County staff can facilitate the implementation. I was also pleased to hear of the coordinated effort between the Superior Court and the District Court in the use of Courtroom space. Your recent efforts to follow a more flexible schedule in court sessions in order to allow more efficient use of the Superior Courtroom in the New Courthouse is highly commendable. All of government is being called upon to operate more efficiently and effectively during these tight fiscal times. Your recent actions have shown you to be responsive to these concerns while still maintaining the utmost dignity of the Court. Thank you for your forward thinking attitude. We will be asking for your future involvement as we continue the development of the third floor courtroom. In the meantime, please feel free to call either Pam Jones or myself with any questions or comments which you may have. AREA CODE (919) 732-8181 • 968-4501 • 688-7331 • 227-2031 • FAX (919) 644-3004 Ext. 2300 , 5TA7z o- r e WnM_Y State of IVIort Cazofi.na Oerzeza/ eouof cqu1LLCe Patricia S. Love /5B ]L1tz Co(_. LCt a It LJ Lstzlet DISTRICT COURTJUDGES CHIEF DISTRICT COURT JUDGE STANLEY PEELE October 6, 1993 LOWRY BETTS Mr. Moses Carey Chairman Orange County Board of Commissioners Hillsborough, NC 27278 Dear Mr. Carey: I take this opportunity to write you and thank you for the wonderful job that Orange County has done for parts of the Court system. Most particularly, the probation officers and the juvenile court officers are really luxuriating in their new elegant space. The cashier's and the clerk's office have also moved and they are delighted with their new arrangements. May I urge you to call another meeting of the facilities committee as soon as possible, as we need to proceed on the needs of the Courtroom itself. As you may have heard, on Wednesday, September 22 , 1993 , the Fire Marshall closed the District Courtroom (the downstairs Courtroom) because there were more than 82 people in the room. While I appreciate the Fire Marshall doing his job upon receiving a complaint, it is certainly an embarrassment to the Chief Judge to be reminded of what the law is. It was certainly self-evident that there were more than 82 people in that Courtroom and halls and up the stairs. As I recall, the docket was listing almost 300 cases. I am sure that you understand how badly I feel to assign myself and two other Judges to hold court in a room that I know cannot contain the cases that are assigned to it and that I know is a fire hazard and is creating a possibility of some serious incidents occurring. These possibilities include courtroom violence as well as the obvious fire hazard. I have been consulting with Pam Jones, who has been consulting with the architect about the third floor Courtroom. The architect reminded her and me that the third floor must contain a second exit to pass the fire codes. Obviously, the downstairs Courtroom does not have but one exit at the present Mr. Moses Carey October 6, 1993 Page Two and is a fire hazard for that reason in addition to the number of people it can accommodate. I would hope that a meeting of the facilities committee would engender some support for additional safety precautions in the existing Courtrooms and certainly in a new Courtroom. It was my unfortunate experience this past week in Chatham County to be confronted by an incredibly angry defendant, who screamed so loudly that he has damaged my hearing and came very close to assaulting me and perhaps others in the Courtroom. It was a very frightening experience and I hope that we can prevent its recurrence either here or in Chatham County. As you know we are not utilizing the old Courthouse appropriately and I would hope that we could reconsider the various possibilities to include that Courthouse in our scheduling. The Courthouse in which I reside continues to have very serious roof problems, and the leaking roof has damaged some very old Court records. All of these problems that I have enumerated, I hope, will encourage you to call a meeting of your committee once again. I really appreciate the yeoman work that Pam Jones has done for us, we are so grateful and want to help her in any way we can. Most Sincerely yours, Patricia S. Love Chief District Court Judge PSL/mh cc : The Honorable F . Gordon Battle The Honorable Stanley Peele The Honorable Lowry Betts COMMUNITY QUESTIONNAIRE FOR OCEMS Introduction: Bello. My name is__-__. am a volunteer calling on behalf of the Orange County Emergency Medical. Services. We are conducting a sutptey to determine what Orange County citizens expect front t.heir'l ".EIS System, what they are willing to pay for that service, and what method of funding they prefer. Our study requires that: we Interview only one ADULT .if; years or older In your household who has lived In Orange County for at least one :year. In order to choose that person, 1 need to know how many ADULTS 18 years of age or older live in your household. (Choose a Random Adult and ask to speak to that person. if unavailable, schedule a callback.) ' h Begin Survey In this survey when we mention INS, we are referring to the scope of actions that occur from the time a call for an ambulance k placed (usually weans calling 911) to and including the time the subject is delivered to the hospital. I . Start time AM PM ©Or .III U NiliiY ©tJEartr[l©iN1In NII ;1E [ROM (NARVAIR BA$IC tw1NDCLa rANDiNgQF EMER E �MEL�I_' 'Ef�V �CM:5) 1. On a scale of 1 f.o•10, where 1 is little understanding and 10 is high understanding, how would you rate your understanding of the EMS system in Orange County? 1 2 3 • 4 5 G 7 8 9 10 LO-VI Kfr►o-t om 2. Have you ever used an ambulance service in Orange County? Yes No DK Ref, • 3. Have you ever used an ambulance service outside Orange County? 1 Yes Nf o DK Ref. L6+ 7ls � (Note: If No, DK or Ref., skip to question 7.) 4. On that occasion, did you pay for the service? (If more than one occasion, use most recent.) Yes No DK net, (Note: If No, DK, or Ref., skip to question 7,) 5. How did you pay for the service? 2 7 12 e_croitie_ti`rLs 40. 7 Xti 7su nc,e (Other than Medicare/Medicaid) t 1 ►0 . Paid out of pocket 7e 4 Medicare/Medicaid (4. a DK f�1 Refused t�� Other_,_ 6. And how much did you pay for the service? 2 7 TL e_ ©v a e-071 r (9 I Less than $100 [1 $100 - $200 ri $201 - $300 27 in $301 - $ 100 I I More than $400 I DK 2 F I Ref. 7. I am going to road a series of situations, t"or each one, please tell roe if you would be vety likely, somewhat likely, somewhat unlikely, or vary unlikely to call 911 and request an ambulance. 7a, You believe you or someone with you has suffered a heart attack or stroke. 9'21 1g. Very likely f Somewhat likely UK 111 Somewhat unlikely I�1 • Ref. Very unlikely 7b. You believe you or someone you are with has experienced trauma such as an accident, gun shot wound, or knife wound. 84. 7 M Very likely . ci` 1 LJ Somewhat likely ' ' I Dtt Somewhat unlikely I' DI Ref. L_1 Very unlikely • Page 2 i . 1 I i i i) 1 III I I•I . i • ■ 7c. You believe you or someone you are with is in need of a blood pressure check 6 ► ? LI Very likely 11 01( 6 " Somewhat likely I. D.3 LI Somewhat unlikely Li Ref. ?14' Very unlikely 7d. You believe you or someone you are with experienced trauma such as a fracture or cut. ' 2-,2 [] Very likely • 2-U 7 Somewhat likely LJ DI: 3 '3 2 ° 0 E] . Somewhat unlikely Li Ref. / r L__ ] Very unlikely 7e, You believe you or someone you are with has experienced a mental disorder, • . q. q' C. _I Very likely 4, 71-] DI< i&3 H Somewhat likely `. i . 0 1 Ref. 2 7, 1 [._I Somewhat unlikely 14'3 NI Very unlikely . 7f. You believe you or someone you are with needs transportation to the hospital or doctor's office for an appointment or check-up; this individual requires special equipment such as a wheelchair or stretcher, • 2-©�7 I Very likely a — J..0 Li OK 2.S l [1 Somewhat likely 2� i D I Ref. ti_q, 8 - [II Somewhat unlikely ,II Very unlikely Page 3 7g. You believe you or someone you are with needs transportation from the hospital to their place of residence. I_._J Very likely • 4t, T L, Somewhat likely 7. z [1] Ref. g7' 6, 70, C.�.� Somewhat unlikely @VeIy unlikely 8. If you were to dial 911 for an ambulance, how soon would you expect it to arrive? 2 2,7 I-1 Less than 5 minutes 5 7 Within 5 - 10 minutes �°. 71 Within 11 - 20 minutes 110 I I More than 20 minutes • s1 DK c-fl fief. Q sT/MET11QD QFLt UNDING Presently in Orange County you do not receive a bill for emergency ambulance services . However the cost ranges from $150 to $300 per trip. In view of this, how do you feel about the following: 9a. I am willing to pay additional properly taxes (between $25-$50) for the EMS service t expect. Ye No UK • net, 36, ? 9b. I am willing to pay a yearly fee (between $40-$50) for the EMS service I expect. X Yes No OK nef. 9e, I am willing to pay a set fee (between-$200-$300) each time I use the service, X Yes (No UK .lief. 3 8, - ,,5-6„��. Z- 4. ? Page 4 9d, I am willing to pay up to a $1.00 surcharcjo on a monthly uWily bill, X Yes No OK net. 82.3 / 3 2, a "' 10. In view of this, which of the following methods of funding would you prefer? 6, 7 [ 1 Additional property taxes $25 $5() per year 4. 7 n Subscription of ! '1O.$5o per year 14,3 Li User fee between $200-$300 per use Pt, Z_ Add up to a $1,00 surcharge on a monthly utility bill L 1 - K �-��� REF, DEMQ_G3APHIC 11. What is your date of birth? ./�--_-----------____-_ Month Usy Year • 12. Dd you currently have health insurance? Yes No !Refused to answer 87 17—, 3 s 5— 13. What is the highest grade you completed in school? (Do not read list; probe if neoes.sary,) t3, 3 n Less khan 12th grade 0 lot *2_, 1 ' 7 r1 High school but no college 0 G 1 S. ( ' 2. . D Technical school 11' 3 .� Some college, no degree 0 G / k; 97 c1 6 college degree 0 C- ( 7. 6 q.6 l_ I Graduate or professional degree p G t 4, f� IaDI 1 Other 51-1 Refu<ed,to answer Page 5 141. What would you estimate was the total income of your household in 1992? ((lead choices: if Income - $30,000, choose $30-$45,000.) 7041 Less than $ 15,000 Between $15,000 and $30,000 l ,3 Between $30,000 and $45,000 S 3v Greater than $45,000 7'y I Don't lc,no"w sc 7F-1 ilefused to answer 15. Are you male or female? (Ask only if unsure.) oc- 47. 4 Male [ J Female © G S Z, 15 . What race do you consider yourself to be? (Do not read choices.) S White 0 G, 3 o, 5 ( 3 . 8 13lack C- 15 • y c j Other — 1. b Refused to answer 17. How many telephone numbers reach this household? (Not the number of telephones in the house.) AM Slop time PM III !'age (3 ORANGE COUNTY HILLSBOROUGH NORTH CAROLINA ..;:kuzzy r:s. &taal;aed 176.2 MEMORANDUM TO: Orange County Board of Commissioners John Link, County Manager FRO et •od Visser, Assistant County Manager DATE: November 4 , 1993 RE: Commissioners ' Work Session on EMS Strategic Plan On behalf of the EMS Strategic Plan Steering Committee, let me provide you with a brief introduction to the material which the Committee would like to discuss at the Board' s work session next Tuesday night. The attached "read ahead packet" , although not entirely self-explanatory, will give you a notion about the committee' s work to date. In preparing for the work session, the committee has proceeded under 15 the assumption that the EMS strategic plan would be discussed for approximately the first hour, before the Commissioners move on to the subject of employee compensation. The committee will make a brief presentation of about 15-20 minutes, highlighting a few points in the attached packet, allowing about 45 minutes for Board questions and discussion. Major topics will include: the shift to focus on patient outcome as the central n a r 1 factor in planning delivery of emergency medical service; results of a telephone survey of Orange County citizens concerning the Orange County EMS system; and examples of some of the types of recommendations that will ultimately come from the EMS strategic planning process . While much work has been done, particularly by the medical sub- committees on trauma, cardiac, and pediatric care, a lot more remains to be done in the months ahead. Perhaps the most important objective f. for next Tuesday' s work session, from the committee ' s perspective, will be to ensure that the committee ' s direction in the strategic planning process is compatible with the Board' s vision for the future of the Orange County EMS system. I know the committee appreciates your devoting time specifically to this subject. Please let me or Nick Waters know if you have any questions in advance of the work session. AREA CODE (919) 732-8181 • 968-4501 • 688-7331 • 227-2031 • FAX (919) 644-3004 7,.. Bonn /47/e.--otfal(4-6-c Q....- //4/,,3 `c 2 / ken ChAui0143 FP P " F € P a x a m� ,. _ .. F � � ¢ { 064 PavxF. • A � /® iii 1 ,,• i AO I /// -Y /5-... • -. ..nom, f .,,,,,,/ t 'w z. ...,.....s /s` 4 frc., -e. //, - /7 D 6 7/ J 4C it ,,,/Y• s n`3 '''x8 Q,�c,.2, ''ss ztax sue$ ti1 a3g F' � xe � aa�.,, . 'v.,q x, 40 '�e x A s $ vSza z "P ITT R K • Report on activities of the strategic planning group to date g p • Describe the thought process to be used in making specific recommendations • Dialogue with Commissioners to obtain n their input into the common vision for OCEMS • Identify/discuss several recommendations the group is prepared to make tonight • Agree on next date for input to Board UANNI1CGLE Lrj,11)Nll�i 0 I�1C (� (�3�C1 Develop areas Environmental for outcome Outcome goal Resource Resource Scan sub-committees identification allocation oats 1 . EMS today 1 . Flow chart 1 . Identify how it works what now resources 1 . Cardiac happens required to 2. EMS tech- 1 . Reallocate meet goals nology today 2. Trauma 2. Identify existing areas for 2. Identify resources 3. Broader 3. P e d s improvement All costs of society in resources 2• Allocate which EMS 4. Mass 3.Propose new system casualty outcome 3. Make resources functions goals and recommenda measures -tions Ongoing assessment and feedback 1 . Measure outcomes 2. Assess results 3. Make changes Orange County Commissioners Vn Alf�r tr C IP I A Nrl V1 U N br If N H\/ Orange County EMS MS fl fldvIjisory Council Co u ncil Chr.- - Chr. —Chr. Chr. PEDIATRICS Steering TRAUMA PED I RTR I CS MHSS CASUALTY CARDIAC Committee S. ELLIOTT J. SMITH " fiC L J. SMITH D. JONES B.=STECKLER Chr.— DATA D, Noe LL x-Chr.— RESOURCES H. Caldwell —Chr.— PUBLIC INFO. B. Lockwood s � 7 2,� s .r 'a ,;. '»> •gib 4 r IV IT,ITS S � GEL £ �'a ;N ai• "�' x �. a.%.c.>a a - t 5""i r: ea �k a .. '' r x {2 er°�� ✓'� n a $ 6Q ashySt r'3S _.tF `fi% d ar" 7$ Q S S � r c ,- ,..E IT . • Completion of work by individual medical groups; final reports of cardiac, peds, and trauma sub-committees doge • Identification and analysis of current resources by the Resource sub-committee • Recognition of need for a common vision for OCEMS • Survey of Orange County citizens to obtain their input into a common vision for OCEMS • Work sessions held to begin integration of the information and formulation of specific recommendation as related to the vision s'a 5�y AFIL 0. NT ss 'ON co LEME fi x .1 10, ....... a fi A k - i n,b !n €r:K -as ?* 's95�al, y��` i • PREVENTION AND PUBLIC HEALTH EDUCATION • TRAINING AND SKILL DEVELOPMENT • EQUIPMENT • COMMUNICATION • INTEGRATION OF SERVICES • EVALUATION AND FOLLOW-UP • THESE MAY ALSO BE REFERRED TO AS ATTRIBUTES OF AN EMS SYSTEM - 1 I � C Ike, it� 8: , aR§ URV k Y f �I�:F T �e�. �v aAd{ a, as��'�'�',�`k����'��� s�r �'�d��s� �N�� .� �����s ��x•5��x�dv�e '�'`t�S �,,gs c��k $ - s;a� £� -- w S • FOUR MAJOR OBJECTIVES — Determine level of citizen understanding of the OCEMS system — Determine the expectations which citizens of Orange County have of their EMS system — Determine trade-offs citizens are willing to make in terms of cost vs. service — Determine how citizens feel the EMS system can best be funded DONE IN CONJUNCTION WITH THE SURVEY RESEARCH UNIT OF UNC (PUBLIC HEALTH • TELEPHONE SURVEY; DATA COLLECTION COMPLETED, ANALYSIS BEING DONE z � x £ Y\ a _ � ka �:yEa 3�mfl`� a:3w•fit �� g >y,.E � '�a*a,sa h � v E • '£ std !. a y' x a >S t< uck � g-x £ � �• � � . ' x `�aas�E:.` w �i � w,z r s �✓.::vg�f� '„5k�u."H� qx s.-.:;�'` �.;. ����, :� g�.y,w<,.:�a�, �,�� a C �. a.£ ...:�, CY §P :� ak k '� `� a t��a' F • ABOUT 20 VOLUNTEERS COMPLETED THE DATA COLLECTION PHASE • ABOUT 850 TELEPHONE NUMBERS CALLED • 204 SURVEYS WERE COMPLETED • OVERVIEW OF RESULTS THUS FAR • SCHEDULED FINAL REPORT: a g, Z �r SUES-5 IL �. fi 3 'X S 3 3C t: qa 'Y'. /�TX¢ ,?b'.S' ✓''SnW F �3:,' F � ..,. Y � MEDIC . j.e e &e Cd :�2zy Ta a�'• -. �t3g`. £'ss £�'-.:''a �2 hz rE, S. q s'a?�' �x.........a��. � .#...,� > 's� t • How to get input from three groups into a common vision • How to integrate information from three perspectives and arrive at recommendations • How to evaluate recommendations relative to impact on patient outcomes • How to do cost/benefit analysis with h limited, subjective information x 0 f TW�11.: I,S. Es ,,, w Xl • Each group did their version of a vision statement • Chairs of the three rou s meta ' g p and identified common elements across s rou g p • Arrived at major elements of a vision statement • Related common and unique recommendations from sub-committees to vision elements • Related recommendations to potential impact on patient outcomes Q1,NM � � $"#• �, s a .��a r C m ��r ��'�.Za.S �'!� .����@��� Y��.�jPrw,q,� � „;c�� .a'n5� #���cY�j A`a�'�`8 2.a.�'� 'k�� S � ��ic�s�'kr'a 4�< i k r� ,r • Devised ways of looking gat cost/benefit with limited, subjective information • Defined and drew a system diagram Y g m to aid in the understanding of relationships between various elements of the system I SYSTEM D 1 RGRRM OF EMS D ATA COLLECTION 0 Morbidity and PREVENTION mortality stats 2) Surueys of patients IDENTIFY 3) other data GRPS CITIZEN ZEN —_��RESOLUTI ON MEDICflL OF PROBLEM NEED 1)Patient satisfaction 2)Physiological outcome ADJUST SYSTEM EFFECT ON PATIENT OUTCOMES I i y; %Rf^Q G ago.d•L 5 R AN 01 F`1T Ysl � 7 AT 1, F x ION.z� . NUMBER OF PEOPLE AFFECTED Low Medium High Low COST Medium High I R .F' S, D 3 sa rF^ 'c: 1 .5 v':,'i s 4...... AN y�MOS I e� t -45 ,lo lit k.i'Fr a .x xss� s �,:-� � �.y�' � �r x `:��i����z,�.y �e��x� %� s��:� ya s.; � a� - r ,�:.� xa.t < ?i:, y't ,•w �x a s,: �' a'x�+f ks R� �u`u'?.a .,.... n.� :,.: 4 ..w.�.c,:.., t,•s..::�� ..?:� .x �:. fu .. 1�..,-.�. 1E IMPACT TO PATIENT OUTCOME Low Medium High Low COST Medium High � �� 5 % RL `� NH � P BETJIIEE 7,77.74n -7: p '7, M1 �zQ 506 � #"A HMl i Dormnt X-71 S 077: ISM NE"I'M '��.. z ¢? £ Vdzzz PATIENT OUTCOMES Physiological Patient Attributes EMS is/wants to be outcome satisfaction 10 9 8 7 6 5 4 3 2 1 10 9 8 7 6 5 4 3 2 1 2 3 4 5 6 7 8 9 10 Prevention & Public health Training Equipment Commuication i Integration of services Evaluation & Follow-up �•. m LE: ... E COM ..... IDATIO _',311T" _ N S "3Y';s4.ti -. a"^�1:k aa .,nv u' s ✓ase a..y M,g 710,14777.t xw s::�< •c s z ;r•' £� ,l^'i H :" �,K, ,�, 3,£��. z ag'' gym ' b ,s.. 3'* M: .` °' wsy. �. � �.: �� ''�.� ��•f �.�fi� � �r�w�s�.,. Fx�� : ��� �.c�a,� ��,"� ga'"�'�*��..? � a s•a.xw,:. F 5 �,�, � as ax��: �k:... 3 x s;w ..a..�:m.�,z�s,�t4,,,m.:.�h � .,rr'�,er.;,a� `z�.:A� �'4�� ��,.. � ��w<�:z,.������� '���s;����•��a.a �..�:> "��..r,e„�F a �.��z a�,�' �^i.� ,�; ���a �, s:�s'. i • PREVENTION AND PUBLIC HEALTH EDUCATION - Appropriate use of 911 system resulting in a decrease in the burden on the system >> Physician office training to prevent delay cardiac care >> Provide peds 24 hour "Hot line" for referral of problems other than true emergencies • TRAINING - Involve all levels of the system (First Responders, communications/dispatch, EMT's, ER) >> Recruitment, coordination, and enhancement of First Responder training and system >> Additional training in peds skills and pre-hospital care to increase confidence and competence of infrequently used skills 1� p 4 s 0 1 M S 4p 6 Y s. x b .__. DATI s R a a $t .are"� y, D n OJ'Ste-. 1 3 • EQUIPMENT — Tiered system with ongoing re-evaluation of personnel, equipment and locations >> Appropriate (standardized) equipment for First Responders--AED's, # of pieces of equipment,02, radios, maps, etc. >> Purchase and maintain specific peds equipment for vehicles and for ongoing training • COMMUNICATION — Institute pre-hospital thrombolytic therapy screening questionnaire — Expand peels protocols, consider moving toward more field decisions with peds care to reduce time loss — hands free communication devices • INTEGRATION OF SERVICES — Integrate EMS with Human Services agencies in Orange County (Health Dept., Social Services, etc.) ;. S �„��:a t 3'3 �'a'� .R R.��.#���2 .zi.� w +sx.�?"a�v �>, Res a,R .�` x �::tj ^Y .e� xi, 5,3*�.d�'� ,a., ,: t R>2•s�'¢ rxa:r £ x.>.':: >�.s 7` r, a 4p s .., r£ . .s E•':a:, y Y, s ... ,. ,r;:Z:. s `-" s :. 4 a;: +E ��'=x�'n bu &o: rr Is ...ter rx qq',m '`i S�. ` ♦'::. n z OA k �(y E'"b,�' � '�'n R`N' .��'��''L� �S b 3' 'k k. 2e n`>R �� ,��, x?R' 8� .�� .§�.; ! ➢3:'_Y b� � Y�, F G: :a S a OM SC . I�T Escya tm€ s .S Rai... R # :.s F fi,�': "' �.b Fa � g;� ,u`` u-�,2.�,,a.:..;�,. w;,�,:: �;., ��.«°..�:�'^k.' a,,.:%X-� �•' ,2,a ..s. 3c Viz?a. � ,;��.�.�r r�,� Ya` : � i • Evaluation and Follow-up — Upgrade the EMS Council to a major decision making/ recommendation-making body to the County Commissioners to 1) Establish follow-up and evaluation of this strategic planning effort 2) Evaluate recommendations concerning the evolution of the EMS system, and 3) Periodically assess the overall effectiveness of the service and provide input to Commissioners � a s x Ecc; YE'.,. g.:: :.; .., `•`.s,i Q 7,a eUi '�_;;'�9 xy s:. d&i:�m & aw s °..t �'�' 4y k • r„:!:'�z 3' '.'g 7"�€". x �: } �; '-" a E �:s is ,c g X- 1"E �- ': v...... s '�;y a` a„'�'i:.`" a"sewe, CK.,:, 'd a� E ^si� aS`s� r brag a:'s' "; •'aar a:.:;m" #;e f axua ys�. § KL a Z .E :.� k •H f`� ' >,�:s.:" .e.�:d",?"•� f,�,.��5.� `'�'.�sa 'y} ,i � � �.> �� E� >;aS,� � S hsi3. �f���.s'�.� =��E �,�"�k :e x;,i !- a � b�P�'3���'�xm: �,v .,x t �} ® EMS NEEDS TO BE INTEGRATED WITH OTHER HEALTH RELATED SERVICES WITHIN THE COUNTY ® EMS ADVISORY COUNCIL ROLE SHOULD BE EXPANDED CURRENT EVALUATION METHODS ARE VERY SUBJECTIVE; THERE EXISTS A NEED FOR RESOURCES TO BEGIN WORKING WITHIN THE TOTAL EMS SYSTEM TO MAKE EVALUATION EFFORTS MORE OBJECTIVE