In this week’s tip segment we have an interview segment recorded back at EMS Today 2012 during the EMS 10 awards. Our coverage there was sponsored generously by Physio-Control and they arranged for our team to interview the EMS 10 awardees and talk about their innovations. This was primarily for the Innovations in Patient Care podcast I produce and which is also sponsored by Physio-Control.
You can check out that podcast over in the iTunes store and download all the episodes. I thought it would be good to include these video segments in the MedicCast but had to delay since I wanted to make sure that the EMS today and Physio-Control had made use of this video as much as they needed to before I went ahead and released them here on the MedicCast.
The EMS 10 Awards select 10 people recognized last year for being EMS innovators in a variety of ways. I was able to invite Chris Montera to join me and we basically split up the duties of handling these interviews and so next up is an interview with Pat Songer. Pat’s from Nevada and his EMS Director of his hospital based department there and he is bringing some interesting community care medicine aspects to his program in that rural area. He’s also vastly improving their critical care approach to handling patients in the community and I’m really excited to get into this interview segment. Check out what’s going on with Pat Songer when interviewed by Chris Montera.
Catch the video segment in this week’s show – Rural Nevada Critical Care Innovator Pat Songer from the MedicCast.
CHRIS: Hi I’m Chris Montera here at The EMS 10 2012 awards joined by Pat Songer from Humboldt County are Humboldt General Hospital in Winnemucca, Nevada. So, I’m so glad that I have a friend that is a fellow EMS 10 awardee. So tell me about why you were nominated for the award?
PAT: You know, I’m still trying to get my head around that. I think it’s because I have a great team you know. I really believe my that my people, my guys should be here, instead of myself. They’re the ones that this award should really go to. I’m just pushing them in the right directions and I think this is just a collaboration of what we’ve done over the last seven years to bring a small rural service to a level of excellence.
CHRIS: So tell me a little about your background. Where did you come from before you came to Winnemucca, and then tell a little bit about the innovations in patient care as far as, I know you guys use ultrasound and things like that, so a little about your background first.
PAT: I’ve basically always been in rural EMS. I’m from a small town in Montana, and then to a small town in Idaho. I’m always kind of working with small rural communities. I was an owner of an ambulance service at one time. I just jumped in feet first early in my EMS career and the road of hard knocks, I guess you could say, learning.
And then I lived little bit, about a year in Durango with a flight service there, you know, still rural EMS and I really believe that in rural communities in America we should be getting good positive outcomes just as in metropolitan areas. We just have to surround ourselves with good people and focus on good patient care for our communities.
CHRIS: How big is the community you serve?
PAT: We serve an area of about 10,000 square miles. Obviously our population area is dense in one area and very rural in others which has some very challenging and unique ways of responding. Code 3 and 130 miles is a long response for us but it’s what we do a couple times each month.
CHRIS: You could finish a good book in that time.
PAT: . . . and some of them do.
CHRIS: So you’re doing some other interesting things and we’ll talk about patient care in a minute but first let’s talk about “Burning Man.” You now have the contract to cover that. How was your experience with that this year?
PAT: It’s been great. You know we’re a small hospital but we try to step outside the limits from time to time. We’re very community based and very family and team oriented and I believe those are the values that some organizations are looking for and I think that was what the Burning Man organization was looking for. Plus being a hospital based ambulance service brings some of that value to the organization.
The Burning Man is a mass gathering event of about 50,000 people so they require clinical services and ambulance services. When they were looking to renew that contract I think they were looking for a community based service.
CHRIS: Burning Man creates a city of 50,000 people in the desert for 7 days. So let’s talk about patient care, I assume you guys have 12-leads and stuff like that but what are some of the new things you’re doing as far as ultrasound?
PAT: We’re doing portable ultrasound in the field. I think we try to do some innovative things and you know ultrasound and iStats – a portable lab the field. I believe that what we do in the field since we have to figure out ways to shorten system times in rural areas to get patient to definitive care.Our nearest trauma center and nearest cardiac centers are 165 miles to the west in Reno Nevada, so there are things you have to do to shorten system times and not only shorten system times I think you need to do things that reflects upon making sure of the health and wellness of your community financially. And the outcomes are balanced very well.
Ultrasound, for example, gives us the ability to do rollouts in the field instead of having you receive a $30,000 helicopter bill for a rule-out of a possible acute abdominal injury is important. Instead of just flying because it meets trauma criteria our paramedics can rule out, or rule in. Maybe we can have the local surgeon take care of issues instead of having them go to a trauma surgeon because it’s a localized injury and with portable ultrasound those things can be done with the technology we have nowadays.
CHRIS: So what are you guys doing with the iStat? Troponins. . .?
PAT: Troponins and ‘lytes and things like that, helping with our 12-lead program also shortens system times so we can make decisions whether to launch aircraft or just go straight to Reno bypass. Our goal is, and I think we will have it by the summer, is thrombolytics in the field and that’s kind of the goal we’re striving to. 12 leads in the field and doing troponins so we can reach that goal.
CHRIS: So you’ve done that, built that system. Now you’re getting ready to do something near and dear to my heart. You’re starting a community paramedic program?
PAT: We are.
CHRIS: So tell me about what you’re going to do with that? Tell me what’s the population you’re planning to serve?
PAT: I think we can serve, especially in a rural area, a community’s health and wellness in way that really outside of the box. Especially our community, which is a mining community and some of our lifestyles aren’t the best but I think we can also do things that keep people out of the hospital. Our CEO is behind us 100 percent on seeing what we can do to keep people outside of the hospital.
You know we’re a small service so reducing our call volume isn’t as urgent as for some of the larger services, but we can do some things that can reduce the number of patients coming through our ER for some acute issues and also increase the health and wellness of our community by increasing some wellness programs and things like that.
We’ve actually been trying to do this for about three years and thanks to you we can move this forward very rapidly and I think now we kind of have a focus on where we want to go.
CHRIS: And what to me is kind of cool about that is you have the hospital CEO says we’re trying to reduce patients coming into the hospital. That’s almost counterintuitive.
PAT: It’s a double-edged sword but as healthcare reform gets traction that will be a different story and he knows that. He sees the future of health care reform and I believe he’s looking at the future. But it is also counterproductive for a community to keep doing things the way we’ve always done them just because we have to have numbers to pay for facilities.
Chris: That’s kind of enlightened, actually. So, tell me a little about your ideas or how you feel you’ll be advancing into the future with your service? You know, hey, you’re at the top of the game, now where are you going?
PAT: You know, community paramedicine is truly the next step, but I also believe that we need to continually focus on what we do to reduce system times, to produce positive patient outcomes, thrombolytics in the field, working to move the hospital now to a level four trauma center. Doing little things to create continuity of care from the field through the ER to the next higher level of care.
I think community paramedicine ties together with all of that. This all ties together. I think some the things that we can produce as community paramedics will also produce positive patient outcomes in the safety aspect of what we do. Respond to the safety type of issues that we have out there. I think that all ties together. I think that if we make our community, the wellness of our community better I don’t believe our call volume will go down, it will just be shifted to a different direction. Our call volume will actually go up.
I believe the financial stability of our healthcare system in a local small rural community will increase.
CHRIS: Think about the impact of your healthcare system, there’s kind of this ripple effect outside. You’re taking your people now that aren’t having missed sick days, and they don’t have child care issues. The ripple effect on the economy . . .
PAT: . . . is enormous.
CHRIS: So EMS 10 awards, you received it, what are your feelings about the future something like this in our industry?
PAT: It’s very humbling for me especially from a very small community and some of the other recipients I see, you wonder why I’m sitting here, but that’s very humbling and very grateful. But I’ve got to give the congratulations to my team. I’m pretty sure we wouldn’t be here if they didn’t believe in me and I didn’t believe in them.
I believe that they’ve brought the organization to where it is now. I steered the ship a little bit, but they’ve really gotten here through their hard work.
CHRIS: Thank you Pat for joining us here on the EMS 10 Awards and congratulations on your award.
Catch the rest of the news from this week’s show in Episode 293 – Rural Nevada Critical Care Innovator Pat Songer from the MedicCast.