MCHB Conference Webcasts
2005 EMSC Annual Grantee Meeting
April 12-13, 2005
BRYNA HELFER: How are you guys doing? Are we on? Excellent. Can you guys hear me?
UNKNOWN PERSON: Yes
BRYNA HELFER: Oh, good. You guys can hear me. I'm worried about the people in the back, but I'm going to go there, too.
Anyways, what you failed to mention, Dan, is I got my start at the national level right here in the EMS for Children program with Jane Ball, I was very excited to be part of the center for a number of years, and it's great to be back. I'm very excited about being here.
Just out of curiosity, how many folks are here today that I had the opportunity to work with as coordinators? Quite a few, great. So for some of you, this will be a review. And I think we cannot review the topic we are about to talk about with this partnership collaboration and how to move that forward especially at a time 20 years post the initial entry of EMS for children.
And so today as we move forward in our conversation, we are going to talk about partnerships, collaboration and the National Academy of Public Administrators talk about that in terms of successful partnerships. What do you think those successful partnerships have been led by? What do you think the key ingredients are to successful partnerships? Anyone?
UNKNOWN PERSON: Collaboration
BRYNA HELFER: Collaboration. Beyond that? Trust. What else? There are some key ingredients that the National Academy of Public Administration has identified. Anyone want to take a guess? More guesses. Come on. Funding, resources, yes. But resources are broader, we'll get back to that. What else?
UNKNOWN PERSON: Leadership.
BRYNA HELFER: Leadership is critical. What else? Communication. You've got three of them. There's one more. Infrastructure. And one more I forgot the most important that you guys have all been very focused on here at EMSC the last few years. Outcome, results, outcome, making a difference. Direct outcome. Making a difference for the individual child and family. Making a difference for the system and making a difference for the community.
Results, communication resources. What else did we say? Infrastructure and leadership.
So let's break those down a little bit. We started to talk about the collaboration piece and partnerships, but let's talk about what resources mean. Someone said funding. But let's get bigger than that, you guys. Some of you have been with me on this, but let's review it.
What do resources mean? Come on. Talk to me. People. What about people? What kind of people?
UNKNOWN PERSON: Dedicated.
BRYNA HALFER: Dedicated. What else?
UNKNOWN PERSON: Knowledgeable.
BRYNA HELFER: Knowledgeable. What else? Another table. Come on, talk to me. There's 20 --
UNKNOWN PERSON: Energetic.
BRYNA HELFER: What else? Come on, talk to me.
UNKNOWN PERSON: (Inaudible.)
BRYNA HELFER: What is it? Families, yes. What else? Expertise. What is another resource beside people and funding. We know the funding is on the top of your list. Dan already said we are not allowed to talk about funding, right? Didn't you say that? Oh, we are, but outside of federal resources, so money outside of federal resources is okay, right? What else?
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UNKNOWN PERSON: Time.
BRYNA HELFER: Time. What else?
UNKNOWN PERSON: Data.
BRYNA HELFER: Data. What else
UNKNOWN PERSON: Organizations.
BRYNA HELFER: Equipment. Organizations. What about organizations, what do they bring to the table?
UNKNOWN PERSON: More people.
BRYNA HELFER: Okay. So the point is that lots of pieces, now one of the things that we know about systems in development and mature systems, is that around leadership, that it's diffuse, okay. The National Academy of Public Administrators talk about that, that it's not about one person or one organizations, but leadership is diffuse throughout your community and throughout your partner organizations, that resources are diverse and stable. That communication is beyond your internal mechanism. Are you all from the same state by chance? Same region? Good. Okay. So they are externally communicating. This is good, they are working outside of their box. That's mature.
If you're just getting started and you're having diffuse leadership, that's really good. And we want to just see where we are at relative to these four components, five components: Results, communication, leadership, resources, infrastructure in your coalitions relative to specific topics.
And what we want to do, we have this listed five times on the wall, okay. And here we have over here, emergency department pediatric training and equipment guidelines. And over on the right side it says, Done well, and on the left side it says, Need to begin relative to broad coalition support, effective partnerships, leadership, identification of resources and communication. Are they diffuse? Are they diverse? Are they stable? Do you have external communication? Is it regular? Do people know they are part of a coalition or not? Or is it the same old same old that you're always going through it, relative to emergency department pediatric training, relative to state disaster plans and implementing pediatric priorities? How many of you know that there's a new executive order for emergency preparedness for people with disabilities? Two people. Excellent. Okay. That's good give them a hand, come on, they know. Are you working with those communities? Are you part of your state disaster plans? Are kids an integrated component? Are you working with the broad community on that or is it just the same people you've worked with for the same 20 years?
Family centered care, who are you working with? How are families involved? What's the training engaged? Who are your partners? Pediatric EMS and trauma data collection. Where are kids in this process and who are your partners? And pre-hospital pediatric training and equipment guidelines.
We want you to vote, whether you need to begin, you need significant action, you need action or you've done well, you've done well, in your state. And everyone in this room is going to vote on each piece of paper five times. There's a set over there, there's a set back there, a set overhear. You're going to come up, there's markers -- there's markers, you're going to put an "X", I think I'm doing really well in my state relative to pediatric EMS and data collection, relative to broad coalition support, partnerships, leadership, communication and results. Okay. I'm going to add results. Does that make sense to anyone?
So lots of markers. You're going to all get up because guess what, we are way to comfortable in our EMSC roles. So we are going to break this up a little and we are going to just get out of our chairs or roll over to those walls and we are going to mark on each sheet. This end of the room is going to go that way and you guys are going to come this way and you guys go that way and we have facilitators to help you. Grab a marker or pen and put a big X on each line where your state is relative to each issue. This is a quick thing. Wait don't go yet. When you come back, I want you to make sure you are sitting at a table where you don't know the people, where you don't work with them every day, where you're not in the same discipline and you talk to them as your peers. You want to mix up the tables a little bit, so if you're sitting with everyone from the same table, you New England folks, I see you together over there. And Nelson, Terry, that doesn't count. You live together, work together, you've got to sit with other people.
So get up, come back, you've got to mix it up. Ready, go, this is quick. Go. Who needs a marker here? You go. Put some Xs up there. Where is your state relative to these issues based on your perspective?
Okay. Everybody up. That's it. It's okay. You're allowed to stand up. Yep. This is good. Get the day going.
Hey, how are you doing? What's up?
Everybody up. Everybody gets to vote. You should be voting on five different pieces of paper. Everybody gets to vote.
Hi, Betty. How are you doing? What's happening?
UNKNOWN PERSON: We are doing we are good
BRYNA HELFER: Okay. Based on your state, what you believe, perspective.
Okay. Just put those Xs up. Five Xs. One on each page. There's three sets, so if one is crowded go to another one. Have a seat back where you don't know people or you don't see them every day. And have a seat back.
Okay, good. Everybody marks an "X" five times. Let's just see how people are doing. Oh, my gosh, are we spread out here. Well, there's some things we do well. Oh, good. We are spread out. Wow, you can start to see some clustering, people are spread out across issues.
Sit somewhere where you don't know the people, you don't work with them every day and they are not in your discipline. They are not in your discipline, that's a key factor here, keep that in mind. Oh, my gosh. We are spread out. Some clustering. Some clustering. Not as good on this one. I can see where we have work to do. This is good.
Perspective is really important. Perspective. Okay. If everybody can grab a seat. How's it going? I want to talk to you. Have a seat back where you don't know people or you're in a different discipline. The emergency docs cannot all sit together, that’s the here. The injury folks cannot sit together, all the family folks cannot sit together. Are you mixed up here? Have you met each other? You might want to meet people at your table. Go ahead and introduce yourselves. Introduce yourselves. Introduce yourselves, get to know each other, where are you from, what do you do, you know a conversation. You all know each other? Have you met each other? Make sure you know each other, at least your names. All right.
Shhhhhh, Shhhhh. Okay. We are going to get started here. Now, where is the deal? Now that you're back at your tables, facilitators, raise your hand. Can you all grab some tables, you know where you are split up across tables. We have some facilitator spreading
If I could have everybody's attention. Okay. This works. Okay. So here is the deal.
Shhhhh. Okay. So what we are going to do here for about 25, 30 minutes is we are going to start to share. Now, perspective, building perspective is really important. And in that study that I noted earlier about partnerships is one of the things we know about communication and partners and leadership is that people listen to each other. And they listen to different perspectives and that they're flexible about that. So this conversation is the beginning, okay. It's just to get us started because we don't have-- we could easily do this for a day, but we are only going to do it for 30 minutes or 25 minutes okay. But what I want you to do, in your group you can start with a topic, any of those five topics-- by the way, before I get started did you notice a topic that wasn't up there? Injury prevention wasn't up there. How many people think they need action? Significant action relative to partnership, leadership, resources? How many people need to begin? Okay. So that topic wasn't up there, but it will be interesting because some of these are very clustered. If you look at -- what does that say, in pediatric, pre-hospital -- this group is pretty clustered on the done well side. If you look at some of the family centered care, it's pretty spread out. So within your group at your table, you're going to pick a topic, and I want you to start sharing. Who's done well Everybody here owns their own perspective. So this isn't about being right or wrong this is about listening and sharing. If someone needs significant action, you might have some strategies about how it's been done really well relative to partnership, collaboration, resources, infrastructure, leadership and results. That's the conversation does that make sense to everyone?
So, you're going to pick a topic, you're going to have this conversation, sharing dialogue, listening, being helpful, but not stepping forward when somebody else is trying to just identify what the challenges are, you might have the solution and this is a time to share. So we are going to have a conversation, give you a lot of time, a big 25 minutes and then we will come back and reflect upon that and talk about what's working and what's working well, okay. So have fun. Have a good conversation. Or not.
This is great. You guys are firing it up. This is lots of good exchange. You know, this is so cool. This is -- you know what's cool about this? This so cool, you know, what's so cool about this? Is this is what the grantee meeting is all about. And this is just the start of the meeting. So how long are you here for two or three days? So you're going to have the opportunity to continue this conversation throughout, to talk to people from other states, from other communities, from other disciplines, to start to share how it's going, what's been going well, what's been challenging. This is what the grantee meeting is all about. And I hope as you move forward through the next three days and when you return home that you continue this conversation. And we are going to continue it now in this large group. And I just want to -- we have some roving mics, right? Diane can we grab some those mics and run around the room?
Let me point out a couple of things. Let me just point out some observations I made. When I look across the spread, there's some difference of opinion about some of this stuff. We don't all agree on where we stand over here on state disaster plans, integrating real priorities. Boy, some of you feel like you need to begin. Some of you feel like you've done well, and we have a lot of spread here. Lots of conversations to start to be had back in your states, because there's only a couple of you here. So you are going to take this conversation back and start to dialogue with the people in your state to say how can we do better? What are the opportunities to get to a point where we can say we are doing this really well? Here we have this side of the room again is spread relative to emergency department pediatric training, but these folks actually pre hospital and emergency department is pretty clustered on the done well side. So some of you eel like you've done pretty well on that, but the two pieces that are pretty consistent across the room as I look that are spread difference of opinions, family centered care, state disaster planning and data collection. They are kind of a spread here, a consensus spread that we don't have agreement on across the room.
So tell me, what are some of the conversations you all had. Who had something that they think they needed some action on? What's -- who—
UNKNOWN PERSON: Data collection.
BRYNA HELFER: Data collection. And what were some of the highlights of that conversation?
UNKNOWN PERSON: (Inaudible.)
BRYNA HELFER: Okay. Here we come back to that money thing. But did you find out some other things you needed? What were some other things you learned about what you might use?
UNKNOWN PERSON: There programs out there that are already out there that are better than the hand held wonderful paper system that we collect and put in that special file in that special place where it stays forever and ever.
BRYNA HELFER: Thank you. Who else thought they need some action relative to an issue? Anyone? Go ahead, yes.
UNKNOWN PERSON: Talking about data collection, we decided that we collect data well, but using it is a different story.
BRYNA HELFER: Using it. Anyone else have that issue, using data? Okay. So maybe there's some conversations that need to go on.
What else? Who else had something they've done really well or reaction or somewhere in between? What were some of the conversations you were having? Yes.
UNKNOWN PERSON: Family centered care.
BRYNA HELFER: Family centered care. What about it?
UNKNOWN PERSON: Family centered care, there needs to be I think more coalition building, more use of the AAPs form on, you know, what issues children might have for special health care needs, dissemination of the form, getting regional authorities involved so that they are on board with using it, HIPPA issues. But in a region where it worked, the form, having that information saved children's lives, and it's something that needs to happen more uniformly across the MS regions. Using children's hospitals maybe as centers and from a state perspective and there are also rural issues where it's hard to centralize because of the nature of the population.
BRYNA HELFER: Did anybody else have anything on family centered care they want to share with us?
UNKNOWN PERSON: We talked about family centered care here and one of the things that I learned was that there's actually child life support personnel that are in children's hospital that are there to support the parents to be able to support the child so that was new information for me. And of course we explored it, Linda here is from Indian Health Services -- Betty, right? Betty. Mentioned how culturally they are very supportive, they come together as a group so that they are supporting each other.
But then in Louisiana they have families supporting families for those children with special needs. So there's network and collaboration going on all over the place.
BRYNA HELFER: So you learned a few new things today.
UNKNOWN PERSON: Yes.
BRYNA HELFER: Anyone else around family centered care? You've got a mic coming.
UNKNOWN PERSON: Thank you. I learned that, you know, I've been focused on the pre hospital and having the pre hospital people learn what goes on in families' homes, but New Mexico is doing a unique thing where their medical students are going into homes for two or three hours and actually learning what the family goes through at home so we need to incorporate that into our program. We need to take action.
BRYNA HELFER: Very good. What about another topic? Who had another conversation? Where are the Kentucky folks. These guys had a very -- they didn't -- these are great folks because they don't follow directions which I love. So they actually got up and they toured the room. So can you share some perspectives of what you learned? Speechless.
UNKNOWN PERSON: Sure, what we did was we just simply looked at everything, you know, and put our thoughts down on the paper as we talked. And we are not all Kentucky here, by the way.
BRYNA HELFER: Sorry.
UNKNOWN PERSON: We have Wisconsin and Minnesota with us.
So we talked about what we felt like we did well in each particular category. We felt that in pre hospital training yes, we do, we do a lot of pre hospital training. But how many of these folks are EMS folks and how many of these folks are hospital folks? And this doesn't really correlate well with -- well, actually it does. The pediatric training and guidelines seem to correlate pretty well.
So what we were talking about, is this rural versus urban and do the rural folks get an opportunity to have the same things that the urban folks have. And the same way with EMS. Is the proper EMS equipment, actually it may be mandated to be on board the ambulance, but is it used. I've worked in ambulance services where the cabinets are sealed because if you open the cabinet and use it you have to count it and put the stuff back. Anybody work in a service like that?
BRYNA HELFER: Can you talk to us relative to your conversation about your state disaster plan?
UNKNOWN PERSON: Our state disaster plan is very lengthy. It has a wonderful-- it has an entire chapter about livestock. Kentucky is a rural state, livestock is very important. It's a food source. It's our livelihood. We're a rural state. We have a chapter in our disaster plan about pets. Well, I'd like to see if I'm gone to the New Maverick Fault next time is slips that my dog King, my chief of security, German Shepard, I'd like to see that somebody throws him a bone. But is there a chapter about children? And the answer is no.
BRYNA HELFER: Okay, so, perfect point. I just heard the goose bumps in this room. Pets, livestock, not kids. Where are we in that process of state disaster planning?
Other conversations?
Thank you. Give him a hand. He was good.
Okay. Other conversations. Who else wants to share? UNKNOWN PERSON: (Inaudible).
BRYNA HELFER: What was that?
UNKNOWN PERSON: Drinks are on you.
BRYNA HELFER: That's been known to happen.
Anyways, new conversation. Somebody else, please. What did you guys talk about?
UNKNOWN PERSON: We talked about training equipment, that in Nevada we've used federal grants, bioterrorism grants to purchase Broslow bags to put in every ambulance and every hospital so that everybody has the right equipment, and then tie it back to our data collection program that they have to use that and that they have to train their people in PEP and that the hospitals have to provide staffing to train those people in PEP so they use the right instructor level to teach PEP.
BRYNA HELFER: Okay. A couple more. We have time for two more. Who else, Illinois? I heard Illinois had some time for good perspective building during this session.
UNKNOWN PERSON: We just shared that we are from Chicago, and there's a large part of Illinois that is not near Chicago, down state, that we don't really know anything about what happens down there and how the EMS system works and is incorporated. It was really two separate entities within the same state and we obviously need to work on this together.
BRYNA HELFER: Anyone else have separation of those issues in the State? No one else?
UNKNOWN PERSON: Florida.
BRYNA HELFER: Over, there, yes.
UNKNOWN PERSON: We are not a state, but the District of Columbia certainly has that problem. We have an excellent children's hospital that probably across the board is well prepared for many of the issues that have been discussed, but for the rest of the acute care hospitals, we've got nine or ten. I can tell you they are really at the beginning stage, so that really tells you a significant disparity for the district and it probably reflects some other states as well.
BRYNA HELFER: Okay. Anyone else hat wants to share? We've got time for one more. Come on. Over here. Do you guys -- George, sorry.
UNKNOWN PERSON: Dr. Fulton really made me do this. But I'm from Kentucky, also. And I just wanted to say a word about education. And the gentleman, Tom Taylor who is way across the room, so you can see we did divide ourselves, one of the reasons our education program is so successful is because of his efforts. We offer both PEP and PAILS. He journeys to the counties where the program needs to be offered, and then he goes back and does an instructor course so that they can self sustain the program by teaching their own over time, and he's taught hundreds of pre hospital care providers in our state, really has done a wonderful job. And I think if you're front line is dynamic and enthusiastic, a good teacher can convey the message that that's really important for education.
TOM TAYLOR: Can I have a raise?
BRYNA HELFER: Did anyone hear about new partners? You know, people, organizations, thinking that you just had never thought about in this process? Yes, Cindy, rhi
UNKNOWN PERSON: One of our members is from Rhode Island and we have lots of disaster planning, and we talked about where we are succeeding and not succeeding. She has contact ed-- have I ever needed that. Those of you who know me know I don't need this. She has contacted Hasbro Toy Corporation and asked them to supply across their state supplies to entertain families, children of all ages and adults so that after we've done the initial triage and we are planning for shelter in place, we have the ability to give families some sort of normality. And Hasbro has come to the table.
BRYNA HELFER: Any other creative partnerships? Yeah, that's good. What else? Who else? What else did you learn about people you hadn't thought about connecting with? Nothing? Yes. Just yell it out.
UNKNOWN PERSON: Disabilities planning counsel in this state. We are networking with them using the emergency forms and they have doctors going into families' homes, and so we are out their using the ASAP form and getting that out.
BRYNA HELFER: Excellent. Disability planning forms. There's a DP counsel in almost every state
Who else? Yes?
UNKNOWN PERSON: We talked about in Minnesota they went through a program where they are able to use some of the disaster money from the Fed to put AED's in schools, that was one of the acceptable equipment. And the idea of using schools for the hub of disaster planning. I thought that was very creative, because in a disaster situation, the schools naturally becomes hubs.
UNKNOWN PERSON: Where are you located? Where was that done?
UNKNOWN PERSON: That was in Minnesota.
BRYNA HELFER: Minnesota. Okay. Other creative thoughts?
UNKNOWN PERSON: Bryna?
BRYNA HELFER: Yes.
UNKNOWN PERSON: This actually goes back more to the education piece in terms of something I think we all need help with, and that is I think we would all agree our education programs are great maybe in place, but how do we evaluate them?
BRYNA HELFER: Evaluation of education programs. Anybody have any thoughts on that that you talked about in your tables? Anyone doing some good things relative to evaluating education programs? You're right, we need to work on that.
Okay. Anyone else? Creative thoughts you learned today? Yes?
UNKNOWN PERSON: We have—
BRYNA HELFER: Use the microphone.
UNKNOWN PERSON: We have proposed plan, we haven't actually started it yet, but in our grant, we will be at six months and 12 months after educational programs, be having a pop quiz when people come to pick up their paychecks, they have to retake the PEP exam or the PALES exam, so it will retest educational information, not skills information. But before they get their paycheck, they have to retake the test. It will enable us to see what kind of educational retention we have.
BRYNA HELFER: I think that stirred some conversation in the room. That was good.
yes?
UNKNOWN PERSON: I know in Oklahoma we wound up taking a continuing education program to the table, asking them to make it mandatory for just a few hours, and we was told by the providers there that they've got enough pediatric continuing education. We wound up deciding this wasn't good enough, so we looked it up, checked out through a blind study where we used NIDARK to assist us, and found out yes, they do get enough pediatric continuing education, because the median and mode numbers for basic level, intermediate level and paramedic level was zero. So we found out that no, they got none.
As we brought this information back to the table, they all of a sudden said, would you like to reintroduce this to us?
We decided what we wanted to do was put together an actual categorical compilation of what they needed in all levels.
BRYNA HELFER: So they needed hard data to show they weren't doing it. So that was really helpful for you. Other thoughts? Who haven't we heard from? What have you guys talked about back here? What did you learn?
UNKNOWN PERSON: The disaster plans and the pediatric priorities in our state, we didn't feel that it was being looked at all simply because the State police in our state are the ones that are tasked with doing that. What we are trying to do is change a little bit of their thinking, thinking outside the box, it's hard to tell a police officer that it's not just law enforcement.
BRYNA HELFER: Thank you. That's a great segway because what we are talking about is continuous engagement. We cannot, we cannot let it slide. We cannot just get comfortable. And Ron Havelock writes about, you know, we are frozen, we are comfortable. We've got to unfreeze it, mix it up a little bit and refreeze it. And that takes hope and energy and creating an environment for dialogue, for listening, for exchanging and for being open to flexible, creative solutions. And that is where we need to start spending some of our energy now in the EMSC Program. We are only 20 years old. We have to get to a hundred, and it's going to take every single one of us in the room doing that
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I want everyone to raise your hands and say at the count of three, Happy Birthday EMSC. One, two, three (Entire room participating.
BRYNA HELFER: Happy Birthday, EMSC.
I want to be back here in 20 years to say it again.
Go, do good work, do not get comfortable, think outside of the box, get creative, continue the dialogue that we've started here throughout the week and when you return home. Thanks for having me. All right.