The importance of data collection and sharing

Cross-posted from the Follow the Crew blog at CodeSTEMI.tv.

We had a wonderful time in Dearborn. I was welcomed as a brother at Dearborn Fire Department and got to learn about an awesome fire-based EMS system which made me happy. In addition, we met some motivated and passionate caregivers at Oakwood Hospital.

They are doing some awesome things in Dearborn and it's clear they're doing a great job treating STEMI patients. However, there's one area that created some cognitive dissonance for me and it's data sharing (or lack thereof) between the hospital and the EMS system.

One of the first questions I asked when we arrived at Oakwood was whether or not they had a multi-disciplinary STEMI meeting. "Absolutely!" we were told. Every Wednesday morning and all the stakeholders were present from emergency medicine, nursing, cardiology and administration.

"What about EMS?" Blank stare.

Finally I was told, "We have an EMS liaison." Unfortunately, it soon became clear that it wasn't enough. The bottom line is that the EMS Chief does not have a seat at the adult table in this hospital. That doesn't mean it isn't a great hospital.

I dragged my feet before writing this blog post because I don't want to cause any offense or ruffle any feathers. However, we are the First Responders Network. We tell stories from the point of view of EMS. The bottom line is that everyone we met at Oakwood talked about their extraordinary door-to-balloon times (less than 60 minutes and even less than 40 minutes) but we still haven't seen it on paper in context.

The door-to-balloon times at Hilton Head Hospital hang on the wall of the emergency department (warts and all).

As Carl Sagan said, "Extraordinary claims require extraordinary evidence." Another quote from Thom Dick comes to mind. "Your agency is not the best in the nation. It's not the best in the state, either. In fact, it's probably not very good at all, unless you can prove it." We're not doing a commercial for Oakwood Hospital we're telling the story of their system which includes EMS and their interaction with EMS.

Every EMS system has room for improvement and my own EMS system is far from perfect. We have our own politics and our own struggles. In some areas Dearborn Fire Department and Oakwood Hospital are better than we are. Having said that, when it comes to quality and process improvement I'm a bit of a skeptic, and justifiably so. I'll spare you the details but I still don't know the actual "call received" time in my own EMS system.

The bottom line is, you might be the best EMS system or the best hospital on Earth.

Don't tell me. Show me.

6 Comments

  • jedi master says:

    Are you kidding? 20% of the hospitals in this country can do a cath. You expect all these big city agencies to read 12 leads and not transmit to an Er Dr who gets it wrong as much as a new medic does? And you want seats at the big table? Earn it first.

  • Baker says:

    ^^^ so you are saying we as ems don’t deserve a seat at the big table, and on what basis did you come to this conclusion, are you implying that we as medics are incapable of making a correct interpretation of a 12-lead??

  • I have no idea what you're talking about "Jedi Master" but you don't sound like a wise Yoda to me.

  • FTMPTB says:

    Jedi, I'm confused… If your system, and worse your ED docs are that poor at diagnosing STEMI's… You all need some remedial training. Most well trained systems, have a close to 90% accuracy, PREHOSPITAL. I think you just called yourself out.

  • BH says:

    Jedi must be that nitwit from LAFD that said it was impossible to train their medics to read 12-leads. 

  • Dr. William Dillon says:

    Data must be shared to advance care.  The real gains in STEMI care in the future will be with Pre-hospital care.  Door to balloon is fine but it is a really not the best measurement.  Over 90% of PCI hospitals are within the guidelines.  1st med contact is a better measurement.  Data has to be collected and shared.  How else will you know if there is a problem.

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