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American Indian/ Alaska Native Health

Emergency Medical Services for Children

Six Emergency Medical Services for Children grants support the regionalization of pediatric care that will benefit American Indian, Alaska Native and rural communities. 

Working with State governments and accredited schools of medicine, the projects will develop regionalized systems that share resources beyond State borders and develop models of inclusive care that can be replicated in other regions where access to specialized pediatric medical treatment is limited due to geographical distances or jurisdictional borders.  

Components of these models are expected to yield strategies for engaging communities, working across jurisdictional governments and improving the capacity to treat children that will benefit other communities and can be applied to disaster preparedness.

Alaska 

Department of Health and Social Services
Trauma Program
EMSC State Partnership Regionalization of Care
Julie Rabeau, Trauma Program Manager
Section of Emergency Programs, Trauma Program
Julie.Rabeau@alaska.gov
Award:  $200,000

The Alaska EMSC State Partnership Regionalization of Care project will investigate solutions to overcome the challenges of promptly delivering specialized pediatric care to children in rural, frontier and wilderness communities of the State, and the indigenous Alaska Native and American Indians.

Optimal emergency care may be difficult for rural hospitals.  Rural hospitals and sub regional clinics have less access to emergency medicine trained staff, and with a low volume of pediatric medical and trauma patient cases, emergency personnel patient assessment skills for pediatric patients are not maintained.  The project will focus activities to increase statewide pediatric-specific training in disaster preparedness, integrate pediatric components in disaster response planning, provide training to stakeholders and providers, establish a regionalization of pediatric care program, and integrate pediatric components with the current trauma designation, consultative or educational processes.

Arizona

Department of Health Services
Maternal and Child Health, Injury Prevention
Pediatric Prepared Emergency Care
Tomi St. Mars MSN, RN, CEN, FAEN, Injury Prevention Program Manager
Tomi.st.mars@azdhs.gov
Award:  $199,915

Arizona implemented and launched a three-tiered voluntary pediatric emergency care facility network in September of 2011. The Arizona Chapter of the Academy of Pediatric’ s (AzAAP) Best Care for KIDS is home to the Pediatric-Prepared Emergency Care, a voluntary program recognizing hospitals prepared to stabilize and/or manage pediatric medical emergencies. AzAAP will certify that hospitals meet specific criteria for personnel training, equipment, and facilities that support optimal care for ill or injured infants, children, and teens. Pediatric-Prepared Emergency Care is a partnership between hospitals, physicians, nurses, and emergency personnel, and the Emergency Medical Services for Children program at the Arizona Department of Health Services.  The Pediatric Prepared Emergency Care program allows a facility that cares for children to be truly prepared to provide pediatric care through required pediatric continuing education, equipment, policies, protocols, and quality improvement. Through the SPROC Project, Arizona will expand into the more rural and tribal communities throughout the state and will integrate evidence-based guidelines into clinical decision-making for all participating facilities.

California

Regents of the University of California
Office of Research, Sponsored Programs
TACTICAL: Transport of Acutely Ill and Injured Children to Institutions of Higher Care from Allied
Timothy Horeczko, MD, MSCR, Project Director
Award:  $199,964

TACTICAL comprises the North Coast EMS Agency, the UC Davis Medical Center, and community representatives.  As the sole EMS agency in the region, North Coast EMS (NCEMS) is the health care access point for more than 21,000 EMS calls per year and the critical player in developing further infrastructure in the region.  As the only Level I trauma center in its catchment area (spanning 33 counties and 65,000 square-miles), the UC Davis Medical Center is a natural ally. To engage and learn from the communities at risk, this consortium will work in partnership with the referring hospitals, the non-profit community organization United Indian Health Services (UIHS), and the healthcare safety net for the Hispanic community, the North Coast Clinics Network, and other key EMS system and community partners.  This remote, rural, and diverse community, with primarily basic medical resources will build a technological, procedural, and human infrastructure with seamless access to the full spectrum of health services. The partners will develop a regionalized, standardized health care delivery system that integrates at both the local and regional levels to ensure evidence-based emergency medical services - either by transport or telemedicine - and by increasing access to ongoing education and quality care to this underserved area.

Montana

Department of Health and Human Services
Office of Research, Sponsored Programs
Montana’s Inclusive Model for Pediatric Emergent Care (MIMPEC)
James DeTienne, EMS and Trauma Systems Section
jdetienne@mt.gov

Award:  $200,000

The Montana Inclusive Model for Pediatric Emergent Care (MIMPEC) Program will develop an accountable, culturally competent, and accessible system of care for pediatric patients across the state, which will result in providing the right care at the right time in the right place. A model of care that can be implemented will mean children will not be mismanaged due to inadequate equipment or training during transport, and children will not have to be transported outside of the State as the appropriate provision of care can be offered closer to home.  MIMPEC will implement a replicable regionalized system of healthcare for pediatrics in Montana by establishing and solidifying structure for program execution; examining capabilities of each component of the healthcare system to optimize sharing of resources; developing and implementing processes to manage and treat acutely ill and severely injured children; developing and implementing processes to provide pediatric specialty services for children requiring access to a higher level of service while keeping the child in the home community; and facilitating access to and retrieval of clinical data to provide safe, timelier, efficient, effective, equitable and patient-centered care.

New Mexico

University of New Mexico
Health Science Center, Department of Emergency Medicine
A Child Ready (CR) System of Regionalized Pediatric Emergency Care
Robert Sapien, MD, Dept. of Emergency Medicine and Pediatrics
RSapien@salud.unm.edu
Award:  $200,000

In partnership, the University of New Mexico (UNM) Division of Pediatric Emergency Medicine and the UNM Center for Native American Health (CNAH) will design, develop, and disseminate a Child Ready (CR) system of regionalized pediatric emergency care in New Mexico and the border regions of Arizona, Colorado, Texas, and Mexico. Additional components of this system include providing guidance to facilities to help them arrive at a level of readiness to manage pediatric emergencies; assist providers caring for acutely ill or injured children; and conduct injury prevention activities in communities. The primary populations of focus for this initiative will be children and families in tribal and rural areas of New Mexico.

Pennsylvania

University of Pittsburgh
Office of Research, Office of the Provost
Regionalized Rural Pediatric Emergency Care
Jeremy M. Kahn MD MS, Associate Professor
kahnjm@upmc.edu
Award:  $200,000

This project represents an innovative collaboration between the Children’s Hospital of
Pittsburgh, the University of Pittsburgh, School of Medicine, and the Pennsylvania Department of Health and Public Welfare. Through a structured program of community engagement, provider education, and comprehensive telemedicine, the project will develop and implement a regionalized system of pediatric emergency care in rural western Pennsylvania. The program will build off existing collaborations between rural community health providers and a major academic referral center, leading to both improved emergency care access in the region and knowledge on how to improve pediatric emergency care nationwide.