notice of cancellation · 2018-03-22 · san jose, ca 95126 408.885.4250 voice 408.885.3538 fax ....
TRANSCRIPT
County of Santa Clara Emergency Medical Services System Emergency Medical Services Agency 976 Lenzen Avenue, Suite 1200 San Jose, CA 95126 408.885.4250 voice 408.885.3538 fax www.sccemsagency.org
NOTICE OF CANCELLATION
NOTICE IS HERBY GIVEN that the meeting of the Emergency Medical Services Committee Meeting scheduled at 1:00 p.m. on Thursday, December 4, 2014 at the Sheriff’s Department Auditorium, 55 West Younger Avenue, San Jose, has been cancelled. The next regular meeting of the Emergency Medical Services Committee is scheduled for 1:00 p.m. on Thursday, March 5, 2015 at the Sheriff’s Department Auditorium, 55 West Younger Avenue, San Jose.
A division of the Santa Clara County Public Health Department
County of Santa Clara Emergency Medical Services System Emergency Medical Services Agency 976 Lenzen Avenue, Suite 1200 San Jose, CA 95126 408.885.4250 voice 408.885.3538 fax www.sccemsagency.org
EMERGENCY MEDICAL SERVICES COMMITTEE
Chair: Health Advisory Commissioner Harry Hall
Thursday, December 4, 2014
1:00 pm – 3:00 pm
(Voting Members Requested to RSVP by November 26, 2014)
Santa Clara County Sheriff’s Department Auditorium 55 West Younger Avenue
San Jose, CA 95110
All reports and supporting material are available for review on the Santa Clara County EMS Agency website at www.sccemsagency.org and in the EMS Agency’s offices at least one week prior to the meeting. This information is also available the day of the meeting. ( Indicates supporting documentation attached. Indicates committee action required). 1. Call to Order / Roll Call (Commissioner Hall) 2. Introductions and Announcements (Commissioner Hall) 3. Public Comment (Staff) This portion of the meeting is reserved for persons desiring to address the EMS Committee on a Committee-related matter not on the agenda. Speakers are limited to two (2) minutes. The law does not permit Committee action or extended discussion on any items not on the agenda except under special circumstances. Statements that require a response may be placed on the agenda for the next regular meeting of the Committee. Regular Items (Commissioner Hall) 4. Approval of October 2, 2014 Meeting Minutes
A division of the Santa Clara County Public Health Department EMSCO December 4, 2014 Page 1 of 52
5. Summary of Items Presented to Board of Supervisors or Health & Hospital Committee (Natividad)
6. EMS System Update (Petrie)
A. County Staff Recommendation Regarding Exclusive Operating Area
Request for Proposal
7. Medical Director Report – Clinical Care (Dr. Rudnick) () 8. EMS Trust Fund (Petrie) ()
A. Accept Written Report on the Financial Status of the EMS Trust Fund (Natividad and Petrie)
9. Exclusive Operating Area Contract Status (Blain)
A. County EOA Update i. Accept Rural/Metro Response Time Performance Report () ii. Accept Status of Deliverables ()
B. Accept Fire Department Response Time Performance Report ()
C. Palo Alto EOA Update – Accept Verbal Report 10. Hospital Destination, Diversion, and Advisory Status Report (Diaz) () 11. FY 15 EMSCO Meeting Dates 12. Member Roundtable and Reports 13. Next Meeting and Adjourn (Commissioner Hall)
March 5, 2015 from 1-3 pm at the Sheriff’s Department Auditorium, 55 West Younger Avenue, San Jose, CA 95110
Venue and Parking Instructions • Visitor parking is available at the County building parking lot designated “Visitor” areas. • No food or uncapped beverages are permitted in the training room. • This meeting will be recorded.
EMSCO December 4, 2014 Page 2 of 52
Emergency Medical Services Committee Sheriff’s Department Auditorium, 55 W Younger Avenue
October 2, 2014 1300 to 1500 Hours
Meeting Minutes
Item Discussion Action 1. Call to Order/Roll Call Chairman Harry Hall called the meeting to
order at 1:04 p.m. A quorum was present. • Meeting called to order.
2. Introductions and Announcements
• None
3. Public Comment No members of the public provided comment.
• None
Calendar Items 4. Approval of June 5, 2014 Meeting Minutes Without discussion, the committee approved
the consent calendar. M/S/C • June 5, 2014 Meeting Minutes
approved. M/S/C J. Coffaro/R. Hooks
5. Distribution of Revised EMS Committee Standing Rules
Michael Petrie reported that at the EMS Committee’s June 5, 2014 meeting members voted to revise the Standing Rules of the EMS Committee to require only two members of the Health Commission on the EMS Committee and to allow the committee to maintain a quorum with only on Health Commissioner present. Reducing the number of Health Commissioners assigned to the EMS Committee reduced the total committee membership to 15 and changed the quorum requirement from 9 to 8. A copy of the new Standing Rules of the EMS Committee provided for members.
• Informational Only
1
EMSCO December 4, 2014 Page 3 of 52
6. Summary of Approved or Pending Board of Supervisors, and Health and Hospital Committee Items
Without discussion, the committee accepted the approved Board of Supervisor and Health and Hospital Committee items. Health and Hospital Approved Committee Approved Items: • Emergency Medical Services (EMS)
Agency Report – August 13, 2014 • Report-back on Status of Agreement
with Racing Hearts – September 10, 2014
Summary of Board of Supervisors Approved Items: • Report on Improving First Responder
Time Performance – June 10, 2014 • Agreement with FirstWatch – September
9, 2014 • Request for Delegation of Authority to
Execute Agreement with Rural/Metro’s Accountant – September 9, 2014
• Informational Only Summary of Approved BOS and HHC items accepted as presented.
7. EMS System Update A. Rural/Metro Contract Revision
Michael Petrie reported: • On September 23, 2014, County staff
presented a report to the Board of Supervisors recommending that we begin the development of an RFP for 911 Paramedic Ambulance Services in the Santa Clara County Exclusive Operating Area to potentially award a new contract, starting July 1, 2016. The Board of Supervisors unanimously voted to support County staff’s recommendation.
• Mr. Petrie emphasized that this action only allows the EMS Agency to develop the RFP; thus providing the County with the option of later releasing a RFP. The Board of Supervisor’s action does not compel the County to release the RFP or, if it
• Informational Only
2
EMSCO December 4, 2014 Page 4 of 52
B. San Jose Fire Department Response Time Performance
releases the RFP, to execute an agreement with the bidder. Further, County staff has committed to bring the RFP back to the Board of Supervisors before it is released. This action does not negate the County’s right to extend the term of the Agreement with Rural/Metro for one or two additional 3-year periods, by providing Rural/Metro no less than (60) days prior written notice. A copy of the report provided for members.
• The EMS Agency anticipates approximately that 18 months is necessary to create and release an RFP for 911 EOA paramedic ambulance services, to select the desired vendor, and to provide time for the vendor to prepare for operation.
• Michael Petrie reported on the San Jose
Fire Department’s Code 3 response time performance between January 2012 and April 2014, based on information provided by the San Jose Fire Department.
• The report details the San Jose Fire Department’s Code 3 (Red light and Siren) and Code 2 (No Red Light and Siren) response time performance between January 2014 and July 2014. The response time standard for each category is 90 percent.
• The County of Santa Clara Auditor (Harvey Rose Corporation) is continuing their management audit of the San Jose Fire Department’s response time. While the EMS Agency has support that audit, we are not privy to the content or timing of the results of that audit.
• Informational Only
3
EMSCO December 4, 2014 Page 5 of 52
8. Medical Director Report – Clinical Care • Dr. Rudnick provided reported on the Ebola Response at the EMS Agency. A meeting was held with the Public Health Officer to develop guidelines for Infectious Disease Control Measures for EMS providers which is to be sent out on Monday, October 6, 2014.
• Information only.
9. Exclusive Operating Area Contract Status A. County EOA Update –
i. Accept Rural/Metro Response Time Performance Report
ii. Accept Status of Deliverables
B. Accept Fire Department Response Time Performance Report.
C. Palo Alto EOA Update – Accept Verbal Report
• John Blain provided an update on the
status of Rural/Metro as the EMS System’s 911 paramedic ambulance provider. The report on (September 2013 to August 2014) response time performance shows Rural Metro has been compliant in all zones and overall performance.
• John Blain reported on the Fire
Department Response Time Performance (July 2013 to June 2014). The audit by Harvey Rose Agency is near completion and they will provide a report to the County
• No report.
• Rural/Metro Response Time
Performance Reported accepted as presented. M/S/C K. Horowitz/J. Coffaro
• Fire Department Response Times
Performance Report accepted as presented. M/S/C J. Coffaro/R. Hooks
10. Hospital Destination, Diversion, and Advisory Status Report
• Linda Diaz reported on the status of hospital destination, diversion and hospital advisory status levels for February 2014 through July 2014.
• The overall volume and daily averages of patients transported within the last six months saw a small decrease. Despite the decrease, the overall hours of diversion hours have increased. There was a significant increase in stroke diversion although this was attributed to one facility with a prolonged CT issue. Trauma Center an STEMI center diversion times remained low.
• Information only.
4
EMSCO December 4, 2014 Page 6 of 52
11. Member Roundtable and Reports
• Richard Kline reported that the California State Trauma Advisory Committee has sent out the State Trauma Plan for a second and final comment period. To view the plan, visit the State EMSA website: www.emsa.ca.gov/trauma.
• Jo Coffaro commended the EMS Agency for their work Wall Times. The California Hospital Association will hold a meeting in late October to discuss wall times and how to work with ambulances and hospitals so everything is working well together. The Santa Clara County EMS Agency will assist with presentation to providers as they are highlighted for their best practices. Ms. Coffaro also reported on the State EMS Awards for 2014. The Hospital Council and the California Hospital Association have been accepted be sponsors for EMS Providers.
• Michael Petrie announced the State EMS Awards Luncheon will be held in San Francisco on Wednesday, December 5, at the Marine’s Memorial Hotel.
• Information only
12. Next Meeting The next meeting will be held on December 4, 2014 from 1:00 to 3:00pm at the Sheriff’s Department Auditorium.
• As noted.
13. Adjournment There being no further business, the meeting was adjourned at 1:45pm
• Meeting adjourned.
5
EMSCO December 4, 2014 Page 7 of 52
MEMBERS PRESENT Harry Hall, Chair, Health Advisory Commission Kenneth Horowitz, , Health Advisory Commission Jo Coffaro, Hospital Council of Northern CA Rick Kline, Santa Clara County Trauma Surgeons Jose Chavez, Public Safety Sector Paramedic/EMT Randy Hooks, Permitted Non-911 Ambulance Provider Kralyevich, Private Service EMT/Paramedic Elaine Nelson, South Bay Emergency Medical Directors James Silva, Santa Clara County Medical Association Michelle Woodfall, Santa Clara Trauma Managers
MEMBERS ABSENT Steven Drewniany, Santa Clara County Police Chief’s Tom Haglund, County City/County Managers Jeff Taylor, 911 Contracted Ambulance Provider Ginger Miramontes, Emergency Department Managers Eric Nickel, Santa Clara County Fire Chief’s Assoc STAFF PRESENT Michael Petrie, Director John Blain, EMS Specialist Lilia Felix-Villalobos, Executive Assistant Daniel Franklin, EMS Specialist Michael Cabano, EMS Specialist John Montes, EMS Specialist
6
EMSCO December 4, 2014 Page 8 of 52
County of Santa Clara Emergency Medical Services System
Emergency Medical Services Agency 976 Lenzen Avenue, Suite 1200 San Jose, CA 95126 408.885.4250 voice 408.885.3538 fax www.sccemsagency.org
Date: December 4, 2014 To: Santa Clara County EMS Committee Members From: Patricia Natividad
Senior Management Analyst
Subject: Summary of Approved or Pending Board of Supervisors and Health and Hospital Committee Items
Health and Hospital Approved Committee Approved/Pending Board Items:
Semi-annual report relating to the status of the EMS Agency and EMS System for period January 1, 2014 through August 31, 2014 – November 12, 2014.
Accept semi-annual report from Emergency Medical Services (EMS) Agency relating to the status of the EMS Agency and EMS System for period January 1, 2014 through August 30, 2014.
At their December 14, 2010 meeting, the Board of Supervisors requested that the EMS Agency provide regular updates to the Health and Hospital Committee regarding the performance of the County Exclusive Operating Area 911 Ambulance Provider, Rural/Metro of California.
On November 22, 2011, the Health and Hospital Committee requested that the EMS Agency provide an update in February 2012, and then provide future updates in May and November of 2012 and in subsequent years. A semi-annual report covering January 1, 2014 through August 30, 2014, is attached and provides the requested information. A copy of the report can be viewed on the Health and Hospital Committee Meeting Agenda web and is attached. Summary of Board of Supervisors Approved Items: Direct Administration to begin the process of developing a Request for Proposals for Countywide Exclusive Operating Area (EOA) Advanced Life Support Emergency Ambulance Services that may result in the implementation of a new EOA Emergency Ambulance contract on July 1, 2016 – September 23, 2014. In order to maintain the highest degree of flexibility for the County and to keep all options open for the Board regarding the EMS Ambulance contract, the Administration recommends the initiation of a process that may result in a new Request for Proposal for services starting 7/1/2016. The development of a new RFP and the implementation of a new 911 Exclusive Operating Area ambulance contract typically take approximately 2 years to complete.
A division of the Santa Clara County Public Health Department EMSCO December 4, 2014 Page 9 of 52
Although the contract implemented in 2011 with Rural Metro is considered a model contract by many throughout the state, changes in health care and EMS reimbursement have materially impacted the financial viability of our EMS system in Santa Clara County and other EMS systems throughout California and the nation. The County’s relationship with Rural Metro has been challenging in a number of ways since the contract was initiated on July 1, 2011. However, both parties have been working diligently toward stabilizing the local EMS system as that is our singular priority. Rural Metro is current performing as expected and meeting or exceeding response time requirements. In addition, the costs of services for Rural Metro are significantly lower than those of surrounding jurisdictions. Thus, the citizens of Santa Clara are currently receiving quality ambulance service at a very good price. The recommendation to develop a new RFP does not commit the County to actually issue the RFP, to change our current contract, to change providers, or not to extend the current contract when it ends in 2016. However, starting the process does provide the Board with those options in the future. Due to the California Emergency Medical Services Authority (CAL EMSA) imposed limitations on the modification of the 911 Exclusive Operation Area (EOA) contract to address financial and other operating issues, administration cannot currently recommend such actions. After three years of experience working with this contract, we now understand both its strengths and weaknesses. Since we have little or no flexibility to modify the existing agreement without significant risk to the EMS system, our only practical option is to begin the RFP process.
A division of the Santa Clara County Public Health Department EMSCO December 4, 2014 Page 10 of 52
County of Santa Clara
Santa Clara Valley Health & Hospital System
Public Health Department
Board of Supervisors: Mike Wasserman, Cindy Chavez, Dave Cortese, Ken Yeager, S. Joseph Simitian Page 1 of 2 County Executive: Jeffrey V. Smith
74090
DATE: November 12, 2014
TO: Health and Hospital Committee
FROM: Daniel Peddycord, Public Health Director
SUBJECT: Semi-annual Report on EMS System and EMS Agency
RECOMMENDED ACTION
Accept semi-annual report from Emergency Medical Services (EMS) Agency relating to
status of the EMS Agency and EMS System for period January 1, 2014 through August 31,
2014.
FISCAL IMPLICATIONS
This report is for informational purposes only; there is no impact on the General Fund.
The County does not provide any direct funding in support of the services provided by the
911 emergency medical services system because the cost of the Santa Clara County
Emergency Medical Services (EMS) System is paid by system providers, such as hospitals
and ambulance companies, individuals who use these services, and their medical insurers.
REASONS FOR RECOMMENDATION
During their meeting on December 14, 2010, the Board of Supervisors requested that the
EMS Agency provide regular updates to the Health and Hospital Committee regarding the
performance of the County Exclusive Operating Area 911 Ambulance Provider, Rural/Metro
of California.
On November 22, 2011, the Health and Hospital Committee requested that the EMS Agency
provide an update in February 2012, and then provide future updates in May and November
of 2012 and subsequent years. This report provides the requested information including the
status of the EMS System and highlights of some activities of the EMS Agency during the
period from January 1, 2014, through August 31, 2014.
CHILD IMPACT
The recommended action will have no/neutral impact on children and youth.
SENIOR IMPACT
EMSCO December 4, 2014 Page 11 of 52
Board of Supervisors: Mike Wasserman, Cindy Chavez, Dave Cortese, Ken Yeager, S. Joseph Simitian Page 2 of 2 County Executive: Jeffrey V. Smith
Agenda Date: November 12, 2014
The recommended action will have no/neutral impact on seniors.
SUSTAINABILITY IMPLICATIONS
The recommended action will have no/neutral sustainability implications.
BACKGROUND
This semi-annual report emphasizes the period from January 1, 2014, through August 31,
2014.
Because the EMS Agency has been reporting frequently to the Health and Hospital
Committee and Board of Supervisors regarding EMS system issues, this report emphasizes a
few of the EMS Agency’s activities such as Ebola preparedness and response and focuses on
areas most central to EMS system performance such as pre-hospital clinical care and quality
improvement.
CONSEQUENCES OF NEGATIVE ACTION
The Health and Hospital Committee would not receive the information requested from the
EMS Agency.
ATTACHMENTS:
2014 November Semi Annual HHC REPORT 2014-11-12 (PDF)
EMSCO December 4, 2014 Page 12 of 52
Santa Clara County Emergency Medical Services Agency
Semi-Annual Report To the Board of Supervisors’ Health and Hospital Committee
November 2 0 1 4 January 1 to August 31, 2014
EMSCO December 4, 2014 Page 13 of 52
1 Santa Clara County EMS Agency November 2014
TableofContents
Table of Contents ......................................................................................................... 1
EMS Agency Activities ................................................................................................... 2
Ebola Preparedness and Response ................................................................................. 2
Hospital Diversion and Delay of Ambulances at Hospital Emergency Departments ............... 3
Training and Education ................................................................................................... 4
Rural/Metro serving as County Ambulance .................................................................... 7
EMS Trust Fund ............................................................................................................. 7
EMS Trust Fund Revenue ................................................................................................ 8
EMS Trust Fund Expense ................................................................................................. 9
EMS Agency Fee Schedule ........................................................................................... 10
EMS System Descriptive Statistics ............................................................................... 12
Prehospital Clinical Care and Quality Improvement .................................................... 14
Rural/Metro Response Times ....................................................................................... 14
Air Ambulance Transports ............................................................................................ 19
Hospital and Specialty Care Facilities .......................................................................... 20
Hospital Volume and Destinations ................................................................................ 20
Hospital Diversion of Ambulances ................................................................................ 21
Trauma System ............................................................................................................. 22
Stroke System ............................................................................................................... 23
STEMI Care System ....................................................................................................... 24
EMSCO December 4, 2014 Page 14 of 52
2 Santa Clara County EMS Agency November 2014
EMSAgencyActivitiesThis semi‐annual report emphasizes the eight‐month period from January 1, 2014
through August 31, 2014, and includes information and data from calendar year 2013 to
provide context and precedent to the reader.
EbolaPreparednessandResponseThe Santa Clara County Emergency Medical Services (EMS) Agency, in collaboration with
the Department of Public Health and County Health Officer, has acted rapidly and
comprehensively in response to the threat of Ebola. The EMS system’s efforts started in
late July by reeducating EMS providers about proper infection control techniques and
the use of Personal Protective Equipment (PPE). As the outbreak expanded, the EMS
System began to distribute information form the Centers for Disease Control and
Prevention (CDC) and the World Health Organization (WHO) to stakeholders to inform
emergency responders of the scope of the Ebola outbreak and to identify the signs and
symptoms of the disease.
The Ebola epidemic is the largest Ebola outbreak in history. Ebola is at epidemic levels in
Guinea, Liberia, and Sierra Leone. Following identification of the case in Dallas, Texas,
The EMS Agency instituted specific Ebola screening methods within the EMS System to
quickly identify potential Ebola cases within Santa Clara County. This immediate action
was necessary to protect pre‐hospital providers should they encounter a patient that
potentially has the disease, and to provide mechanisms to immediately notify the
County Health Officer and the Centers for Disease Control and Prevention. The EMS
Agency released an Administrative Order on October 8, 2014, that revised Santa Clara
County Prehospital Care Policies relating to infection control and implemented a new
policy regarding Ebola Virus Prevention and Control. These policies define different
types of infection control precautions, define minimum equipment inventories,
treatment guidelines, and created a screening mechanism for the Ebola virus. These
policies also prescribe the practice by which emergency responders identify suspect
cases and rapidly notify the Health Officers and EMS command staff.
As the epidemic evolves, care standards and CDC guidance continue to change. The
EMS Agency and Public Health Department are working to ensure our policies remain
consistent with current guidelines. The EMS Agency has convened a committee of EMS
EMSCO December 4, 2014 Page 15 of 52
3 Santa Clara County EMS Agency November 2014
System stakeholders, including representatives from fire agencies, ambulance providers,
communications centers, and hospitals. This committee is working together to ensure
that prudent policies and procedures are in place to properly identify, treat and
transport a potentially Ebola infected patient. The EMS Agency will continue to review
the tools, conduct exercises and make any corrections to the guidance as needed. All
responding agencies have initiated training activities.
While there is a very low likelihood that an Ebola infected person may present to the
Santa Clara County EMS System, there is a very high likelihood that system responders
will be able to safely identify, treat and transport this patient appropriately.
HospitalDiversionandDelayofAmbulancesatHospitalEmergencyDepartmentsIn summer of 2014, the Santa Clara County EMS Agency, collaborating with hospitals in
Santa Clara County, the County Communications Department, and Rural/Metro, hosted a
Lean Six Sigma Black Belt Course to provide advanced statistical process control training
to EMS System stakeholders and to statistically evaluate the root causes of extended wall
times in Santa Clara County. Generally defined, wall times are the time interval starting
when the ambulance arrives at the emergency department (ED) and ending when
emergency department staff accepts responsibility for the patient and moves that
patient off the ambulance gurney.
The results of this project were surprising. The conventional wisdom that most of the
wall time delays were attributable to hospitals failing to rapidly accept care of the patient
was statistically proven inaccurate in most instances in Santa Clara County. In fact, this
study identified that the mean time interval starting from the ambulance patient arriving
in the emergency department and ending when the ambulance was available for another
response was 31.32 minutes. Of that time, a mean of 1.57 minutes was used to enter the
facility, a mean of 10.42 minutes was used to place the patient in a bed and to transfer
care to the hospital, and a mean of 18.52 minutes was used by the ambulance crew to
restock and to complete paperwork. Thus we learned that most of the “wall time” delay
was attributable to the EMS crews restocking and completing their paperwork.
While this study had a small sample size, its findings are significant. In many instances,
the current practice of automatically placing ambulances back in service during slow
EMSCO December 4, 2014 Page 16 of 52
4 Santa Clara County EMS Agency November 2014
periods at 30 minutes may increase out of service times. Therefore, EMS practices are
being revised to create a culture that strives for 20 minute hospital drop times for all
patients transported to hospital emergency departments, and hospitals are investigating
new methods of emergency department intake of ambulance patients. While this
problem will be solved in the long term, this study shows the importance of
understanding, defining and measuring the problem, before solving the problem. If the
EMS Agency would have tried to unilaterally reduce extended wall times through
regulatory fiat, before truly understanding the problem, the results would have angered
stakeholders, but not reduced wall times. This study is a great example of the EMS
System emerging as a learning and quality‐focused meta‐organization.
TrainingandEducation
Training
From January 1, 2014, to August 31, 2014,
the Santa Clara County EMS Agency
provided 1,293 hours of continuing
education to 244 EMS personnel. From
October 2013 to February 2014 over 2,400
providers complete the annual EMS
Update Training. This mandatory annual
training emphasizes policies and protocols that have been revised; however, this
training cycle also included education and assessment training on the Santa Clara
Assessment for Missed Posterior Stroke (S.C.A.M.P.S) Trial.
EMS System Training and Education Videos
The Santa Clara County EMS Agency created and released the following videos as
educational resources for those who live, work and play in Santa Clara County. Each
video provides insight into the 911 Emergency Medical Services System and feature
some of the equipment used by the EMS professionals in the Santa Clara County EMS
System.
EMS Training and Education Totals
Training Opportunities 9
Number of Prehospital personnel in attendance
244
Number of Continuing Education Hours provided
1,293
EMSCO December 4, 2014 Page 17 of 52
5 Santa Clara County EMS Agency November 2014
The Santa Clara County EMS System Overview
video provides a summary of the services provided
in the Santa Clara County EMS System.
AN INSIDE LOOK: Santa Clara County 911 Ambulances
This video provides an orientation to the
capabilities and equipment contained within Santa
Clara County 911 Ambulances known as "Medic"
units.
Santa Clara County EMS RADIO SYSTEM and COMMUNICATIONS PROCEDURES
This video provides guidance for the use of the Santa
Clara County’s EMS Communication System.
Santa Clara County Multiple Patient Management
Plan ‐ MPMP
This video provides an overview of how to implement the Santa Clara County Multiple
Patient Management Plan while responding to a multi‐causality incident (MCI).
Public Education
From January 1, 2014, to June 30, 2014, the EMS Agency promoted six public education
campaigns related to emergency medical services. These monthly campaigns included
Medical Alerts, the Santa Clara County Emergency Alert System (AlertSCC), Pool Safety,
EMSCO December 4, 2014 Page 18 of 52
6 Santa Clara County EMS Agency November 2014
Stroke Awareness, Preventing Snake Bites and “Pull to the Right for Sirens and Lights.”
Each month the EMS Agency provides educational campaign materials to every fire
department and ambulance company within the Santa Clara County EMS System. These
materials include educational flyers, postcards, posters, and pamphlets to pass out to
the community, and talking points for use during presentations. By coordinating the
public education campaigns for all providers within the EMS System, the public message
is consistent, regardless of which organization provides the message. This minimizes the
possibility of misinformation and assures a coordinated message countywide.
Social Media
The EMS Agency actively uses social
media to promote and distribute
information about EMS events. As a
result, the number of people following
the EMS Agency’s Facebook page has
EMSCO December 4, 2014 Page 19 of 52
7 Santa Clara County EMS Agency November 2014
doubled since last year. On the EMS Agency’s Facebook page or Twitter feed, you will
find information about monthly educational campaigns and training announcements,
recognition of EMS providers and information about EMS meetings and forums. An
example of recognition shared on the Agency’s Facebook and Twitter feed was the
Proclamation issued in recognition of EMS Week held in June of 2014. This provided a
way for the EMS Agency to share the event with the many EMS Providers that were
unable to attend the Board of Supervisors meeting. The EMS Agency’s Twitter feed is
@XSCEMS.
Rural/MetroservingasCountyAmbulanceRural/Metro of California, operating as County Ambulance, has provided emergency
paramedic ambulance service for the Santa Clara Emergency Medical Services (EMS)
System since July 1, 2011. The
Santa Clara County EMS System
continues to be stable, and
assures that every person who
calls 911 for a medical
emergency will receive an
emergency paramedic
ambulance and trained first
responders.
From January 1, 2014, through August 30, 2014, Rural/Metro met contractual response
time performance standards, every month, in all five zones, for emergency and non‐
emergency calls. Detailed information about EMS System performance, including
Rural/Metro’s response time performance statistics, is provided later in this report.
EMSTrustFundThe EMS Trust Fund’s purpose is to provide funding for projects with a countywide
benefit to EMS System providers, enhance the services provided within the EMS System
and to improve the delivery of 911 emergency medical care in the County. The EMS
Trust Fund is a backward‐looking fund; that is, funds collected in one year are expended
the following year. This process provides policy and spending oversight by the Board of
Supervisors, and provides adequate time to consider spending allocations in the context
EMSCO December 4, 2014 Page 20 of 52
8 Santa Clara County EMS Agency November 2014
of strategic EMS System change. EMS Agency plans to bring its FY16 EMS Trust Fund
Recommendations to the Health and Hospital Committee for review and approval in
March 2015.
EMSTrustFundRevenueThe EMS Trust Fund is funded with revenues from liquidated damages (fines) from the
contracted 911 paramedic ambulance provider (Rural/Metro) for failing to meet per‐call
response time standards; monthly zone response time standards; or for failing to meet
other contract stipulations, such as maintaining minimum ambulance availability or
avoiding ambulance breakdowns.
Month / Year Amount
July 2013 $183,000
July 2013 – Rural/Metro Bankruptcy Relief ($183,000)
August 2013 $209,250
September 2013 $217,750
October 2013 $272,500
November 2013 $271,750
December 2013 $278,280
January 2014 $238,750
February 2014 $281,000
March 2014 $278,280
April 2014 $249,000
May 2014 $182,500
June 2014 $330,500
TOTAL $2,809,560
Average Monthly Liquidated Damages $234,130
The amount of these liquidated damages is significantly greater than the amount of
liquidated damages in previous 911 paramedic ambulance service contracts. However,
the greater amount of liquidated damages is primarily due to a substantially more
expensive fine structure. In some cases, fine levels in the Rural/Metro contract are ten
times greater than in prior contracts.
EMSCO December 4, 2014 Page 21 of 52
9 Santa Clara County EMS Agency November 2014
EMSTrustFundExpenseEMS Trust Fund expenses are approved by the Health and Hospital Committee and the
Board of Supervisors before the start of the fiscal year. The EMS Agency routinely
provides detailed financial reports to the Health and Hospital Committee about the EMS
Trust Fund. This EMS Trust Fund summary discusses how expenditures from the EMS
Trust Fund improve emergency medical services within Santa Clara County.
Category A: Reserve
At the Board of Supervisors’ direction, starting in Fiscal Year 2011‐2012, a reserve
category was established in the EMS Trust Fund. This amount, which is at least 20% of
the EMS Trust Fund, is placed into reserve and used only for significant strategic projects
that benefit the EMS System with a long range focus. Following approval by the Board
of Supervisors, these funds could also be used if the EMS System experiences an
unanticipated financial burden, such as the failure of an ambulance provider or an
extraordinary increase of cost of service or supplies, or a material decrease in system‐
wide third‐party payor reimbursement. During the 2013‐2014 Fiscal Year, $575,000 of
the EMS Trust Fund monies was placed into reserve.
Category B: Training, Education and Recognition Funding authorized in this category was used for annual training, education, exercises,
and recognitions. Funds were used in the following subcategories:
∙ EMS System Information to the Public
∙ Training (which is not funded by grants or other sources)
∙ Exercises (which are not funded by grants or other sources)
∙ EMS Provider and committee member recognition, and EMS Week
During the 2013‐2014 Fiscal Year, $235,000 was allocated to training, education, and
recognition.
Category C: Benefit to EMS System Stakeholders
Funds were allocated from this category to assist EMS System Stakeholders with one‐
time or short‐term needs. During Fiscal Year 2013‐2014, funds were allocated to the fire
EMSCO December 4, 2014 Page 22 of 52
10 Santa Clara County EMS Agency November 2014
departments within Santa Clara County to provide hardware to support the County EMS
System Data Project. This funding will provide fire departments with the ability to enter
and transmit patient care data from the scene of an emergency; rather than waiting to
enter data until the unit has returned to a fire station. This allocation was essential to
creating a comprehensive EMS System data collection and analysis capability. During the
2013‐2014 Fiscal Year, $200,000 was allocated to short term and one time projects that
benefit EMS System Stakeholders, such as manikins to help emergency responders
improve their ability to secure patients’ airways and to better analyze EMS System
clinical data.
Category D: Strategic Initiatives
Projects in this category emphasize initiatives that strategically advance the Santa Clara
County EMS System, often in the longer term. During FY 2013‐2014, funds were
allocated to the implementation of the 10 Goals in the EMS System Strategic Plan.
Implementation of the EMS System Strategic Plan is necessary to allow the County EMS
System to adapt to the anticipated care and reimbursement changes associated with
the federal Affordable Care Act and national health care reform. Implementation of the
10 Goals in the strategic plan would allow the County EMS System to continue to
provide excellent clinical care, to better target patient needs to resources, to assure
operational efficiency, to remain financially stable, and have high levels of patient and
stakeholder satisfaction. Monies were also allocated to fund further development of
the Comprehensive EMS Data System. Category D funds were also spent to support the
development of the Integration of hospitals into the Comprehensive EMS Data System,
to support development of the Sobering System, Six Sigma Training, and the Public
Health Department Operations Subsidy. During Fiscal Year 2013‐2014, $1,640,000 was
allocated to strategic projects and $750,000 was provided as a general subsidy to the
Public Health Department.
EMSAgencyFeeScheduleThe EMS Agency relies on fee‐for‐service fees for funding operations, including system‐
wide planning, policy and clinical protocol development, analysis, and operational and
clinical quality improvement. The EMS Agency has not increased its fees since July 1,
2011.
EMSCO December 4, 2014 Page 23 of 52
11 Santa Clara County EMS Agency November 2014
The EMS Agency did not request a fee modification from the Board of Supervisors for
Fiscal Year 2014, because unprecedented changes in the EMS System operations and
EMS Agency planning and quality improvement linked to the EMS System Strategic Plan
will occur in starting in the second half of Fiscal Year 2014. The current fee structure is
listed on the following page:
Fiscal Year 2015 EMS Agency Fee Schedule
ITEM/SERVICE FEE
INDIVIDUAL FEES
EMT Certification $50
EMT Re‐Certification (biennial) $50
Paramedic Local Accreditation $150
Identification Card $20
Replacement ID Card (certification, accreditation, system ID)
$20
Photocopying $4.75 (1st page)
$.10/ea. Addl.
COMPANY FEES
Ambulance Service Permits (annual fee)
Basic Life Support $5,500
Advanced Life Support $6,000
Critical Care Transfer $6,000
Air Ambulance Service $8,000
Ambulance Vehicle Permits (annual fee)
Basic Life Support $950
Advanced Life Support $950
Critical Care Transfer $950
Air Unit $950
Non‐Transport BLS/ALS Unit $800
Education Program Certification (every 4 years)
EMT Program $1,000
Paramedic Program $5,000
Prehospital Continuing Education $1,000
Specialty Care Designation (annual fee)
Trauma Center Designation $100,000
EMSCO December 4, 2014 Page 24 of 52
12 Santa Clara County EMS Agency November 2014
Stroke Center Designation $10,000
STEMI Receiving Center Designation $10,000
911 Receiving Center Designation $10,000
EMSSystemDescriptiveStatisticsListed in the following tables are statistics that describe the characteristics of the Santa
Clara County EMS from January 1, 2014, through August 30, 2014.
The County of Santa Clara
Daytime Population 2.2 million
Resident Population 1.8 million
Geographic Size 1,132 square miles
Proportion of Rural/Urban Land 2/3 rural
Municipalities 15
911 System Call Volume
January through
August 31, 2014 Annualized
Total Responses 73,513 126,022
Total Events with Ground Ambulance Transports 48,521 83,778
Total Patients Transported by Ground Ambulance 48,987 83,977
EMS Aircraft Response 86 147
EMS Aircraft Transports 57 97
Ground Ambulance Interfacility Transports
January through
August 31, 2014 Annualized
Ground Ambulance (Jan‐August 2014) 28,843 49,445
Ground Ambulance 2013 54,982
Ground Ambulance 2012 54,254
Ground Ambulance 2011 49,322
Specialty Center Patients
January through
August 31, 2014 Annualized
Stroke Patients 1,249 2141
EMSCO December 4, 2014 Page 25 of 52
13 Santa Clara County EMS Agency November 2014
Trauma Patients 3,923 6725
STEMI Patients 216 370
Pre‐Hospital Care Provider Agencies
Fire Departments 11
Ground Ambulance Services 11
Air Ambulance Services 2
Pre‐Hospital Care Personnel
Emergency Medical Technicians 2,489
Paramedics 754
Mobile Intensive Care Nurses 22
Accredited EMS Field Supervisors 17
Permitted EMS Assets
Fire Apparatus 159
Private Ground Ambulances 216
Private Air Ambulances 3
Private EMS Non‐Transport Units 16
Communications Centers
Public Safety Answering Points (PSAPs) 13
Secondary PSAPs 10
Private Ambulance Dispatch Centers 10
Air Ambulance Dispatch Centers 2
Acute Care Facilities
Acute Care Hospitals 12
Emergency Departments 11
Level 1 Trauma Centers 2
Level 2 Trauma Centers 1
Base Hospitals 1
Burn Centers 1
Stroke Centers 10
STEMI Centers 8
County Managed Medical and Health Disaster Resources
Field Treatment Site Trailers 8
EMSCO December 4, 2014 Page 26 of 52
14 Santa Clara County EMS Agency November 2014
Specialty Services Trailers 3
Chem‐Packs 8
Medical‐Health Operations Center 1
EMS Radio Caches 7
Disaster Medical Support Units 2
Prehospital Training Programs
Emergency Medical Technician 7
Paramedic 2
EMS Fellowship 0
PrehospitalClinicalCareandQualityImprovement
Rural/MetroResponseTimes
AmbulanceResponseTimestoEmergencyCallsThe chart below identifies Rural/Metro’s response times to Code 3 (emergency red light
and siren) calls by month from January 1, 2014, through August 30, 2014, in each of the
five ambulance subzones within Santa Clara County. The response time standard is 90%
or greater, and is represented by the yellow horizontal line on this graphic. During the
January 1, 2014 to August 31, 2014 reporting period, Rural/Metro met contractual
response time standards in each of the five subzones, every month.
EMSCO December 4, 2014 Page 27 of 52
15 Santa Clara County EMS Agency November 2014
County Ambulance Code 3 Response Times
Code 3 Response Jan 14 Feb 14 Mar 14 Apr 14 May 14 Jun 14 Jul 14 Aug 14
Overall 93.30% 92.64% 92.83% 91.67% 94.03% 93.97% 92.66% 92.58%
Zone 1 92.40% 92.07% 93.03% 91.38% 94.19% 93.46% 92.12% 92.65%
Zone 2 91.93% 91.58% 92.46% 90.19% 94.09% 93.45% 91.50% 91.60%
Zone 3 94.29% 93.41% 92.69% 92.86% 94.06% 94.01% 94.63% 93.70%
Zone 4 93.38% 93.34% 92.85% 91.64% 93.40% 93.83% 91.82% 92.02%
Zone 5 95.49% 90.62% 93.68% 91.45% 95.81% 97.12% 92.33% 92.62%
AmbulanceResponseTimestoNon‐EmergencyCallsThe chart below identifies Rural/Metro’s response times to Code 2 (non‐emergency)
calls by month from January 1, 2014, through August 31, 2014, in each of the five
ambulance subzones within Santa Clara County. The response time standard is 90% or
greater, and is represented by the yellow horizontal line on this graphic. During the
January 1, 2014 to August 31, 2014 reporting period, Rural/Metro met contractual
response time standards in each of the five subzones, every month.
86.00%
88.00%
90.00%
92.00%
94.00%
96.00%
98.00%
100.00%
Jan 14 Feb 14 Mar 14 Apr 14 May 14 Jun 14 Jul 14 Aug 14
County Ambulance Code 3 Response Time Compliance by Month
Overall Zone 1 Zone 2 Zone 3 Zone 4 Zone 5
EMSCO December 4, 2014 Page 28 of 52
16 Santa Clara County EMS Agency November 2014
County Ambulance Code 2 Response Times
Code 2 Response Jan 14 Feb 14 Mar 14 Apr 14 May 14 Jun 14 Jul 14 Aug 14
Overall 94.60% 92.70% 94.60% 93.32% 94.79% 95.62% 93.18% 94.23%
Zone 1 97.16% 95.34% 94.95% 95.64% 95.95% 96.87% 97.06% 95.83%
Zone 2 94.76% 92.64% 93.72% 93.44% 96.27% 95.89% 91.67% 93.20%
Zone 3 93.41% 90.79% 95.02% 93.36% 94.73% 96.30% 92.72% 92.67%
Zone 4 93.80% 91.63% 93.74% 91.09% 92.13% 93.55% 91.48% 94.78%
Zone 5 92.68% 95.24% 100.00% 94.12% 98.04% 97.35% 94.74% 95.83%
FireDepartmentFirstResponderResponseTimes
FireDepartmentFirstResponderResponseTimestoEmergencyCallsThe chart identifies fire department response times to Code 3 (emergency red light and
siren) calls by month from January 1, 2014, through August 31, 2014, for each of the first
responder fire departments within Santa Clara County. Fire departments should achieve
a response time of 90% or greater, and those who achieve a response time of 95% or
greater are exempted from any response time liquidated damages incurred during that
month.
86.00%
88.00%
90.00%
92.00%
94.00%
96.00%
98.00%
100.00%
Jan 14 Feb 14 Mar 14 Apr 14 May 14 Jun 14 Jul 14 Aug 14
County Ambulance Code 2 Response Time Compliance by Month
Overall Zone 1 Zone 2 Zone 3 Zone 4 Zone 5
EMSCO December 4, 2014 Page 29 of 52
17 Santa Clara County EMS Agency November 2014
The San Jose Fire Department has complied with the 90th percentile response time
performance standard three times during the Janaury 2014 through August 31, 2014
period. While this performance does not allow the City of San Jose to cure its
continuing Breach of Annex B, which is the voluntary reimbursement agreement, it
appears that since the Board of Supervisors’ action in February 2014, the San Jose Fire
Department’s response time performance is trending toward gradual improvement.
In February 2014, the Board of Supervisors directed its Management Audit Division to
conduct a limited scope of management audit of the San Jose Fire Department’s 911
EMS response policies and procedures to identify the issues impeding the department’s
ability to respond to emergency medical 911 calls in accordance with the goals specified
in the agreement between the County and City, and to make recommendations that
would enable the City to achieve the performance goals. The findings and
recommendations of the final audit report have not been released and are not included
in the report. A summary of the final audit report will be included in the next EMS
Agency’s Semi Annual Report to the Board of Supervisors’ Health and Hospital
Committee in May 2015.
80%
82%
84%
86%
88%
90%
92%
94%
96%
98%
100%
Jan 14 Feb 14 Mar 14 Apr 14 May 14 Jun 14 Jul 14 Aug 14
Fire Department Code 3 Response Time Compliance by Month
Gilroy Milpitas Morgan Hill Mt. View San Jose
Santa Clara Santa Clara Co. So. Santa Clara Co. Sunnyvale
EMSCO December 4, 2014 Page 30 of 52
18 Santa Clara County EMS Agency November 2014
Fire Department Code 3 First Responder Response Time Compliance by Month
Code 3 Response Jan 14 Feb 14 Mar 14 Apr 14 May 14 Jun 14 Jul 14 Aug 14
Gilroy 98.54% 98.18% 96.79% 98.18% 98.78% 99.59% 98.05% 98.45%
Milpitas 98.27% 95.28% 96.60% 97.36% 96.04% 96.72% 95.17% 96.46%
Morgan Hill 95.16% 95.65% 98.34% 98.33% 99.54% 96.32% 95.81% 95.48%
Mt. View 96.76% 97.40% 97.20% 95.78% 95.33% 96.51% 97.61% 97.28%
San Jose 88.06% 87.66% 88.75% 90.39% 88.94% 90.31% 92.53% 88.95%
Santa Clara 96.54% 95.67% 96.91% 95.47% 95.40% 95.13% 96.07% 93.91%
Santa Clara Co. 96.12% 95.25% 96.10% 97.17% 96.30% 95.31% 95.39% 95.96%
So. Santa Clara Co. 93.15% 90.24% 97.03% 95.45% 94.12% 96.33% 90.91% 90.99%
Sunnyvale 97.78% 98.36% 98.81% 98.35% 98.25% 98.79% 99.20% 98.28%
FireDepartmentResponseTimestoNon‐EmergencyCallsThe chart below identifies fire department response times to Code 2 (non‐emergency)
calls by month from January 1, 2014 through August 31, 2014 for each of the first
responder fire departments within Santa Clara County. Fire departments should achieve
a response time of 90% or greater, and those who achieve a response time of 95% or
greater are exempted from any response time liquidated damages incurred during that
month. Several fire departments choose to respond Code 3 to all incidents.
80%
82%
84%
86%
88%
90%
92%
94%
96%
98%
100%
Jan 14 Feb 14 Mar 14 Apr 14 May 14 Jun 14 Jul 14 Aug 14
Fire Department Code 2 Response Time Compliance by Month
Mt. View San Jose Santa Clara Santa Clara Co.
EMSCO December 4, 2014 Page 31 of 52
19 Santa Clara County EMS Agency November 2014
Fire Department Code 2 Response Time Compliance by Month
Code 2 Response Jan 14 Feb 14 Mar 14 Apr 14 May 14 Jun 14 Jul 14 Aug 14
Mt. View 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 97.44% 97.87%
San Jose 94.46% 93.67% 96.18% 96.55% 96.55% 96.50% 97.86% 97.30%
Santa Clara 98.52% 98.58% 95.47% 98.47% 96.64% 98.62% 99.21% 97.35%
Santa Clara Co. 100.00% 98.73% 100.00% 99.37% 100.00% 98.67% 99.45% 99.35%
AirAmbulanceTransports
Air ambulance utilization continued at relatively low levels during the first half of 2014.
The number of air ambulance dispatches and transports shown in this chart is based on
the first eight months of 2014. This volume of responses and transports has remained
relatively static since approximately 2009. The EMS Agency considers this volume of air
ambulance responses and transports appropriate.
Year Dispatches Transports Utilization Percent
2002 540 254 47%
2003 524 236 45%
2004 545 251 46%
2005 463 205 44%
2006 443 221 50%
2007 442 207 47%
2008 248 137 55%
540 524545
463443 442
248
184 176 179 183
12986
254236 251
205 221 207
137111 103 107 109
74 57
0
100
200
300
400
500
600
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Air Ambulance Utilization by Year
Responses Transports
EMSCO December 4, 2014 Page 32 of 52
20 Santa Clara County EMS Agency November 2014
2009 184 111 60%
2010 176 103 59%
2011 179 107 60%
2012 183 109 60%
2013 129 74 57%
2014 (8 months) 86 57 66%
HospitalandSpecialtyCareFacilities
HospitalVolumeandDestinationsFrom March 1, 2014, through August 31, 2014, there were 37,782 ambulance
transports from the 911 System to hospitals within Santa Clara County. Santa Clara
Valley Medical Center continues to demonstrate the highest volumes.
Ambulance Destination by Hospital
Hospital Mar 14 Apr 14 May 14 Jun 14 Jul 14 Aug 14 Total
El Camino ‐ Los Gatos 100 107 95 86 90 82 560
El Camino ‐ Mt. View 694 637 667 661 594 670 3,923
Good Samaritan 594 568 567 595 588 589 3,501
Kaiser ‐ San Jose 596 559 599 543 513 519 3,329
Kaiser ‐ Santa Clara 675 685 677 629 597 624 3,887
O'Connor 595 583 564 551 496 575 3,364
Regional San Jose 1,080 1,120 1,116 1,072 1,033 1,145 6,566
0
200
400
600
800
1000
1200
1400
Mar‐14 Apr‐14 May‐14 Jun‐14 Jul‐14 Aug‐14
Ambulance Destination by HospitalMarch - August 2014
El Camino ‐ Los Gatos
El Camino ‐ Mt. View
Good Samaritan
Kaiser ‐ San Jose
Kaiser ‐ Santa Clara
O'Connor
Regional ‐ San Jose
Saint Louise
Stanford
VA ‐ Palo Alto
VMC
EMSCO December 4, 2014 Page 33 of 52
21 Santa Clara County EMS Agency November 2014
Saint Louise 269 233 273 246 212 260 1,493
Stanford 441 440 511 511 492 521 2,916
VA ‐ Palo Alto 89 95 87 78 151 79 579
VMC 1,308 1,259 1,318 1,273 1,242 1,264 7,664
Total 6,441 6,286 6,474 6,245 6,008 6,328 37,782
HospitalDiversionofAmbulancesHospital diversion levels have dropped significantly over this six month period. EMS
Agency policy limits hospitals to no more than 36 hours of diversion per month and all
facilities have met this benchmark. This standard is represented by the yellow horizontal
line on this graphic. There was a significant increase in the hours noted for stroke
service advisory. This was attributed to a mechanical failure and resulted in a 124 hour
CT/stroke diversion. This issue has been resolved and the agency does not anticipate
any further problems.
0.005.00
10.0015.0020.0025.0030.0035.0040.0045.0050.00
Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14
Ambulance Diversion by HospitalMarch-August, 2014
El Camino - LosGatosEl Camino - Mt.ViewGood Samaritan
Kaiser - San Jose
Kaiser - SantaClaraO'Connor
Regional - SanJoseSaint Louise
EMSCO December 4, 2014 Page 34 of 52
22 Santa Clara County EMS Agency November 2014
Total Monthly Hours of "AMBULANCE DIVERSION" Status
Hospital Mar 14 Apr 14 May 14 Jun 14 Jul 14 Aug 14 Total
El Camino ‐ Los Gatos 0.00 0.00 0.81 0.00 0.00 0.00 0.81
El Camino ‐ Mt. View 21.09 12.51 12.04 10.11 12.78 14.83 83.36
Good Samaritan 1.51 1.50 0 0.00 3.01 0.00 6.02
Kaiser ‐ San Jose 2.91 9.78 4.51 11.63 6.00 10.99 45.82
Kaiser ‐ Santa Clara 0.00 6.02 1.5 0.00 0.00 1.51 9.03
O'Connor 3.00 1.50 1.51 3.00 6.63 3.00 18.64
Regional San Jose 0.09 0.00 3.11 3.58 3.01 1.26 11.05
Saint Louise 16.58 7.51 19.05 4.52 16.59 8.93 73.18
Stanford 4.53 0.00 3.03 1.50 9.05 4.52 22.63
VA ‐ Palo Alto 6.98 2.44 10.68 12.04 16.15 21.04 69.33
VMC 30.44 15.58 14.75 19.19 10.35 22.24 112.55
Total 87.13 56.84 70.99 65.57 83.57 88.32 452.42
TraumaSystemBetween January 1, 2014, and June 30, 2014, 3,923 trauma patients were seen in the
Santa Clara County trauma system. This includes 3,257 adults and 323 pediatric patients
(pediatric age range is 0 to less than age 15). Eighty percent of trauma patients were
transported to a trauma center by ambulance, while eleven percent of trauma patients
were transported to a trauma center by an air ambulance. Effort continues to
standardize the trauma system within the Bay Area through the Regional Trauma Care
Committee. This committee is evaluating inter‐facility trauma transfers and working to
increase outreach to non‐trauma centers in order to facilitate an ease of transfers for
seriously injured patients.
CountyofOriginSanta Clara County is the primary county of origin for trauma patients that enter the
Santa Clara County trauma system, producing 44% of the volume of trauma patients.
Other counties refer some of their trauma patients to Santa Clara County, producing
significant proportions of the total trauma volume in Santa Clara County. Those counties
include: Alameda County at 2%; San Mateo County at 13%; Monterey County at 5%; San
Benito County, and Santa Cruz County at 3%.
EMSCO December 4, 2014 Page 35 of 52
23 Santa Clara County EMS Agency November 2014
MechanismofInjuryNinety‐three percent of the injuries in the Santa Clara County trauma system are caused
by a blunt mechanism of injury, such as motor vehicle/motorcycle injuries, pedestrians
struck by car, and bicycle accidents. The remaining seven percent are caused by
penetrating mechanisms of injury, such as gunshot wounds and stabbings. These
percentages have remained constant for the past four years.
DispositionfromtheEmergencyDepartmentFifty‐one percent (51%) of trauma patients are admitted to the hospital. Forty‐eight
percent (48%) of trauma patients are discharged from the emergency department. Less
than one percent (0.80 %) of trauma patients expired in the emergency department.
StrokeSystemThe Santa Clara County Board of Supervisors approved a stroke care system developed
by the Santa Clara County Emergency Medical Services Agency in March of 2006. This
evidence‐based system provides patients the opportunity to be transported to the
closest, specially designated hospital, which can provide immediate stroke care to
patients who show symptoms of an acute stroke.
0%5%
10%15%20%25%30%35%40%45%50%
Santa Clara Alameda Monterey San Benito Santa Cruz San Mateo
Injury by County of Origin January ‐ June 2014
EMSCO December 4, 2014 Page 36 of 52
24 Santa Clara County EMS Agency November 2014
The need for rapid intervention is based on clinical evidence that treatment with an
anti‐clotting drug (IV tPa) within three and a half hours of the onset of their symptoms
may prevent and possibly reverse the effects of the blocked circulation to the brain. The
Santa Clara Stroke System was designed with two specific goals. The first goal is to
increase the number of patients who arrived in the emergency department at the stroke
center within the time necessary to allow administration of anti‐clotting agents. The
second goal is to educate the public about stroke symptoms, and the need to call 9‐1‐1
if symptoms are present.
January 1, 2014 through June 30, 2014 Performance Data
Criteria County
Performance Data Percentages
Total Stroke Volume 1,249 100%
Total Number of Ischemic Strokes 1,003 80%
Total Strokes Transported by EMS 648 39%
Total Strokes Self‐Transported 485 41%
Total patients by interfacility Transfer 96 8%
% of Ischemic Stroke treated by IV tPA 17% National Average (1‐8%)
STEMICareSystemSanta Clara County’s STEMI (S‐T Elevation Myocardial Infarction) Care System continues
to be regarded as a model system of care. A STEMI is a serious type of heart attack
associated with higher rates of morbidity and mortality. Patients identified by
paramedics as STEMI Alert patients, based on a 12‐lead electrocardiogram, are treated
rapidly with Percutaneous Coronary Intervention (PCI), which includes balloon
angioplasty and stents, to open the blockage in the artery.
The median length of stay in the hospital after the procedure is two days. From January
2014 through June 2014, 94% of the patients treated with Percutaneous Coronary
Intervention had median door to balloon (D2B) of less than 90 minutes, versus a
national benchmark of 75% of cases treated in 90 minutes or less.
EMSCO December 4, 2014 Page 37 of 52
25 Santa Clara County EMS Agency November 2014
Median door to balloon times for patients that arrive by EMS is 55 minutes, well below
the national benchmark of 58 minutes. The median time for those who arrive by other
methods is considerably higher with a rate of 77 minutes.
Criteria Jan to Jun 2014 Jan to Jun 2013
Total cases with documented STEMI 216 217
Median Door to Balloon time in Minutes
64 66
Goal Met (D2B <90 min 75% of cases National standard)
94% of PCI cases were performed in less than 90
minutes
95% of PCI Cases were performed in less than 90
minutes
Total STEMI cases brought by EMS 123 124
Total STEMI Cases who self‐transported
43 83
Total STEMI Cases brought by Interfacility transport
8 12
EMSCO December 4, 2014 Page 38 of 52
A division of the Santa Clara County Public Health Department
County of Santa Clara Emergency Medical Services System
Emergency Medical Services Agency 976 Lenzen Avenue, Suite 1200
San Jose, CA 95126
408.885.4250 voice 408.885.3538 fax
www.sccemsagency.org
Date: December 4, 2014 To: Santa Clara County EMS Committee Members From: Michael Petrie EMS Director Subject: Rural/Metro Contract Revision On September 23, 2014, the Board of Supervisors directed County Staff to begin to develop a request for proposal (RFP) for 911 Paramedic Ambulance Services in the Santa Clara County Exclusive Operating Area to potentially award a new contract, starting July 1, 2016. It is important to emphasize that this action only allows the EMS Agency to develop the RFP; thus providing the County with the option of later releasing a RFP. The Board of Supervisor’s action does not compel the County to release the RFP or, if it releases the RFP, to execute an agreement with a bidder. Further, County staff has committed to brining the RFP back to the Board of Supervisors before it is released. This action does not negate the County’s right to extend the term of the Agreement with Rural/Metro for one or two additional 3-year periods, by providing Rural/Metro no less than (60) days prior written notice. Since the last EMSCO meeting on October 2, 2014, the EMS Agency has released a solicitation to hire a RFP consultant, met with the California EMS Authority to discuss their parameters, considerations, and constraints on RFP processes to create an exclusive operating area, and begun to draft a new RFP. The EMS Agency anticipates approximately that at least 18 months is necessary to create and release an RFP for 911 EOA paramedic ambulance services, to select the desired vendor, and to provide time for the vendor to prepare for operation. I will provide an oral report on this item and answer questions at the EMS Committee Meeting. Options 1) Accept the EMS Director’s oral report as presented. 2) Do not accept the EMS Director’s oral report as presented. Recommendation 1) Accept the EMS Director’s oral report as presented.
EMSCO December 4, 2014 Page 39 of 52
County of Santa Clara Emergency Medical Services System
Emergency Medical Services Agency 976 Lenzen Avenue, Suite 1200 San Jose, CA 95126 408.885.4250 voice 408.885.3538 fax www.sccemsagency.org
Date: December, 2014 To: Santa Clara County EMS Committee Members From: Eric M. Rudnick, MD, FACEP, FAAEM Santa Clara County EMS Agency Medical Director
Subject: Clinical Care/Medical Directors Report
The Santa Clara County EMS Agency has been incredibly busy in regards to planning for the most recent emerging infectious disease (EID), Ebola Viral Disease (EVD). This epidemic has been devastating to various Western African countries. The outbreak has been the largest since the viral hemorrhagic fevers were first identified in1976. Although currently the risk is small to the citizens of Santa Clara County, we at the EMS Agency have used this to strength our working relationship with Public Health. I have worked closely with our Health Officer Sara Cody, MD, and our Deputy Health Officer George Han, MD. There have been many long hours planning for the possibility of a patient presenting with EVD.The various stakeholder groups have risen to the challenge of trying to protect the public and their providers with a disease that has such a high mortality rate. We have taken advantage of this opportunity to strengthen the approach to provider safety and how EMS deals with infectious diseases. We have released an “Infectious Disease Control Measures” protocol to reinforce what is good practice for the EMS provider community. We have also released an EVD specific protocol following both CDC and Cal-OSHA guidance. To place this current threat in perspective, the 1918-1919 Pandemic Influenza outbreak killed approximately 50 million people worldwide. It is estimated that between 20 to 40% of the world’s population became ill. So it was felt that a strong approach to infectious diseases was long overdue. Thank you for your attention and respectfully submitted.
A division of the Santa Clara County Public Health Department EMSCO December 4, 2014 Page 40 of 52
Month / Year Amount
January-14 $238,750.00
February-14 $281,000.00
March-14 $278,280.00
April-14 $249,000.00
May-14 $182,500.00
June-14 $330,500.00
July-14 $206,750.00
August-14 $323,500.00
September-14 $349,000.00
October-14 $325,500.00
November-14 $
December-14 $
Total for CY14 $2,764,780.00
Average Monthly Total In Period $276,478.00
County of Santa Clara Emergency Medical Services System
Emergency Medical Services Agency 976 Lenzen Avenue, Suite 1200 San Jose, CA 95126 408.885.4250 voice 408.885.3538 fax www.sccemsagency.org
Date: December 4, 2014
To: Santa Clara County EMS Committee Members
From: Patricia Natividad
Senior Management Analyst Subject: EMS Trust Fund – Liquidated Damages for Calendar Year 2014
Monthly Liquidated Damages for Response Time
January 1, 2014 – December 31, 2014 .
A division of the Santa Clara County Public Health Department EMSCO December 4, 2014 Page 41 of 52
A division of the Santa Clara County Public Health Department
County of Santa Clara Emergency Medical Services System Emergency Medical Services Agency 976 Lenzen Avenue, Suite 1200 San Jose, CA 95126 408.885.4250 voice 408.885.3538 fax www.sccemsagency.org
Date: December 4, 2014 To: Santa Clara County EMS Committee Members From: John Blain Contract Manager Subject: County EOA Service Area Response Time Performance Report for County Ambulance History and Issue The County has entered into agreements with private and public entities to provide emergency medical response and advanced life support ambulance transportation services. Periodic response time compliance reports have been provided to the EMS Committee for the purpose of providing public review of those entities’ performance and compliance with contractual response time requirements. The County has performance based contracts with the following entities:
1. Rural/Metro of California (County Ambulance provider) Context Compliance is measured by several key performance indicators that include; response time requirements based on population density; designated response areas; type of response priority (red lights & siren or non-red lights & siren); total number of responses; total number of late responses; and total number of responses exempted (removed) from compliance calculations. Compliance is achieved when ninety (90%) percent or more of the responses meet the specified response time requirement in each response priority within each designated response area. This report contains response time compliance data for November 2013-October 2014. Cost There is no direct cost to the EMS Committee to accept and/or not accept the report. Legal Issues There are no legal issues related to accepting and/or not accepting the report. Options 1) Recommend that the EMS Committee accepts the “County EOA Service Area Response Time Performance Report for November 2013-October 2014”. 2) Recommend that the EMS Committee does not accepts the “County EOA Service Area Response Time Performance Report for November 2013-October 2014”. Recommendation 1) Recommend that the EMS Committee accepts the “County EOA Service Area Response Time Performance Report for November 2013-October 2014”.
EMSCO December 4, 2014 Page 42 of 52
Rural/Metro of California [County Ambulance Provider]
Code 3 Response Nov 13 Dec 13 Jan 14 Feb 14 Mar 14 Apr 14 May 14 Jun 14 Jul 14 Aug 14 Sep 14 Oct 14
Overall 93.26% 92.90% 93.30% 92.64% 92.83% 91.67% 94.03% 93.97% 92.66% 92.58% 92.17% 92.44%
Zone 1 91.78% 92.73% 92.40% 92.07% 93.03% 91.38% 94.19% 93.46% 92.12% 92.65% 91.52% 91.31%
Zone 2 93.71% 92.63% 91.93% 91.58% 92.46% 90.19% 94.09% 93.45% 91.50% 91.60% 91.44% 92.20%
Zone 3 94.25% 93.62% 94.29% 93.41% 92.69% 92.86% 94.06% 94.01% 94.63% 93.70% 92.35% 93.03%
Zone 4 92.83% 92.47% 93.38% 93.34% 92.85% 91.64% 93.40% 93.83% 91.82% 92.02% 92.59% 91.99%
Zone 5 92.81% 92.84% 95.49% 90.62% 93.68% 91.45% 95.81% 97.12% 92.33% 92.62% 93.19% 95.35%
EMSCO December 4, 2014 Page 43 of 52
Rural/Metro of California [County Ambulance Provider]
Code 2 Response Nov 13 Dec 13 Jan 14 Feb 14 Mar 14 Apr 14 May 14 Jun 14 Jul 14 Aug 14 Sep 14 Oct 14
Overall 94.43% 94.44% 94.60% 92.70% 94.60% 93.32% 94.79% 95.62% 93.18% 94.23% 93.11% 93.61%
Zone 1 96.50% 96.91% 97.16% 95.34% 94.95% 95.64% 95.95% 96.87% 97.06% 95.83% 93.71% 95.73%
Zone 2 93.61% 93.74% 94.76% 92.64% 93.72% 93.44% 96.27% 95.89% 91.67% 93.20% 91.91% 94.02%
Zone 3 94.57% 94.27% 93.41% 90.79% 95.02% 93.36% 94.73% 96.30% 92.72% 92.67% 93.70% 93.77%
Zone 4 92.60% 92.98% 93.80% 91.63% 93.74% 91.09% 92.13% 93.55% 91.48% 94.78% 92.49% 90.90%
Zone 5 97.67% 95.56% 92.68% 95.24% 100.00% 94.12% 98.04% 97.35% 94.74% 95.83% 96.19% 96.75%
EMSCO December 4, 2014 Page 44 of 52
A division of the Santa Clara County Public Health Department
County of Santa Clara Emergency Medical Services System Emergency Medical Services Agency 976 Lenzen Avenue, Suite 1200 San Jose, CA 95126 408.885.4250 voice 408.885.3538 fax www.sccemsagency.org
Date: December 4, 2014 To: Santa Clara County EMS Committee Members From: John Blain Contract Manager Subject: County EOA Service Area Response Time Performance Report for Fire Departments History and Issue The County has entered into agreements with private and public entities to provide emergency medical response and advanced life support ambulance transportation services. Periodic response time compliance reports have been provided to the EMS Committee for the purpose of providing public review of those entities’ performance and compliance with contractual response time requirements. The County has performance based contracts with the following entities:
1. Gilroy, City of 2. Milpitas, City of 3. Morgan Hill, City of 4. Mountain View, City of 5. San Jose, City of 6. Santa Clara, City of 7. Santa Clara County Central Fire Protection District 8. South Santa Clara County Fire District 9. Sunnyvale, City of
Context Compliance is measured by several key performance indicators that include; response time requirements based on population density; designated response areas; type of response priority (red lights & siren or non-red lights & siren); total number of responses; total number of late responses; and total number of responses exempted (removed) from compliance calculations. Compliance is achieved when ninety (90%) percent or more of the responses meet the specified response time requirement in each response priority within each designated response area. This report contains response time compliance data for October 2013-September 2014. Cost There is no direct cost to the EMS Committee to accept and/or not accept the report. Legal Issues There are no legal issues related to accepting and/or not accepting the report.
EMSCO December 4, 2014 Page 45 of 52
Options 1) Recommend that the EMS Committee accepts the “County EOA Service Area Response Time Performance Report for October 2013-September 2014”. 2) Recommend that the EMS Committee does not accepts the “County EOA Service Area Response Time Performance Report for October 2013-September 2014”. Recommendation 1) Recommend that the EMS Committee accepts the “County EOA Service Area Response Time Performance Report for October 2013-September 2014”.
EMSCO December 4, 2014 Page 46 of 52
Fire Departments
Code 3 Response Oct 13 Nov 13 Dec 13 Jan 14 Feb 14 Mar 14 Apr 14 May 14 Jun 14 Jul 14 Aug 14 Sep 14
Gilroy 97.46% 96.45% 97.99% 98.54% 98.18% 96.79% 98.18% 98.78% 99.59% 98.05% 98.45% 98.76%
Milpitas 94.93% 96.96% 97.59% 98.27% 95.28% 96.60% 97.36% 96.04% 96.72% 95.17% 96.46% 91.61%
Morgan Hill 96.49% 100.00% 100.00% 95.16% 95.65% 98.34% 98.33% 99.54% 96.32% 95.81% 95.48% 96.41%
Mt. View 98.58% 98.64% 99.71% 96.76% 97.40% 97.20% 95.78% 95.33% 96.51% 97.61% 97.28% 96.12%
San Jose 96.89% 83.87% 83.87% 88.06% 87.66% 88.75% 90.39% 88.94% 90.31% 92.53% 88.95% 89.36%
Santa Clara 96.81% 95.20% 97.07% 96.54% 95.67% 96.91% 95.47% 95.40% 95.13% 96.07% 93.91% 95.08%
Santa Clara Co. 95.14% 96.13% 95.54% 96.12% 95.25% 96.10% 97.17% 96.30% 95.31% 95.39% 95.96% 95.78%
So. Santa Clara Co. 91.94% 92.31% 97.92% 93.15% 90.24% 97.03% 95.45% 94.12% 96.33% 90.91% 90.99% 90.48%
Sunnyvale 98.13% 98.08% 97.65% 97.78% 98.36% 98.81% 98.35% 98.25% 98.79% 99.20% 98.28% 99.16%
EMSCO December 4, 2014 Page 47 of 52
Fire Departments
Code 2 Response Oct 13 Nov 13 Dec 13 Jan 14 Feb 14 Mar 14 Apr 14 May 14 Jun 14 Jul 14 Aug 14 Sep 14
Mt. View 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 97.44% 97.87% 95.45%
San Jose 96.67% 97.73% 98.55% 94.46% 93.67% 96.18% 96.55% 96.55% 96.50% 97.86% 97.30% 96.29%
Santa Clara 100.00% 99.26% 97.35% 98.52% 98.58% 95.47% 98.47% 96.64% 98.62% 99.21% 97.35% 97.00%
Santa Clara Co. 100.00% 99.26% 97.35% 100.00% 98.73% 100.00% 99.37% 100.00% 98.67% 99.45% 99.35% 98.74%
EMSCO December 4, 2014 Page 48 of 52
A division of the Santa Clara County Public Health Department
County of Santa Clara Emergency Medical Services System
Emergency Medical Services Agency 976 Lenzen Avenue, Suite 1200
San Jose, CA 95126
408.885.4250 voice 408.885.3538 fax
www.sccemsagency.org
Date: December 4, 2014 To: Santa Clara County EMS Committee Members From: Linda Diaz BSN, RN, PHN Clinical Section Manager Subject: Hospital Destination, Diversion and Advisory Status Report History Diversion is a management process that diverts ambulances to the next closest facility. This may be used temporarily by local hospitals when the patient load exceeds emergency department or specialty center resources. Facility diversion should be a last resort and utilized only when emergency department/specialty center resources continue to be overwhelmed after internal procedures to manage the situation have been implemented. Report
The overall volume and daily averages of patients transported within the last six months saw a small increase. Despite the increase, the overall hours of diversion hours are trending down. There was a significant increase in stroke diversion although this was attributed to one facility with a prolonged mechanical problem that was resolved. Trauma Center and STEMI center diversion times remained low. Options
1) Recommend to accept report 2) Recommend to NOT accept report 3) Other options, as determined by the EMS Committee Recommendation
EMS Committee should accept the “County Hospital Destination, Diversion and Advisory Status Report for May 2014 through October 2014”.
EMSCO December 4, 2014 Page 49 of 52
County of Santa ClaraEmergency Medical Services SystemMonthly Hospital Destination, Diversion and Advisory Status Report
Report for Time Period: Oct 2014Table 1: Number of Patients Transported to Hospital ED from 9-1-1 System*Hospital May-14 Jun-14 Jul-14 Aug-14 Sept-14 Oct-14 TotalEl Camino - Los Gatos 95 86 90 82 71 99 523El Camino - Mt. View 667 661 594 670 641 709 3942Good Samaritan 567 595 588 589 561 607 3507Kaiser - San Jose 599 543 513 519 535 579 3288Kaiser - Santa Clara 677 629 597 624 587 680 3794O'Connor 564 551 496 575 575 593 3354Regional - San Jose 1116 1072 1033 1145 1094 1158 6618Saint Louise 273 246 212 260 256 253 1500Stanford 511 511 492 521 533 511 3079VA - Palo Alto 87 78 151 79 83 75 553VMC 1318 1273 1242 1264 1248 1272 7617Total 6474 6245 6008 6328 6184 6536 37775
Hospital May-14 Jun-14 Jul-14 Aug-14 Sept-14 Oct-14 6 Mth AvgEl Camino - Los Gatos 3 3 3 3 2 3 3El Camino - Mt. View 22 22 19 22 21 23 22Good Samaritan 18 20 19 19 19 20 19Kaiser - San Jose 19 18 17 17 18 19 18Kaiser - Santa Clara 23 21 19 20 20 22 21O'Connor 18 18 16 19 19 19 18Regional - San Jose 36 36 33 37 36 37 36Saint Louise 9 8 7 8 9 8 8Stanford 17 17 16 17 18 16 17VA - Palo Alto 3 3 5 3 3 2 3VMC 43 42 40 41 42 41 42Total Daily Average 211 208 194 206 207 210Source: Santa Clara County Communications & Palo Alto Fire Department*Notes for Tables 1 and 2: These numbers only reflect patients that originated in Santa Clara County and were transported bythe County's EOA Ambulance Provider and Palo Alto Fire Department. Data for Stanford does not include patients from San MateoCounty. The data includes but, does not differentiate specialty center status (TRAUMA, STROKE, STEMI, BURN) Page 1 of 2
Source: Santa Clara County Communications & Palo Alto Fire DepartmentTable 2: Daily Average of 9-1-1 Patients Transported By Hospital*
County of Santa ClaraEmergency Medical Services SystemMonthly Hospital Destination, Diversion and Advisory Status Report
Countyytyyyytyytyyyyytyttyyytytytyyyttyyytytytytyyytytttyytytytytytttyyyyyyyy oooooooooooooooooooooooooooooffffffff fffffffff fffffff f ffffffff SaS ntmmmmmmmmmmmmmmmmmmmmmeeerererererererererrrrererereererereerrrerrereeeererrrereererrrerereeerreeerrrerrereerrrrrerrrrrrrrrrerrrrrrrrerrrrererrrrrrrrrrreererrrrrrreeerrrereeere ggegegeggggeggggggegegegegeegegeggggegeggggeegegegegeggegegggegegegegggegegegggeegegggggggegggggeegegeggegegggegeegeeggegggegeegegeeeggeggegegegggeeegeeeeeggggggegegeeeeeeeegggeeeeeeegggggeeeegeeeeeggggeeeeggeegggggggeeegggeeeeeeegggeeeeeeeeeegggeeeeeggeeeeeeggggggggggggggg ncncncncnncnccncnnnnnncnccccccccccnnnnncncncncncncnccnccnnnnnnncncccnncccncnncccnnnnccccccncnccncncnccnnncnnccccncnncccncnnnnnncnccccncncnnnccccccccccy yyyyyyyyyyyyyyyyyyyyyyyyyy yyyyyyyyyy yyyyyyyyyyyyyyyyy yyyyyyyy yyyyyyy yyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyy MeMeMMeMeMMeMMeMeMMeMeMeMeMMMeMeMMMeMeMeMMMMMMeMeMeMeMMeMMeMMeMeMeMeMeMMeMMMMMeeMeMMeMeMMMMeMeMMMMMMeMeMeMeMeMeMMMeMeMeMeMeMMeMMMMMMMMMeMMMMeMeMeMeMMeMeMMMeeMMMMeMeeMeMeMMeeMeeMeMMeeeMMMeMeMMMMMeMMeeMeeMMMMMMMMeMeMMMeMMMMMMeeeeeMeMMMeeeeeedidddddddddddddddddddddddddddddddddddddddddddd c
MooooooooMooooooooooooooooMoooooMooMoooooMooooooooMontntnntntnnttntnnntnntntntttnttnntnnttnnnnntntntnnntnntntntnnnnntnnnnttnnnnnnnntnnnnnnntnnnnttttttnnntttttntttttttnttttttntttnntttttttnttnttttttttntttttttntttthhhhhhhhlllhhhhhhhhhllhhhhhlhlhhhhhhlllhhhhhhhhlhhhhhllllllhlhlllllhhhhhhhllllhhhhhhhlllhhhhhlhlhllllhhhhhhhhhhhhhlhlllhhhhhlllllhhhhhhhhlhlllhllhhhhhhhhhllllllhhhhhhlllllhhhhhhhhhhlllllyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyy y y yyyyyyyy yy yyyyy y y yy yyy y yyy yyyyyyyyyyyy HoHoHoHoHHoHHoHHHHHoHoHHoHHooooooHHHHHoHHoHoHoooooooooooHHHHHHoHoHoHooooooooooooHHHoHoHoHoHoHoHoHoHooHoHooooHoHoHoHHoHoHooHooooHoHoHHoHoHooooHoHHHHHoHoHooooHooHooHHoHoHoHoHHoHoHHooooHoHHoHHooooHHoHHooHoHHHoHHoHHoHoooHoooHoooHHHoHHHHoHHoooHooHHHoHoHoHoHoHoossssssssssspsppppppppppppppssssssssssspppppppppppppssssssssspppppppppppppppsssssssssspppppppppspssssssssssssppppppppspspssssssssssspppppppppppppsspssssssssssspppppppsssssssssssssppppssssspspssssspspspsppppppsssspsssssspspppspsssspsssspspsppppppppppspsspsssspspsppppppppppppppsspspspsssspspppppppppspsssspspppppppppppppsppppppppppppspsspppppppppsppppppppspssppspppppspspspspspppppppppppppppppppititttttitiiiittitititiiiittittiiiititiiittiiiiitiittttttttttttttiiiittttttttiittttttiitttiiiittttiiitttttiiiitttttttaalallaalalalalalalalaalaalalaalalllalalalalalllllaaalllllaalallllaallllaallllllaalllllllalllalaaaaaaalaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa DDDDDDDDDDDDDDDDDDDDDDDDDDDD
County of Santa ClaraEmergency Medical Services System
Monthly Hospital Destination, Diversion and Advisory Status Report
EMSCO December 4, 2014 Page 50 of 52
Table 3: Total Monthly Hours of "AMBULANCE DIVERSION" StatusHospital May-14 Jun-14 Jul-14 Aug-14 Sept-14 Oct-14 TotalEl Camino - Los Gatos 0.81 0.00 0.00 0.00 0.00 0.00 0.81El Camino - Mt. View 12.04 10.11 12.78 14.83 7.51 4.51 61.78Good Samaritan 0.00 0.00 3.01 0.00 2.97 3.01 8.99Kaiser - San Jose 4.51 11.63 6.00 10.99 13.59 9.02 55.74Kaiser - Santa Clara 1.50 0.00 0.00 1.51 0.00 0.00 3.01O'Connor 1.51 3.00 6.63 3.00 1.93 1.51 17.58Regional - San Jose 3.11 3.58 3.01 1.26 0.00 0.00 10.96Saint Louise 19.05 4.52 16.59 8.93 9.03 9.02 67.14Stanford 3.03 1.50 9.05 4.52 7.51 10.53 36.14VA - Palo Alto 10.68 12.04 16.15 21.04 42.29 12.01 114.21VMC 14.75 19.19 10.35 22.24 14.89 18.05 99.47Total 70.99 65.57 83.57 88.32 99.72 67.66 475.83
Above 37hrs Above 30hrs Below 30hrs
Color Legend for Ambulance
Diversion ONLY
Table 4: Total Monthly Hours of "STROKE / CT DOWN" Status*Hospital May-14 Jun-14 Jul-14 Aug-14 Sept-14 Oct-14 TotalEl Camino - Los Gatos 0.00 0.00 0.00 0.00 0.00 0.00 0.00El Camino - Mt. View 0.00 0.00 0.00 0.00 0.00 0.00 0.00Good Samaritan 0.00 0.00 0.00 0.00 0.00 0.00 0.00Kaiser - San Jose 0.00 0.00 0.53 4.27 0.00 0.00 4.80Kaiser - Santa Clara 0.00 0.00 0.00 0.00 0.00 0.00 0.00O'Connor 9.66 0.70 0.93 4.22 0.00 58.65 74.16Regional - San Jose 10.07 0.00 0.00 0.00 0.00 0.00 10.07Saint Louise 7.96 26.20 124.69 20.08 111.49 117.14 407.56Stanford 0.00 0.00 0.00 0.00 0.00 0.00 0.00VA - Palo Alto 0.00 6.07 0.00 0.00 105.16 0.00 111.23VMC 2.95 2.24 0.02 0.41 1.53 0.00 7.15Total 30.64 35.21 126.17 28.98 218.18 175.79 614.97Table 5: Total Monthly Hours of "STEMI" Service Advisory Status*Hospital May-14 Jun-14 Jul-14 Aug-14 Sept-14 Oct-14 TotalEl Camino - Mt. View 0.00 0.00 0.00 0.00 0.00 0.00 0.00Good Samaritan 0.00 0.00 0.00 0.00 0.00 0.00 0.00Kaiser - San Jose 0.00 0.00 0.00 23.68 18.81 0.00 42.49Kaiser - Santa Clara 0.00 0.00 0.00 0.00 0.00 0.00 0.00O'Connor 0.00 12.57 0.00 0.00 0.00 0.00 12.57Regional - San Jose 0.00 0.00 0.00 0.00 0.00 0.00 0.00Stanford 0.00 0.00 0.00 0.00 0.00 0.00 0.00VMC 0.00 0.00 0.62 0.00 0.69 0.00 1.31Total 0.00 12.57 0.62 23.68 19.50 0.00 56.37Table 6: Total Monthly Hours of Trauma Center "BYPASS" StatusHospital May-14 Jun-14 Jul-14 Aug-14 Sept-14 Oct-14 TotalRegional - San Jose 5.00 3.84 4.02 11.52 7.45 0.96 32.79Stanford 0.00 0.00 0.00 0.00 0.00 0.00 0.00VMC 0.00 0.00 7.21 0.00 1.51 0.00 8.72Total 5.00 3.84 11.23 11.52 8.96 0.96 41.51Page 2 of 2
EMSCO December 4, 2014 Page 51 of 52
County of Santa Clara Emergency Medical Services System Emergency Medical Services Agency 976 Lenzen Avenue, Suite 1200 San Jose, CA 95126 408.885.4250 voice 408.885.3538 fax www.sccemsagency.org Date: December 4, 2014 To: Members of the EMS Committee From: Michael Petrie EMS Director Subject: 2015 EMS Committee Meeting Dates Michael Petrie will report on the 2015 EMS Committee Meeting Dates. The meetings will continue to be held at the Santa Clara County Sheriff’s Department Auditorium on the following dates:
• March 5, 2015 • June 4, 2015 • October 1, 2015 • December 3, 2015
A division of the Santa Clara County Public Health Department EMSCO December 4, 2014 Page 52 of 52