Rural Health Community Systems
A Rural Health Network Serving Steuben County
 

Check out an online version of the Winter 2000 issue of the 
Rural Health Community Systems newsletter, sent to EMS providers.






What is a Rural Health Network?

 Rural health networks are coalitions that respond to the health care needs of the community. 

 A rural health network is an administrative tool that has the flexibility to establish new systems that can be used by providers to plan, coordinate, and deliver health care services. New organizations created by the network are not considered members of the network; rather they are activities of the network.

 A rural health network is a locally directed or governed organization that provides a set of health and administrative services needed in the community served by the network.

 A rural health network is based on the idea that the sharing of resources and ideas among organizations that deliver healthcare or healthcare related services can help to improve the delivery of rural healthcare services by increasing quality, reducing costs and developing new healthcare delivery systems specific to rural areas.

 A rural health network focuses on identifying, comprehending and fulfilling the ever-changing requirements of the individuals and organizations that use our goods and services. By constantly assessing and improving our products and services, we assure satisfied clients and the most efficient use of our resources.
 

Rural Health Community Systems

Rural Health Community Systems was created in 1997, when the CEOs of Ira Davenport, Noyes Hospital and Rural/Metro Medical Services Southern Tier formed an official “Rural Health Network”, known as the Davenport/Noyes/Rural/Metro Rural Health Network. This organization was an association of nonprofit and proprietary corporations, public agencies and individuals providing healthcare and related services in central Steuben County in New York State. These groups came together in a collaborative forum to address common rural health services issues. The New York State Department of Health, Office of Rural Health, allocated a Rural Health Development Grant to support the activities of this group.
In 1999, the members of the Davenport/Noyes/Rural/Metro Rural Health Network changed the name of the group to Rural Health Community Systems. Along with the name change came a change in the geographic service area of this group. This rural health network now covers all of Steuben County and the environs of Allegany, Livingston, Ontario and other counties as partnerships can be built. The Rural Health Community Systems Rural Health Network has decided to focus on Emergency Medical Services.
The stated goals of Rural Health Community Systems are to:
1. Expand the scope of access to Emergency Medical Services
2. Expand system resources for Community Education about Emergency Medical Services

Rural Health Community Systems was developed to respond to a crucial need. It was not formed to provide services, but rather to help smooth the rocky road of service provision and to improve access to Emergency Medical Services in our service area. The network members, the public, and the Emergency Medical Service providers in this area will reap the benefits.
 

Rural Health Community Systems Projects:
 

  • Emergency Medical Services Youth Corps Project

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    RHCS will develop and implement an Emergency Medical Services Youth Corps Project in Steuben County. This project will be the collaborative effort between RHCS, schools that support the program, interested EMS agencies, and youth participants.

    The program is open to youth at least 14 years of age, and will expose them to the world of EMS through fun and educational hands-on activities and meetings with participating volunteer ambulance corps to which they are assigned. Youth Corps members will receive uniforms, training in first aid, CPR, and Responding to Emergencies, among other things. In addition, the Youth Corps Advisors and participants will take part in ongoing education and prevention activities, as well as Continuous Quality Improvement. We believe that this program will encourage youth to meet necessary requirements and become full members of a volunteer EMS agency. RHCS hopes the program will also stimulate a decrease in high-risk behaviors and increase interest in learning. Comprehensively, the EMS Youth Corps will not only benefit the youth,  But EMS, the community, and schools as well.

    Below are just a few of the goals, not already outlined above, that RHCS hopes to accomplish with this program:
     

    • To help youth become more involved in our community, giving them a sense of community service.
    • Help EMS agencies in our county recruit and retain even more quality, dedicated, and knowledgeable volunteers.
    • Assist schools in helping students’ transition from a school environment to a work environment in today’s highly complex work setting.
    • Give youth a sense of pride in their corps and their accomplishments, a direction for the future, and skills they can always use.

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  • Project Director

  • To oversee project development and lend technical assistance to the individual participating corps, RHCS has hired Gina Ritter-Kirkendall as the EMS Youth Corps Director.

    Gina has 4 years experience in the hospital setting, is continuing her education at CCC, and is currently taking the EMT-D course to be completed in March 2001. She is an active volunteer for Rape Crisis of the Southern Tier, and completing a volunteer Mediator Apprenticeship with the Center for Dispute Settlement.

    With experience in developing pilot programs and as a Youth Service Worker, she has worked with high-risk youth, and assisted with a Big Brother Big Sister program. Gina will be an instructor for the Red Cross’ Responding to Emergencies Course, has training in conflict resolution, disease prevention, anger management, and Introduction to Emergency Management, among numerous other things.

    Mike Sprague, Director of Emergency Management in Steuben County, graciously provides space in the EMO office at the Steuben County Public Safety Building in Bath. Feel free to contact Gina at 607-776-4099, or at rhcsemsy@linkny.com, for further information, questions or comments about the program. 
     
     

  • Rural Health EMS System Review: A Study of EMS Systems in Steuben and Livingston Counties
In early 1999, Rural Health Community Systems, along with the Genesee Valley Rural Health Network, contracted with Ontario County Advanced Life Support, Inc., a subsidiary of Thompsonhealth in Canandaigua, New York, to develop and implement a study of the Emergency Medical Services system in areas of these two counties. Survey questionnaires were developed and sent to EMS providers and Captains and Chiefs of EMS organizations. The surveys that were returned were sent to the Emergency Care Information Center of the Journal of Emergency Medical Services and analyzed. After analysis of this data was completed, the results were published and this information was released to the EMS community in February of 2000. The goal of this project was to obtain data and recommendations that would help define specific issues on which we could work with volunteer EMS agencies throughout the area.

The information obtained from this study now represents the most comprehensive report card for the state of Emergency Medical Services in the region. It provides information that can be used as a quality improvement tool by the EMS agencies themselves. It looks at performance trends for both volunteer and paid EMS systems. It provides a means to help educate the public about how their EMS providers are measuring and improving their delivery of service. The results of this study can be found under “What’s New” at www.ruralhealthresources.com.

The EMS providers who responded to this survey have suggested that there are several areas of concern in regards to EMS in the region. As a result of the concerns which have been identified, Rural Health Community Systems is positioning itself to help sponsor programs on: Medicare billing and payment, volunteer recruitment and retention, EMS service management training and the development of a plan to help market EMS in this area.
 

  • Integration within the Emergency Medical Services Specialty
The major objective of Rural Health Community Systems during its first year of operation was to facilitate the integration of delivery of Emergency Medical Services. This was accomplished by relocating ALS 102, which is one of Rural/Metro Medical Services Southern Tier’s Advanced Life Support Flycars, to the Emergency Department at Ira Davenport Memorial Hospital. Paramedics from Rural/Metro were trained and oriented at Ira Davenport’s Rural Health Training Center, and Nurses from the Emergency Department were oriented to this new system. In June of 1997, Rural/Metro Paramedics began spending four “on-call” hours each day in the ER at Ira Davenport. Over the next several months, this time was gradually increased until the goal of having the Paramedics at the Emergency Room 24 hours a day, 7 days a week, was met. Today, ALS 102 is stationed full time at Ira Davenport. When not busy on EMS calls, the Rural/Metro Paramedics who are assigned to this unit work hand in hand with the Nurses and Doctors in the ER to help improve the delivery of Emergency Medical Services to the population of this area. The Paramedics benefit from exposure to procedures that they observe and assist with in the hospital, and the Nurses and Doctors in the Emergency Room become more familiar with the capabilities of the Paramedics in the pre-hospital setting. This system supports a strong continuity of care approach. From the Emergency Department, Paramedic intercepts with volunteer EMS agencies that transport patients in need of Advanced Life Support are more efficient. This close association with volunteer EMS providers has led to a unity exceeding all expectations.

The concept of using integrated or “shared” staff in the Emergency Department at Ira Davenport Memorial Hospital has been a very positive growing process. The positive attitude of the staff of the Rural Health Training Center made the entire process much easier. The integration process at Ira Davenport Memorial Hospital has been so positive that the entire nursing staff gave the Rural/Metro Paramedics a vote of confidence. In addition, The New York State Department of Health will be using the policies and procedures written for this project concerning quality assurance, pre-hospital, and transfer and discharge practices at Ira Davenport as the criterion for similar shared staff projects across the state.
 

  • Law Enforcement Defibrillator Project
Rural Health Community Systems has been working closely over the past several years with members of both the Steuben County Sheriffs Department and the New York State Police. The project that we are working on with them places automatic external defibrillators in the patrol cars of those agencies and trains the Deputies and Troopers in their use.
 The automatic external defibrillator (AED) is a piece of equipment that, when connected though two electrical leads to the chest of a patient who has no pulse and is not breathing, can analyze the electrical activity of that patients heart. If the AED determines that the patient is in a lethal rhythm called ventricular fibrillation, it can deliver an electric countershock to the heart of that patient. Research has shown that ventricular fibrillation is one of the most common initial heart rhythms that occur in patients suffering from sudden cardiac arrest. Research has also shown that the definitive treatment for ventricular fibrillation is an electrical countershock, but this countershock must be delivered within the first few minutes after the patient suffers the initial cardiac arrest. Due to the fact that both of these police agencies have units patrolling the Steuben County area 24 hours a day, and also to the fact that they are often times closer to a cardiac arrest patient than any EMS unit, it seemed logical to bring them in as members of the network and to work with them so that they are able to augment the EMS system. 

Captain Edward Haag, now retired, of the New York State Police, and Sgt. David Cole, also retired from the New York State Police and now the Undersheriff of Steuben County, worked very closely with Rural/Metro Medical Services on the selection of AED units appropriate for police use and on the training of Troopers and Sheriffs Deputies.
Initially, officers were trained in CPR and the use of the AED. It was decided that more training was needed to make these officers even more effective, and Rural Health Community Services provided the funding necessary for officers to become Certified First Responders.

Today, both of these Law Enforcement agencies have patrol cars in the Steuben County area equipped with AED units and officers trained in their use. 

Rural Health Community Systems also has some funding available for the purchase of defibrillators and the training of individuals to the CPR-Defibrillation level under the scope of the new Public Access Defibrillator law. If you or your organization would like more information about this program, please contact Rural Health Community Systems. Numbers are listed below.
 
 

The Rural Health Community Systems Board of Directors

 James B. Watson, CEO
 Barbara O’Connor, RN, Director of Nursing
 Ira Davenport Memorial Hospital

 Michael Sprague, Director
 Timothy D. Marshall, Deputy Director
 Steuben County Office of Emergency Services

 Arthur Jones, EMT-P, Operations Manager
 Rural/Metro Medical Services Southern Tier

 Everett Ferguson, EMT-P, Executive Director
 Ontario County Advanced Life Support, Inc.

 Mary Jo Bruinooge, EMT
 Hammondsport Volunteer Ambulance Corps, Inc.
 Prattsburgh Fire Department Ambulance

 David Cole, Undersheriff
 Steuben County Sheriffs Department

 Candi Thompson, Director of Health and Safety Services
 American Red Cross-Corning Chapter

 Nan Hammes Project Director
 Retired and Senior Volunteer Program
 

The Rural Health Community Systems Staff

 Betty Wattenberg, MCSA
 Network Consultant

 Adam Oplinger, AAS, NREMT-P
 EMS Youth Corps Project Director

For more information about Rural Health Community Systems, or if you or your organization would be interested in participating, contact:

 Betty Wattenberg
 716-593-2178 or
info@ruralhealthresources.com

 Adam Oplinger
 607-776-4099 or
 rhcsemsy@linkny.com

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