Daniel K. Kehoe President Bigfoot Labs The Next Big Thing in EMS Patient Advocate Team.

Daniel K. KehoeDaniel K. KehoePresidentPresident

Bigfoot LabsBigfoot Labs

TheThe

NextNextBig ThingBig Thing

inin EMS EMS

Patient Advocate TeamPatient Advocate Team

PatientAdvocateTeam

“Rescue the Family” © 2003 Bigfoot Labs

““It has happened to me, It has happened to me, and it has happenedand it has happened

to you as well…”to you as well…”

PatientAdvocateTeam


If everybody is focused on the patient, If everybody is focused on the patient,

who’s looking after the family?who’s looking after the family?

PatientAdvocateTeam


The The NextNext Big ThingBig Thing in in EMSEMS

PatientPatientAdvocateAdvocate

TeamTeam

PatientAdvocateTeam


PAT: Resetting the FocusPAT: Resetting the FocusBeyond the Primary PatientBeyond the Primary Patient

Secondary patientin crisis

LifeStarLifeStar

ParamedicsParamedics

First ResponderFirst Responder

PolicePolice

FireFire

911 Dispatch911 Dispatch

CMEDCMED

PatientAdvocateTeam


Connecting the Family Connecting the Family to the Next Levelto the Next Level

PAT member

Clergy & Immediate family

Hospital services,Longterm support

Friends, extended family,church, social orgs

On scene

One to two hours

Days

Weeks

Secondary patientin crisis

PatientAdvocateTeam


How does a How does a PAT member do this?PAT member do this?

• Separate - Inform - ConnectSeparate - Inform - Connect• Keeps the family “rescuing”Keeps the family “rescuing”

– Retrieve medsRetrieve meds– Get detailed historyGet detailed history– Notify relatives with PAT helpNotify relatives with PAT help– Keep family out of the way of EMS crew!Keep family out of the way of EMS crew!

• Explains what is happeningExplains what is happening• Thinks for the familyThinks for the family

– Ex: “Get coat, purse, directions to hospital”Ex: “Get coat, purse, directions to hospital”

• ListensListens

PatientAdvocateTeam


The History ofThe History ofPatient AdvocacyPatient Advocacy

• Hospital Patient AdvocatesHospital Patient Advocates– Bridge information gap for family before physician Bridge information gap for family before physician

comes out to waiting roomcomes out to waiting room– Connects family to hospital support servicesConnects family to hospital support services– Often are former nursing staff, social workersOften are former nursing staff, social workers

• Field EMS Patient Advocates (PAT)Field EMS Patient Advocates (PAT)– Bridge family’s Bridge family’s Emotional Golden Hour Emotional Golden Hour on sceneon scene– Connect family to next level of long term supportConnect family to next level of long term support– PAT members are products of EMSPAT members are products of EMS

• Attuned to rapid responseAttuned to rapid response

• They know what happens on ambulance callsThey know what happens on ambulance calls

PatientAdvocateTeam


The Secondary Patient’s The Secondary Patient’s Emotional Golden HourEmotional Golden Hour

Emergencyonset

Police/First Responder

arrival

EMS/ALSarrival

911call

SecondarySecondarypatientpatient(family)(family)

involvementinvolvement

0 mins

Loadpatient

Ambulancedeparts

Familydeparts

30 mins 60 mins

CPR Briefhistory

Familyarrives athospital

Hospital

Long termLong termsupportsupport

Physical benefits for primary

patient

PatientAdvocateTeam


The Secondary Patient’s The Secondary Patient’s Emotional Golden HourEmotional Golden Hour

Emergencyonset

Police/First Responder

arrival

EMS/ALSarrival

911call

Secondarypatient(family)

involvement

0 mins

Loadpatient

Ambulancedeparts

Familydeparts

30 mins 60 mins

CPR Briefhistory

Familyarrives athospital

PATarrival

Detailedhistory

Collectmeds

Contactrelatives

Psychologicalbenefits for the family

Contactclergy, etc.

PATleaves

Family involvementwith PAT on

scene

HospitalHospital

Long termsupport

Physical benefits for primary

patient

PatientAdvocateTeam


PAT: A Synergistic Solution for PAT: A Synergistic Solution for EMSEMS

• Senior EMTs leave without growth pathSenior EMTs leave without growth path– PAT keeps experienced EMTs activePAT keeps experienced EMTs active

• EMS service must expand but few $$$EMS service must expand but few $$$– PAT costs virtually nothing to implementPAT costs virtually nothing to implement

• Families need to continue rescue effortFamilies need to continue rescue effort– PAT keeps family involved but out of the wayPAT keeps family involved but out of the way

• EMS crews are busy with the primary patientEMS crews are busy with the primary patient– Police, Fire and EMS handle primary patientPolice, Fire and EMS handle primary patient– PAT takes care of the PAT takes care of the secondary patientssecondary patients

PatientAdvocateTeam


Who are theSecondary Patients?

• Family– Spouse– Children– Parents– Relatives

• Non-family– Close neighbors– Bystanders who are first responders

PatientAdvocateTeam


When is it a PAT Call?When is it a PAT Call?

• Heart attackHeart attack• Untimely death or suicideUntimely death or suicide• SIDS and injured childrenSIDS and injured children• Sexual assaultSexual assault• MVA with long extricationMVA with long extrication• When requested by EMS, PD, FireWhen requested by EMS, PD, Fire• When you just know it is:When you just know it is:

– School bus accidentSchool bus accident– Plane crashPlane crash– Lost childLost child

PatientAdvocateTeam


Requesting PAT MembersRequesting PAT Members

1) Identify the need1) Identify the need- Family needs emotional attention- Family needs emotional attention

- More than you care to handle- More than you care to handle

2) Contact the PD2) Contact the PD- Request PAT member to respond- Request PAT member to respond

over radioover radio

- Listen for responder- Listen for responder

3) Brief PAT member upon arrival3) Brief PAT member upon arrival- Who’s who, patient condition- Who’s who, patient condition

- - No sensitive info over the radio!No sensitive info over the radio!

PatientAdvocateTeam


PAT ServicesPAT Services

• Secondary patient careSecondary patient care– Work with family emotionallyWork with family emotionally– Control information flow about patient to Control information flow about patient to

familty membersfamilty members– Assist family in directions or transport to Assist family in directions or transport to

hospitalhospital– Help with phone calls to relativesHelp with phone calls to relatives– Connect to next level of careConnect to next level of care

• Scene careScene care– Reset moved furnitureReset moved furniture– Clean up biohazards, do needle checksClean up biohazards, do needle checks– Help PD lock up residenceHelp PD lock up residence

PatientAdvocateTeam


Other PAT ServicesOther PAT Services

• Death notificationDeath notification– ““Widow watch”Widow watch”– Death notification (with PD if possible)Death notification (with PD if possible)

• Preparing for decedent viewingPreparing for decedent viewing– Make deceased look presentableMake deceased look presentable– Remove biohazards, EMS equipmentRemove biohazards, EMS equipment– Forewarn family what they will seeForewarn family what they will see– Connect with funeral homeConnect with funeral home

• In-hospital supportIn-hospital support– Take or lead family to hospital EDTake or lead family to hospital ED– Connect with hospital Patient AdvocateConnect with hospital Patient Advocate

PatientAdvocateTeam


PAT SpecialtiesPAT Specialties

• All PAT members can address any PAT All PAT members can address any PAT call needcall need

• Each PAT member specializes in, or Each PAT member specializes in, or has an affinity for, certain calls:has an affinity for, certain calls:– Example: Example:

• Sexual assaultSexual assault• Untimely deathUntimely death• Injured children or children presentInjured children or children present• Spiritual matters, prayer requestedSpiritual matters, prayer requested

PatientAdvocateTeam


Case ReviewCase Review

• Tractor AccidentTractor Accident• Widow WatchWidow Watch• After School AccidentAfter School Accident

PatientAdvocateTeam


The PAT OrganizationThe PAT Organization

The Extended Support TeamThe Extended Support Team

PAT ResoursesPAT Resourses

PAT MembersPAT Members

Core of 10 responders

Specialists outside EMSCalled into unique situations

Preparatory and post-call support

PatientAdvocateTeam


PAT MembersPAT Members

• The “front line” of the PAT programThe “front line” of the PAT program– Work directly with the familyWork directly with the family– Active in the “emotional golden hour”Active in the “emotional golden hour”

• A core team of about 10 membersA core team of about 10 members– Products of longterm EMSProducts of longterm EMS

PatientAdvocateTeam


PAT ResourcesPAT Resources

• Specialists in complicated areasSpecialists in complicated areas– Consulted with or called to sceneConsulted with or called to scene– Might not have an EMS backgroundMight not have an EMS background

• Work to support the PAT core teamWork to support the PAT core team• TrainingTraining

SuicideSexual assaultHospicePsychosisBlindLanguageSIDSClergyCISDPAT follow-up

PatientAdvocateTeam


Extended Support TeamExtended Support Team

• Contributors of special talentsContributors of special talents– The people “behind the scenes”The people “behind the scenes”– Instrumental to PAT successInstrumental to PAT success

PAT collateralHospitalityPublic RelationsExpansion

PatientAdvocateTeam


Are You Ready to be a Are You Ready to be a PAT Member?PAT Member?

• This is for EMTs who This is for EMTs who lovelove to help to help people (“people people”)people (“people people”)

• Those who gravitate toward issues of Those who gravitate toward issues of a spiritual and social nature will do a spiritual and social nature will do wellwell

• This is not a “job”; it cannot be This is not a “job”; it cannot be delegated or appointeddelegated or appointed

• It defies quantification or certificationIt defies quantification or certification

PatientAdvocateTeam


Finding the Right PeopleFinding the Right People

• Mature, experienced EMTs Mature, experienced EMTs onlyonly• Ready to move up in responsibilityReady to move up in responsibility• Strong, confident people skillsStrong, confident people skills• The best candidates will jump at the The best candidates will jump at the

chance once promptedchance once prompted

. . . Or can you help on the PAT Resource or Extended Support teams?

PatientAdvocateTeam


The PAT program will challenge you reactivelybut you must change proactively.

You must strive to become a better, stronger person so that you can

relate to more peopleand help them more effectively

in their time of extreme need.

PatientAdvocateTeam


For more information:For more information:

Daniel K. KehoeDaniel K. KehoeBigfoot LabsBigfoot LabsP.O. Box 393P.O. Box 393Suffield, CT 06078-0393Suffield, CT 06078-0393

Email: [email protected]: [email protected]: (860) 668-2765Phone: (860) 668-2765

The The NextNext Big ThingBig Thing in in EMSEMSPatient Advocate TeamPatient Advocate Team

PatientAdvocateTeam


Frequently Asked Questionsand

Review

PatientAdvocateTeam


Q: “Do we really need PAT members? Don’t EMS crewsand the police on scene already perform this function?”

PatientAdvocateTeam


Q: “I know someone who isn’t an EMT but is really goodworking with kids. Why can’t they be a PAT member?”

PatientAdvocateTeam


Q: “What if I have a bad call and there is no PAT memberavailable?”

PatientAdvocateTeam


Q: “Do PAT members respond to the scene withgreen lights?”

PatientAdvocateTeam


Q: “There are plenty of clergy, social workers, crisis teamsand counselors around. Why not just use them?”

PatientAdvocateTeam


Q: “Do PAT members get involved with patient care onthe primary patient?”

PatientAdvocateTeam


Q: “What if the PAT member gets on scene and it turnsout there is really nothing to be done?”

Daniel K. Kehoe President Bigfoot Labs The Next Big Thing in EMS Patient Advocate Team.

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