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Original Contribution

Prehospital Profiles: Proud to Provide the Gold Standard of Care

Kim Berndtson

It is no small feat to receive accreditation from the Commission on Accreditation of Ambulance Services (CAAS). To earn the designation, an agency must go through a process of comprehensive self-assessment and an external review of the organization.

According to CAAS' website, accreditation signifies that a service has met the "gold standard" determined by the ambulance industry to be essential in a modern emergency medical services provider. These standards often exceed those established by state or local regulation.

With just over 140 agencies nationwide receiving accreditation, Cherokee Nation in Tahlequah, OK, recently earned its second three-year designation, receiving a perfect score in the process. It was the first tribe in the United States and the first EMS program in Oklahoma to receive the honor.

"Our goal at Cherokee Nation EMS is to provide quality prehospital patient care to all those we serve," says Jimmy Summerlin, director for Cherokee Nation EMS. "We are very proud that our service has been CAAS accredited since March 31, 2005."

EMSWorld.com recently asked Summerlin about the accreditation process and what the honor means to the agency.

You mention that Cherokee Nation is the first tribe in the United States and the first EMS program in Oklahoma to achieve accreditation. Why is it important for your agency to receive CAAS certification?

I believe the accreditation process shows the dedication of our program to meet a higher standard. It has allowed us to learn new processes and implement a quality improvement program to continually check ourselves and improve the quality of care and services we offer to our patients.

What did you learn about your agency by conducting a self-assessment? Did that self-assessment lead to any changes/improvements in how your agency is run and/or managed?

One of the biggest benefits to the self-assessment is the detailed review of our policies/procedures and overall daily operations. The assessment helped us identify needed changes to be CAAS compliant and then we track those changes to assess their significance. There have been numerous changes identified through self-assessment and the CAAS process, two of our most recent is the implementation of a quality improvement program for our communications department and a standardized process for effective communication to all staff.

How difficult and/or involved was the accreditation process? How long did it take?

For our initial accreditation process we spent well over a year preparing. There is no doubt the accreditation process requires dedication, but the process is a rewarding experience.

Are there any special challenges your population faces that your EMS personnel responds to?

The biggest challenge is providing services for an ever-growing coverage area. As we see more ambulance services go out of business or decrease their overall staff and or services, the result is larger coverage areas which can decrease the availability of Emergency Medical Services and affect response times to our patients.

What are you most proud of?

We are most proud of the services we offer to our communities. In addition to providing paramedic-level emergency medical services with critical care transport capabilities to Indian and non-Indian clients 24 hours a day, seven days a week, we have our own state-certified EMS training program. It offers numerous training opportunities to health professionals and community members, including CPR, a first responder course and several levels of EMT courses. We also provide communication officers that help staff the Cherokee County 911 center.

Department Profile: Cherokee Nation Emergency Medical Services (OK)

Type of department: Tribal/Paid

Number of employees: 60 (42 full-time and 18 part-time)

Service area: Population 50,000; Square miles 1,000

Call volume: 3,600-4,000 calls annually

Number of vehicles: 8 ambulances and 2 support vehicles

What makes your service different or unique: We are tribally owned and operated. Our EMS service is part of an overall tribal healthcare system that includes eight outpatient clinics, an employee clinic and a tribal hospital that is accredited through DNV (Det Noske Vertias) upholding ISO standards. Our EMS maintains a comprehensive, proactive quality improvement program which is tied into a larger quality management system. Cherokee Nation EMS is a non-reservation tribal EMS service with a coverage area of approx. 1,000 square miles which encompasses everything from urban to extreme rural areas.

Recent changes or improvements undertaken to offer better care/service: Our interview process for prospective employees includes a pre-screening for both knowledge and skills proficiencies.

Recent technology or equipment upgrades: We recently added a LUCAS II chest compression system, Lifepak 15 cardiac monitor/defibrillator and Turkel safety needle for pneumothorax.

Any new or unusual protocols: We have purchased a MAD (Muscosal Atomization Device) for seizure patients.

Special projects or programs you conduct or participate in: We participate in OERSDAC (Oklahoma Emergency Response System Department Advisory Council), RTAB (Regional Trauma Advisory Board) and are board members for Cherokee County 911 Trust Authority.

How do you reduce costs or maximize limited funding: Staffing cost and overtime pay is reduced by utilizing part-time employees to fill the gaps.

Plans for the future: We want to explore research funding methods to expand our services to underserved communities within the Cherokee Nation.

Visit www.cherokee.org for more information.

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