Welcome back. This is the fifth and final module in our series, and this one is going to cover EMS support for hospitals and anti-kickback regulations. To recap where we've been so far, Module 1 introduced the topic with the discussion of why the relationships between hospitals and EMS matter, and we covered the core subjectives. In Module 2, we talked about the different organizations that comprise an EMS system and what impacts they have on patients and hospitals. In Module 3, we talked about ways hospitals can improve their support of EMS field crews. Module 4, we discussed the needs and wants of EMS administration and medical directors for the receiving hospitals. And here in Module 5, we're going to talk about things that EMS can do for your hospital and talk a little bit about how federal laws can factor into the relationships that hospitals and EMS have with each other in the context of anti-kickback legislation. While trying to do what you can to help the EMS agencies in your area, it's worthwhile to keep in mind what the EMS agencies can do to help your hospital. I wouldn't present those sorts of things as a quid pro quo to the EMS agencies, but it will be helpful to have those things in mind so in the course of your discussions and interactions with EMS administration and medical direction, you can bring these things up when appropriate and try to work towards mutually beneficial goals. Because after all, a stronger and healthier relationship between hospitals and EMS agencies should be built on mutual benefit and respect. One of the things that EMS can do to really help your hospital is make sure that there's a timely transfer of information from EMS to the receiving emergency department staff when they're taking over patient care. Now, this isn't always the case, unfortunately. There's almost always a verbal report from the EMS crew to the receiving emergency department team, but oftentimes that isn't followed up immediately with a written report. And so, it's important to try to work with the EMS agencies to make sure that happens as often as possible. There is some guidance on this from the National EMS Management Association, which recently published a position paper on information sharing between hospitals and EMS agencies. And in that paper, they put the burden of responsibility on the EMS agency to try to leave that report with the hospital before the crew leaves the emergency department. But in cases where the crew needs to leave sooner than later because of pending calls, they advocate that an abbreviated report be left behind. That information should include the ambulance service name and unit identifier, a patient name or other sort of patient-identifying information, information about mechanisms of injury or medical complaints, symptoms, vital signs, treatments administered, including time, medication doses, and other pertinent parameters. And very importantly, what were the field impressions and any pertinent negatives. Now, even though they're going to leave behind this abbreviated report, the full report should be transferred to the hospital within 24 hours after that patient transfer. One of the things that EMS can do also to help hospitals is reciprocate with continuing education program access. Now that may include inviting hospitals to attend EMS continuing education sessions, but perhaps even more valuable would be the opportunity for hospital staff to do ride-alongs with EMS or spend some time in the 911 communication center observing emergency medical dispatch processes. It may also be useful to have EMS come into the hospital and do equipment demonstrations for some of the equipment that they use out in the field that aren't necessarily used in the hospital. EMS might also be able to help support hospital continuing education with doing things like pit crew CPR and familiarization on the incident command systems, things that EMS is usually much, much more focused on than hospitals are. Another opportunity for EMS to help hospitals is when hospitals are going through accreditation site visits. It's often requested and helpful to have EMS administration or medical direction participate in those site visits so they can speak to the issues of how hospitals and EMS work together. It'll also be helpful to have EMS invite hospitals to participate in some of the protocol development processes, particularly as it relates to destination protocols. So there's a number of ways that EMS can help hospitals in reciprocation for the many ways that hospitals can help EMS. So to wrap this module up, we're going to talk a little bit about federal laws relating to the relationship between hospitals and EMS and anti-kickback legislation. We're not going to review this topic in a lot of depth, but I think it's very important for everyone to at least be aware of these laws and have a general understanding of what they mean. The federal anti-kickback statute prohibits offering, paying, soliciting, or receiving remuneration to induce referrals of items or services covered by Medicare, Medicaid, and other federally funded programs. And what that means is that hospitals are prohibited from bribing or inducing EMS to give them more business. And similarly, EMS is prohibited from bribing or giving other inducements to hospitals to give business to them. The anti-kickback statute is intended to ensure that medical providers' judgments are not compromised by improper financial incentives and are instead based on the best interests of their patients. So in short, if your hospital is doing anything that might be construed as remuneration, bribes, or inducements to get that ambulance service to bring patients to your hospital rather than a competitor hospital, you should be seeking legal advice to see if you're crossing a line. But with that, it's important to recognize that hospitals can offer high quality services that earn the respect of EMS field clinicians, administrators, and medical directors. These are not bribes or inducements. These are things that won't compromise an EMS clinician's judgment with improper incentives. So that wraps up our class on improving hospital relationships with EMS. I hope you found the information useful. And if you have any questions or comments, please send them to ncdrmail at acc.org. Thank you for your time and attention.

EMS support

hospitals

anti-kickback regulations

relationship

timely transfer of patient information