Welcome back to the Regional Time-Sensitive Care Coalition's course. You're now watching Lesson 5. While you're watching the lessons, if any questions come to mind or if there's any feedback you'd like to share regarding the course or the toolkit, please send an email to ncdrmail at acc.org. Let's do another quick recap of what's been covered up to this point. The first lesson talked about the advantages of effective systems of care programs for time-sensitive conditions and how a Regional Time-Sensitive Care Coalition, or RETSCO, can help make these kinds of systems more effective in your community. In the second lesson, we covered the roles and responsibilities of the RETSCO and the RETSCO manager. In Lesson 3, we talked about the catchment area and the organizations to invite to participate in the RETSCO. Lesson 4 covered the preliminary assessment of time-sensitive systems of care efforts that may already be in place within your catchment area. Now in Lesson 5, we're going to discuss ways to approach setting up that initial meeting to form the RETSCO. Armed with the information from a preliminary assessment, the champions who are trying to start the RETSCO will need to contact representatives from key stakeholder organizations from across the proposed catchment area to invite them to a meeting where everyone can participate in the formation of a RETSCO. Having these discussions over a meal or refreshments is strongly suggested as it really helps to increase attendance and participation. Champions may have to access funds through their own organizations, but in many cases some sort of sponsorship or support will be needed to cover the cost of the venue and or the meal for the meeting. There are several types of organizations to consider for sponsoring that meeting. Hospitals or hospital foundations, pharmaceutical companies or device manufacturers with an interest in time-sensitive care conditions, companies that do a lot of business with the organizations that the champions work for may also be willing to sponsor a meeting. Getting a sponsor is often more likely when the sponsoring company will know that it will be acknowledged at the start of the meeting, may be allowed to briefly say a few words to the attendees and maybe have a table in the back of the room where they can show their wares. That can make the sponsorship a win-win scenario. Give them an answer to their WFM, what's in it for me? Also consider local foundations with an interest in health care innovations, major payers in the region or even local physician practice groups with an interest in any of the time-sensitive care conditions. With the venue, meals and sponsorship taken care of, champions will need to decide which organizations and what person or persons from those organizations to invite to the meeting. There are a few broad categories of organizations to consider inviting. Health care provider organizations, regulatory and oversight organizations, payers and any incumbent systems of care groups. Among the health care provider organizations, we'll obviously want to invite acute care hospitals and ambulance services. Also be sure to include non-transport medical first response agencies, 911 communication centers and don't forget the major post-acute care providers in your region, particularly the rehabilitation centers. They are an important part of the continuum of care. On the regulatory and oversight side, think about health departments. After all, when we're talking about developing systems of care for time-sensitive conditions, these are public and population health issues as we're trying to create programs and infrastructure to better equip entire communities and the overall region for the prevention, treatment and recovery from these time-sensitive conditions. Putting these types of groups together for these types of initiatives is a core competency in public health. Hospital associations and designated hospital quality improvement organizations or QIOs should be invited. We also want to invite any EMS oversight or regulatory groups. That would include independent EMS medical direction offices that cover multiple EMS provider organizations as the EMS system medical director. These kinds of groups may or may not be present in your community or region, but if they are they really need to be included. The payers are another key group to consider. As the ones paying for the health care being delivered in your community or region, they have a vested interest in trying to improve both the quality and efficiency of care. This makes them direct financial beneficiaries of improved systems of care. And there are two categories to consider here. First and foremost are the major insurers. That would also include major employers with self-funded health care networks. The other less obvious category of payers are units of local government like cities and counties. They pay for a lot of the emergency response infrastructure without reimbursement from insurance payers. Local government pays for the 911 communication centers and the non-transport medical first response agencies. Quite often they also fund the EMS regulatory and oversight groups. Local government also pays for any government operated ambulance service costs that are not reimbursed by insurance companies, which can be quite substantial in many places. This payer representation from units of local government is separate from any of the government operated EMS provider agencies. So we might end up with a city or county administrator or elected official representing a unit of local government from a payer perspective, as well as an EMS or fire chief of a government operated ambulance service from a provider perspective. During the preliminary assessment of the catchment area, any currently active systems of care groups should have been identified. These may be regional groups or groups that operate within a particular tertiary care hospitals. Their leaders should absolutely be invited to the meeting. And please include the rehabilitation care facilities and try to get some representatives of medical practices that will be providing secondary prevention services related to time sensitive conditions. In some cases, the medical practice groups that provide acute care services are also the providers of secondary prevention services, like a cardiology group that has interventionalists as well as general cardiologists. Now that we have considered what organizations to invite, we need to decide which individuals from within those organizations we want to invite. In general, we're looking for senior executive level representatives. These are people who are in positions that make high level decisions on behalf of their respective organizations. They can commit their organizations to participate in and support the RETS GO. They can assign people within their organizations to serve on committees, etc. From a hospital, we would invite someone like the CEO from the administrative side and the director of the emergency department and the directors of time sensitive care related service lines, like those who lead the teams for trauma services, the acute care stroke team, and the cardiac cath lab. Keep in mind that for this meeting, we need administrative executives and clinical leaders. This is a meeting to consider forming the RETS GO, which really needs both categories of representatives. For EMS providers, like ambulance services, non-transport medical first response agencies and 911 communication centers, consider inviting both the administrative and medical directors. This applies to government operated agencies, private companies, and volunteer organizations that provide EMS. In the toolkit, there's an appendix with a list of suggested organizations and individuals to consider inviting, as well as a sample invitation letter that describes the reason for the meeting. The invitation letter would ideally come from a very senior public official, such as a mayor, chair of the local county commission, city manager, county administrator, or a local equivalent thereof, such as county judges in Texas. The invitation letter should ideally be on their official letterhead, even if it is sent as an email. Alternatively, the letter can come from the champions. If there is another scenario that is likely to result in a good turnout, these options should not be considered restrictive. For example, a local EMS council, hospital association, or public health department may also have a neutral standing along with enough political influence or gravitas to draw attendance by hospital CEOs and other senior officials. The date may be left open to allow scheduling to occur based on the availability of those who express interest in attending. It is also suggested that the invitation letter be followed up with a phone call to those who do not respond either way to the RSVP. So let's talk about scheduling. Working in conjunction with the organizational sponsors, determine when and where to have this first meeting. When selecting a meeting date and time, priorities should be given to the availabilities of leaders of any existing time-sensitive care groups, hospital C-suite representatives, senior appointed or elected government officials, and payers. Their attendance, input, and support is crucial. You might also ask all of those who express interest in attending to participate in a poll to see when they are available in a given time frame. And this can be done with an online tool like Doodle or a similar resource. Once a time and location are determined, a follow-up letter with the specifics can then be sent out to the entire group of invitees to include those who did not respond to the RSVP. So we have the invitee selected, we have a date and venue, invitations have been sent, we've received supplies to the RSVP, and meals and refreshments are covered. It's about time to have that meeting. We're going to discuss the details of conducting that meeting in the next lesson. As always, please send questions or comments to ncdrmail at acc.org. I'll see you there.

Initial meeting

Sponsorship options

Healthcare provider organizations

Senior executive-level representatives

Scheduling