Hi, Mick Anderson here. Welcome back to the Regional Time-Sensitive Care Coalitions course, and you're now watching the seventh lesson in our series. Got questions or comments? Please send them to ncdrmail at acc.org. Let's do a quick recap of what we've covered so far. Lesson one made the case for why a community or region should establish a time-sensitive care coalition, or RETSCO. In the second lesson, we covered the roles and responsibilities of the RETSCO and the RETSCO manager. In the third lesson, we discussed ways to define the catchment area for the RETSCO and which organizations to invite to participate in its creation. The fourth lesson described how to make a preliminary assessment of time-sensitive systems of care efforts within that catchment area. The fifth lesson covered how to get things set up for a meeting of executive-level representatives from the stakeholder organizations to discuss formation of the RETSCO. In the sixth lesson, we talked about how to conduct the RETSCO formation meeting. In this seventh lesson, we're going to discuss the condition-specific committee meetings. For each targeted condition designated by the RETSCO stakeholder committee, a condition-specific committee should be established. This is where hospital service line administrators, medical directors, and quality managers, as well as ambulance, fire rescue, and 911 center supervisors, quality managers, and medical directors will be most likely to participate. There may also be some frontline clinical staff involved at this level. If the RETSCO has several condition-specific committees, it should be recognized at the outset that the same person from each EMS agency and emergency department should not be the primary representative on every one of these committees. However, there should be a way for key individuals, such as an ED or EMS medical director, to attend any of the meetings as they deem necessary. If any incumbent condition-specific systems of care groups for a particular condition have been incorporated into the RETSCO, that can provide the starting point for the new committee. When a condition-specific subcommittee is created, one of the first things the group should focus on is getting a baseline on the current level of performance in the system of care for that specific condition. To do that, there will need to be some preparatory steps in selecting the measures by which the system of care will be measured and developing processes for individual organizations to collect data, generate measures, and then aggregating those results across like organizations and across the continuum of care. Ideally, the measures selected for measurement of systems-level performance can be ones that are standardized nationally, so that valid comparisons to state and national results can be made. If the hospitals are participating in a registry for a particular time-sensitive condition, the registry reports will typically report on overall performance, and that can be used as a baseline for each hospital. The data from each hospital could then be aggregated to get a picture of how well the hospitals are working collectively. And to the extent that the data allows, the hospital registries may also provide some data or measures that relate specifically to EMS. The EMS agencies and 911 centers may have data and reporting tools to help them get baselines as well. Data across multiple ambulance services, or multiple rescue agencies, or across multiple 911 centers can be aggregated to see how each of those provider groups are working collectively as well. Those baselines are really important to get and as soon as possible. They will allow any subsequent improvements or declines in system performance to be objectively measured and thereby help measure the impact of any forthcoming improvement projects. Provided baseline performance information will also be helpful in applying for grants or other support for the coalition and for any specific improvement projects. After the baseline assessment is completed, the local results should be compared to state and national results. At this stage, the condition-specific committees should look for deficiency gaps between local and state or national results. One of the appendices contains a sample meeting agenda for condition-specific committee meetings. Regardless of the type of organizational structure that's chosen for the RETSCO, a set of bylaws or a similar document should spell out how the RETSCO operates. It needs to address how stakeholder committee and condition-specific committee members are appointed and rotated, how decisions are made, and other operating policies. A more formal and comprehensive set of bylaws will be needed if the RETSCO is going to be a fully independent 501c3 not-for-profit corporation versus an informal coalition. This should be an early agenda item for the stakeholders committee. That's lesson seven. In the eighth and final lesson, we're going to talk about transparency, accountability, and celebration. Please send any questions or comments to ncdrmail at acc.org. I'll see you in the next lesson.

Regional Time-Sensitive Care Coalitions

RETSCO

lesson recap

establishing condition-specific committees

system performance assessment