The Education and Training Department is dedicated to supporting the goals of Grady Emergency Medical Services:
To provide the highest quality pre-hospital patient care to the residents and visitors to the City of Atlanta in a prompt and efficient manner;
To present ourselves as courteous, knowledgeable professionals with a positive, caring attitude toward our customers, Co-workers, and associated agencies;
To strive, through customer and employee input, to constantly upgrade our service.
The Program Vision is to become the leading EMS Education and Training center.
The Program Mission is to develop entry level, highly motivated, technically skilled, critically thinking, and ethical healthcare professionals. To achieve these goals, the Education and Training Department manages several programs: New Employee Orientation, Initial EMT, AEMT and Paramedic Certification Courses, Critical Care Transport Program, Continuing Educations courses, Field Training Officers, annual skills validations to our 300 license employees, and pre-employment interview testing.
The New Employee Orientation (NEO) Program consists of a six week program.
To support the Operations Division and increase employee retention, Grady EMS offers education programs for EMT, AEMT, and Paramedic. Fulltime EMS employees are eligible to receive tuition scholarships to attend our Paramedic program. Our EMS Education program submitted their CoAEMSP self-study and completed the site visit in November 2014.
This program supports our Specialty Transport division which provides interfacility transport BLS, ALS, and Critical Care Transport (CCT ) services. This program is designed to provide education, training and skill validation to paramedics assigned to CCT units. These units transfer patients requiring ventilator support, and medication infusions to long-term and acute care centers. The program prepares medics to obtain nationally recognized certifications in CCT.
The Field Training Officer (FTO) is an integral part of the New Employee Orientation process. The FTO integrates the new employee into the Grady system and culture over a four week period to validate clinical skills and competencies. . The FTOs may assist by taking leadership roles in the continuing education process, research, and quality assurance. The FTO may fill key Operations leadership roles as needed.
Continuing education is a valuable two tier process. The first tier allows for the introduction of new innovations and technologies for patient care. The second tier refreshes and reinforces the knowledge by revisiting patient care topics and modalities.
Examples of classes offered:
Quality Improvement (QI) Officers are responsible for patient chart review for clinical accuracy, completion of data entry, and protocol compliance. QI Officers evaluate a 5% random sample chart review and additionally review categories determined by the Medical Director for 100% review; patients requiring a Level 1 Trauma Center, use of Advances Airways, EZ-IO Insertions, Cardiac Arrests, Chest Pain, CVA/Stroke, Dyspnea, Seizures, BLS tiered response transports, and Narcotic administration. QI Officers have an annual aggregate chart view of 35%.
The QI Officers hold bi-weekly quality assurance meetings with the EMS Medical Director and EMS Fellows to review EMS cases. Additionally, these meetings includes representatives from our City PSAP, EMD call triage, fire first-response, and Grady EMS to allow QI, department leaders, educators, and physicians to review the evolution of a call from call receipt, EMD triage, dispatch, scene management and transport to the ER. Without this integrated QA process, the Medical Directors from the respective agencies would only be able to evaluate parts of the call.
Alternate Destination Protocol - This program was designed to offer patient transports to a neighborhood clinics rather than an Emergency Department for non-emergent medical problems. This program was started in 2010 and continues.
RAMPART seizure study - Grady EMS participated in a clinical study for treatment of patients suffering from prolonged epileptic seizures. The Rapid Anticonvulsant Medication Prior to Arrival Trial (RAMPART) was designed to study whether giving an anti-seizure medicine works better and more quickly when given through an IV or IM. Two similar medicines, Midazolam and Lorazepam, were used in the RAMPART study. http://rampart.umich.edu/rampart/home
Stroke - Grady EMS works closely with the Marcus Stroke and Neuroscience Center to rapidly evaluate stroke patients and initiate a pre-arrival STROKE ALERT. These patients are rapidly evaluated and patients that meet interventional criteria are immediately taken to the Neuroscience center in a process similar to an acute MI requiring a cardiac cath lab. Grady's comprehensive stroke center incorporates the most advanced equipment and an around-the-clock staff of specialized doctors and nurses.
Upstream Mobile Crisis (our version of Community Paramedic) which partnered with a mental health mobile crisis company to respond to 911 calls with a paramedic and Georgia licensed mental health clinician. These calls are designated to the unit once call triage identifies the EMD 25 card. The unit offers point of care services which could include safety plans, same-day or next-day mental health appointments, or transport to an in-patient emergency mental health receiving facilities not attached to an ER.
Hypothermia Protocol [ROSC] - We utilized a Hypothermia protocol for cardiac arrest patients after a return of spontaneous circulation (ROSC). These patients were treated by infusing cold intravenous fluids and cold packs to reduce body temperature and improve outcomes.
Twelve Lead Transmission - Grady EMS reviews STEMI outcomes and First Medical Contact to Balloon Time (FMC2BT) within 90 minutes monthly. We accomplish these successes by transmitting 12-lead EKGs from the patient scene to the ER. 12-lead EKGs are sent from the Philips monitor to the Toughbook or OBMG and then on to the receiving hospital. This allows the ER physician and cardiologists to review the 12-lead EKG prior to the arrival of the ambulance. These critical minutes allow the cardiac catheterization team to prep for the patient and implement processes to allow the patient to bypass the ER and be received on the cath lab table.
Review and implementation of patient care finding identified through our QI program
Decreased INT use for patients that did not meet specific medical criteria. The EMS Medical Director reviewed current literature and updated patient care protocols to reflect the changes. INTs are only initiated for patients receiving certain medications or have a high probability of clinical deterioration.
Decreasing the use of patient -loaded red lights and sirens when no research or literature exists which clearly defines a benefit to the short time savings. These policy and protocol changes were implemented to improve crew and patient safety.
Provide crews frequent in-services and literature reviews on topics when medical practices or regulations change.
Backboards - Implemented new protocol which decreased the use of backboards and defined the new criteria for spinal immobilization.