Present: Jacqueline Blickle, Mark Cichon, Ann Daniels (for Amy Jones), Darcy Egging, Sue Fuchs (Chair), Sam Gaines, Kathy Janies, Trudy Jennings, Rose Lattyak, Dan Leonard, Al Lewin, Evelyn Lyons, Susan Jacewicz O'Kelly, Linnea O'Neill, Linda Sietsema, Myrtis Sullivan, Herbert Sutherland, Kathy Swafford, Alicia Vega (guest - CCAC), Terry Wheat, J. Thomas Willis, Carolynn Zonia

Absent: Brad Acuncius (excused), Joe Hageman (excused), Mike Hansen, Roy Harley, Vyki Jackson, Steve Lelyveld (excused), Cheryl Miles (excused), Maureen Niketopoulos (excused), Mary Ellen O'Brien (excused), Bonnie Salvetti (excused), Kathryn Stewart (excused)

Call to Order: Meeting was called to order at 10:05am

Introductions were made.

Minutes from the September 7, 2007 meeting were reviewed and approved

Announcements/Updates

EMSC appreciation gift - Thanks to our Advisory Board members for their ongoing support!

Welcome

  • New EMSC Pediatric Preparedness Coordinator - Rose Lattyak (contact at rlattyak@lumc.edu or 708-327-2558)
  • New EMSC Advisory Board members (pending IDPH Director appointment)
    • Linda Sietsema, RN, Illinois SAFE KIDS representative (replaces Darryl Patterson)
    • Kathryn Stewart, MD, Illinois Academy of Family Physicians representative (replaces Dr. Rick Leary)

Ethics Training for Appointees of State Illinois Boards

due ASAP (Action: Submit completed Ethics training certificate ASAP to Evelyn Lyons)

Federal EMSC Funding

Sue Fuchs reported the FY08 program funding (in HR 3043) was vetoed by President Bush. In response, a vote to override the President's veto was held; however it was defeated (by 3 votes). In the past, programs that were zeroed out receive emergency funding until some compromise can be reached, so we await further info from Nat'l EMSC. Sue encouraged Advisory Board members to be alert to calls for support as usually immediate response is needed

SB 335 (Illinois Safe Haven Act)

All safe havens (hospitals, police stations, manned fire stations, emergency medical care facilities) "must post a sign in a conspicuous place on the exterior of the building housing the facility informing persons that a newborn infant may be relinquished at the facility in accordance with the Act." Linnea O'Neill distributed a MCHC memorandum from March 2006 that explains that MCHC is participating with the Chicago Department of Public Health (CDPH) to help Chicago hospitals implement the sign ordinance. CDPH has funded the cost of developing and creating the sign, and the Chicago Department of Transportation (CDOT) agreed to install the signs at the hospital sites. By mid-December 2007, all Chicago hospitals should receive their sign. Herb Sutherland asked if signage is bilingual in case the symbol is not obviously meaningful to all cultures. Linnea will check and report back to the Board. (Action: Linnea will check into whether the Safe Haven sign is multilingual.)

Illinois Children's Healthcare Foundation

Evelyn asked if Board members were aware of and/or receiving funding from this organization. Vyki Jackson was aware of funding in southern Illinois for school health programs. EMSC will investigate potential funding.

Joint Commission Resources Pediatric Patient Safety Service

They are now offering a new fee-based consultation service and resources related to pediatric patient safety.

IMERT Pediatric Specialty Team

Sue Fuchs reported the team has received 14 applications to date (from various physicians, nurses, EMS providers, etc.). A mini-boot camp will be held after all the necessary equipment arrives. (Action: Go to www.IMERT.org for more details)

Educational Conferences:

Illinois SAFE KIDS

Evelyn read the following report submitted by Darryl Patterson. Illinois SAFE KIDS Coalition is part of SAFE KIDS Worldwide whose overall goal is to prevent unintentional childhood injury. Illinois has 31 local groups. Recent activities include a railway safety program held in several counties, and included participation from Springfield's Risk Watch program. Another program sponsored by General Motors, promotes car safety for kids growing out of booster seats (events held in Macomb, Bloomington/Normal and Carbondale). Every state has a designee on the Consumer Product Safety Commission that submits claims for product recalls (almost 200 recall claims have been entered into the database for this year alone)

MCHC

Linnea O'Neill reported their Infection Control Committee recently completed brochures on MRSA for consumers and hospital visitors. Linnea offered to send the PDF to Evelyn for widespread distribution, and asked hospitals to request a CD with the source file if they want to customize the brochures to include their hospital logo. Also, MCHC developed a "Living with MRSA" brochure for families and caregivers. Brochures are available on MCHC Web site. (Action: Contact Linnea O'Neill for more information)

IDPH, Division of EMS & Highway Safety Report

Sam Gaines reported:

  • Dr. Damon Arnold was announced as the Director of IDPH on October 1, 2007
  • The EMS/Trauma Strategic Planning process will continue with planned meetings on December 13th (Springfield), March 27th (Chicago), June 5th (Carbondale area) and September 4th (Chicago)
  • This year St. John's Hospital (Springfield) and Advocate Christ Medical Center (Oak Lawn) were honored and received the distinction of achieving PCCC level in Pediatric Facility Recognition.
  • IDPH is working toward re-starting the Trauma surveys

Chicago Children's Advocacy Center presentation

Chicago Children's Advocacy Center Project Presentation - Alicia Vega is Director of the CCAC, serving child abuse victims in the city of Chicago. They are one of 40 centers in Illinois. Primary focus has been to provide support and services to victims of child sexual abuse and their family members. The CCAC provides forensic interviewing, patient advocacy, etc., and unites all agencies involved in prosecuting these cases. They plan to expand services to cover victims of physical abuse. At present, CCAC has a grant thru DCFS to provide coordination for severe physical abuse cases (e.g., children under age 3, head trauma, internal injuries), and are currently contracted with Child Protective Teams (CPT) at Comer Children's, Children's Memorial and Stroger Hospitals. The CCAC Coordinator will work with investigators to guide patient examinations at other area hospitals. Initial Expansion Plan - DCFS investigators will have access to expert physicians for all cases. Target - To identify cases and try to prevent cases that are not child abuse from coming into the system (about 50% cases called into DCFS do not fall under the child abuse parameters).

  • Alicia Vega asked Advisory Board members for feedback on some proposed ideas to expand their current services (e.g., transfer child to one of three contracted hospitals, create a traveling CPT to go to community hospitals to assess patients, have CPTs available for phone consultation, etc).The CCAC has contracted with two agencies to conduct background research (i.e. cost analysis; pre implementation study to determine what is working well, what are the obstacles, etc.).
  • Alicia asked for help in recruiting volunteers for a general focus group with people in the medical community to discuss various issues (such as accessibility to medical records) Advisory Board members suggested CCAC speak with hospital attorneys re: access to medical records since this falls under HIPPA regulations. If CCAC interprets HIPPA laws differently as related to child abuse investigation, then this needs to be conveyed in writing.
  • Linnea O'Neill (MCHC) offered to share this information/interpretation with area hospitals.
  • Linda Sietsema mentioned that Worldwide SafeKids Conference has begun to include child abuse education to its audience and will continue to do so in the future.
  • Herb Sutherland suggested CCAC look at a model similar to the Illinois Poison Center's call center (identify key questions to ask at the time of assessment). Herb also proposed that the Facility Recognition process could be used to query hospitals on their structure for child maltreatment identification, guidelines and training.
  • Terry Wheat asked for information about when a physician should alert DCFS to a case of medical neglect.

Contact Alicia Vega for more informationavega@CHICAGOCAC.ORG

National EMSC Performance Measures

Update - Per Evelyn, National EMSC has identified common measures that each state needs to work toward in order to quantify the work being accomplished.

Goal 66A & B - all EMSC programs are required to conduct a survey of EMS agencies within their state (requiring a 80% compliance) to assess offline/online pediatric medical direction and prehospital supplies. Illinois EMSC is working with NEDARC to conduct a sampling of EMS agencies (proper sampling will include 200 ALS agencies and 100 BLS agencies).

Goal 66C - the Facility Recognition process is already in place so we have met this goal.

Goal 66 D & E - Interfacility Transfer Agreements and guidelines are already a requirement, but we need to encourage that the sub bullets in this measure are incorporated into their guidelines.

Goal 67 - current Illinois rules aren't sufficient as written (measure requires specific # of hours of Pediatric Emergency education for license renewal). Evelyn will bring to the Prehospital Committee to recommend language for adoption into the Rules & Regulations.

Goal 68A - existence of Advisory Committee - we have met this goal.

Goal 68B - pediatric representation on the EMS State Board - Evelyn and Mark Cichon are EMSC representatives so we have met this goal.

Goal 68C - Evelyn's role. We have met this goal.

Goal 68D - work towards integrating measures into state rules. We are still working toward this goal.

Pediatric Bioterrorism Workgroup

Tamiflu instructional brochure - EMSC will use the same layout/format as the Cipro/Doxy brochures (which have been very well received). CMH's PharmD is working on dosing chart. The committee hopes to review a draft at the next meeting.

JumpSTART train-the-trainer workshops - JumpSTART has been adopted by Illinois as the pediatric mass casualty triage system to use. Mo Otting developed a training module for the Chicago Fire Department. EMSC will provide monetary support to bring this education to the rest of state in 2008. A statewide site code for Prehospital CE has been requested. Cards are available with JumpSTART and START algorithm for use during the training sessions. (Action: Additional copies of the START/ JumpSTART can be obtained by contacting Evelyn)

Hospital Survey of Pediatric Resources project - EMSC is compiling survey data for a report that will be available in early 2008.

Emergency Preparedness Planning Guide for Childcare Centers guidelines - EMSC finally received feedback from DCFS with minor suggestions/revisions needed. This resource should be able to roll out in early 2008. IDHS nurse consultants provide technical assistance to day care centers and already using the draft guidelines in their educational sessions.

Facility Recognition Task Force

PCCC Recognition Ceremony on Nov 14, 2007 at Advocate Christ Medical Center, Oak Lawn

Region 8 (second renewal cycle)

  • 12 hospital renewal applications submitted (including 3 PCCC level hospitals)
  • 1 survey conducted in October; 11 surveys scheduled in December/January

Region 4 & 5 (second renewal cycle)

  • Educational session 10/24/07 at Memorial Hospital, Belleville (Region 4)
  • Educational session 10/23/07 at Logan Community College, Carterville (Region 5)

Current participation in facility recognition (109 hospitals)

  • PCCC/EDAP level = 10
  • EDAP level = 81
  • SEDP level = 18

Highlight of key changes/discussion

  • PCCC criteria revision - Physician Specialist criteria no longer requires 50 peds cases/year. Replaced with "pediatric proficiency as defined by hospital credentialing process."
  • EDAP criteria - Request not approved to accept AAPS Board certification requirements as equivalent to the EDAP waiver criteria.

AAP/ACEP Care of Children in the Emergency Dept: Guidelines for Preparedness Tool Kit. A toolkit informational mailing was sent to all ED nurse managers this fall. 

EMSC will submit a paper to the Annals of Emergency Medicine entitled, A Model for Improving Pediatric Critical Care Through Implementation of a Facility Recognition Program.

Quality Improvement

Current CQI monitors:

  • Assessment/mgmt Head Injury/Injury Prevention - 5 regions
  • Assessment/mgmt Extremity Injury - 2 regions
  • Assessment/mgmt Dehydration - 1 region (1 region ended this project)
  • Basic Pediatric Assessment -1 region
  • Neonatal Issues - 1 region (still in development)

Moderate Sedation educational module - Kathy reviewed new PPT presentation slides and asked for comments/feedback. Renee Petzel (Loyola's PharmD) is reviewing the module to ensure drug accuracy (esp in regard to sedating agents). Further physician review pending in mid-December.

Data Initiatives

2007 EMSC Annual Report - Region 11 and Region 3 versions were distributed for review. Final versions will be available on the EMSC Web site by January 2008.

IDOT grant project status - Ruth Kafensztok is back with EMSC. FY08 IDOT grant will support continued updating of the EMS Reporting system (http://app.idph.state.il.us/emsrpt) and a new year of Crash Fact Sheets. Ruth and Dan will conduct a quality assessment of the IDOT database.

Prehospital Committee

Status of EMSC Pediatric Prehospital protocol revisions - final revisions were made at the December EMSC Prehospital Committee meeting (protocols include all levels -- ALS, ILS, BLS, and EMR). State EMS Protocol Committee has reviewed and approved the BLS and EMR protocols as statewide minimum standards. Formal approval from the Advisory Board is needed. Evelyn will email the entire document to Advisory Board members for their review/comments and approval. (Action: All board members are asked to review the final draft of the prehospital protocol document and submit vote regarding approval or disapproval.)

Child Maltreatment CD-ROM and DCFS Mandated Reporter informational mailing - EMSC mailed out Child Maltreatment Awareness - related materials to all Trauma Coordinators, hospitals and EMS System Coordinators to encourage staff education. The packet included: Childrens Memorial Child Maltreatment Awareness CD, and DCFS Mandated Reporter Online training info.

CSHCN reference sheet - Document is finalized and distributed to all EMS agencies and hospitals. (Action: Contact Evelyn for additional copies)

School Nurse Committee

SNEC curricular updates - course materials are still undergoing revision. Goal is to have revised manual and instructor materials completed prior to Summer 2008 course roll-out. 15 chapters are undergoing revisions. Once provider manual is completed, this committee will develop student slides. Laura Filipelli has been contracted to coordinate the chapter reviews and Tamia Karpeles is the copy editor that will finalize the publication.

EMS Region 4 Coalition

Per Trudy Jennings:

  • Shoes & socks for kids program - have fitted over 200 kids with shoes with one more week to go
  • Survey of domestic shelters - A survey was conducted of shelters to identify needed items (ie soap, shampoo, toothbrushes). Each hospital has been assigned to be responsible for collecting a quantity of a specific item.
  • 11th Pediatric Seminar - The 2008seminar will be held March 29th with Dr. Zonia as a speaker.

Other

Use of latex

Terry Wheat asked how best to go about requesting that EMS avoid wearing/using latex when they transport Shriner's patients (as most of their patients are sensitive to latex). Tom Willis explained that latex is the most cost-effective so that is what is usually used, however most ambulances typically have a latex-free kit available. Tom suggested identifying the need for the latex-free kit when calling in the transport request.

Facial structure research

Terry Wheat asked for help in recruiting normally developed kids for a facial anomaly research project.

NHTSA update

Tom Willis announced a Federal EMS Interagency Committee meeting sponsored thru NHTSA on December 18th regarding safety and accountability in the transportation equity act, as well as practice guidelines

2008 meeting schedule

EMSC will announce meeting dates after confirming room availability at both IHA sites (Naperville and the Springfield sites).

Meeting was adjourned at 12:15am

Meeting minutes submitted by K. Janies & E. Lyons