first watch

Richmond Ambulance Authority and FirstWatch Celebrate 12 Years Together

The industry leader in public safety data, FirstWatch® is pleased to announce the 12th anniversary of the company’s founding by Todd Stout, winner of the 2014 Pinnacle EMS Leadership Award and nationally recognized expert in public safety data.

Celebrating this milestone with FirstWatch is the Richmond Ambulance Authority (RAA). Twelve years ago this month RAA became the first EMS agency in the world to implement the commercial version of the FirstWatch biosurevillance system. Coming on the heels of 9-11, it monitored 911 data for unusual trends to provide early warning for bioterrorist or chemical attacks. Jerry Overton, RAA’s executive director at the time, said FirstWatch would be “a significant step in increasing our overall preparedness in these changing times.” RAA has since been at the forefront of change in the EMS profession and continues to use FirstWatch in innovative ways to improve their system’s operations and performance.

RAA was first established in 1991 under the Richmond Ambulance Authority Act in order to provide a unified provision of EMS services for the city of Richmond as a self-operated, stand-alone public utility model. Covering 62 square miles, the ambulance service responds to a resting population of 204,000 (which increases considerably by day) over 55,000 times per year. With a staff of about 260, RAA operates up to 27 vehicles at peak hours. Although it has one of the highest call volumes per capita in the United States, RAA has gained a national and international reputation as a premiere, high-performing EMS system.

Operating on the principles of a high performance public utility model, RAA was founded on patient-centric ideas as taught by Jack Stout, the father of high-performance EMS and FirstWatch founder Todd Stout; Jay Fitch, founder of Fitch & Associate; and Jerry Overton, now chair of the International Academies of Emergency Dispatch (IAED). To date, RAA is one of only 22 systems in the US that has received accreditation from both the National Commission on Accreditation of Ambulance Services (CAAS) and IAED. RAA is also a Commonwealth of Virginia accredited dispatch center.

To gain perspective on how far RAA has come as both an agency and a FirstWatch customer over the past 12 years, RAA Chief Operating Officer Rob Lawrence shares his views.

Q: RAA originally implemented FirstWatch for early detection and alerting, in the wake of 9-11. How is RAA using FirstWatch today?

A: We are using FirstWatch today in every which way we can. From its original purpose, we are using the geosurvelliance and biosurveillance aspect of it to identify clusters of concerning activity and syndromic activity; we have added the Richmond City Health District views and alerts to this data set as well. While we’re still using FirstWatch in this classic sense, we are also now able to use the system to conduct off fraction reviews, provide real-time situational awareness during natural disasters, and enhance operational performance. In the past we have even used FirstWatch to measure long hospital drop times or to spot influenza trends.

Our decision to implement the ePCR reading version of FirstWatch means we take the paramedic’s view of what is happening on the street. With our most recent purchase of the new QA/QI FirstPass system, we’re able to focus our attention on the most important calls as they happen. This in turn points us to where we need to further train and educate our staff. Traditional quality improvement looks at a percentage of your call volume, FirstPass looks at everything – all the time. Everyone talks about how quickly we respond; now we can talk about with immediacy how well we’re performing clinically and we’re very excited about that.

Q: In most recent years you have been honored for your safety and injury prevention programs. How did RAA get into this area and what can you tell us about its success?

A: We believe in the theory that Public Health is an equal part of EMS. If we can prevent an accident from happening before we have to attend to it then we don’t have to cure it. We are constantly looking at what makes up those frequent calls for deployment purposes, what are those conditions, and how can we affect some of those conditions to prevent traffic accidents from happening. When we start looking into our data, we can focus on areas in which these types of accidents are occurring most frequently and provide knowledge and awareness to our city – and the nation.

Q: How important is data to running an ambulance service?

A: Data is everything. It is indeed our favoriteA four letter word…many organizations don’t believe they have as much data as they really do. At RAA we believe we use data to save lives – it is absolutely imperative to us. With the FirstWatch system and those we have developed in house, we pull multiple data sources together to have a more intelligent view of our system as a whole.

Q: What does the future hold for RAA?

A: We’re looking forward to new models for the delivery of healthcare such as Community Paramedicine. FirstWatch is helping us look at some aspects of this right now such as alerting us to frequent users; we’re looking forward to exploring this deeper.

Q: How has your experience been with FirstWatch as an organization?

A: FirstWatch is a family-oriented organization, amazingly responsive; the people who work there are phenomenal, and the values that Todd believes in are apparent by talking to his staff. We are a data-driven organization and FirstWatch helps us to improve our patient care. We embraced the use of data over a decade ago and we (are still) using it…we are still realizing that there is more that can be done with FirstWatch. It’s an integral part of our infrastructure. We love using FirstWatch and working with the people that support it.

About FirstWatch:
FirstWatch, based in Encinitas, Calif., began monitoring 911 data in Kansas City, Mo. in 1999 as a custom-built application. On Sept 23, 2002 the Richmond Ambulance Authority was the first to use the commercial version of FirstWatch. Since then, FirstWatch has grown into a leader in real-time public safety data analysis, helping more than 300 communities across North America.

FirstWatch’s Real-Time Situational Awareness System enables authorized users to monitor what’s happening as events are unfolding, enabling quick action and response. FirstWatch is used to enhance situational awareness to protect the health and safety of emergency responders; to detect and alert public safety and health teams to pandemic disease or bioterrorism; and to enable public safety agencies to monitor operational performance to ensure the efficient and responsible use of resources.

This press release originally appeared at FirstWatch.net.

Dempsey Hometown Hero

Richmond Ambulance Authority Director Receives Home Town Hero Award

Richmond Ambulance Authority Director of Operations Dempsey Whitt was recognized this week as one of the 50 honorees in the 2014 Allen and Allen Hometown Heroes awards.

Now in its fifth year, the Allen & Allen Hometown Heroes award recognizes Virginians who are responsible for generating positive change in the community or in the lives of others. Dempsey’s award was made for service to the Commonwealth of Virginia in two uniforms – that of an EMS provider as both a flight and ground medic, and in his other role as a Sergeant Major in the Virginia National Guard, where he served on active duty in Afghanistan. His citation reads:

“Dempsey has served his country for over two decades, including 400 days in Afghanistan where he earned the Bronze Star Medal for acts of merit. Prior to Afghanistan, Dempsey served as Chief Flight Paramedic at PHI Air Medical. He has also served as a Sergeant Major in the U.S. Army. In addition to his service to his country, Dempsey impacts his community locally as the Director of Operations for Richmond Ambulance Authority. He continues to give back to those in need and is an advocate for his employees. He is an active member in his church and a dedicated runner with the VA National Guard Marathon team. “Dempsey is selfless, always caring, will give all he can give to anyone in need and seeks out ways to continuously give back.”

RAA CEO Chip Decker said, “We are delighted that Dempsey has been recognized as an outstanding Virginian both at home, with us at RAA, and away with his National Guard duties. He is an outstanding leader and sets a fine example for all to follow and this award is well deserved.”

Dempsey will receive his award later this month at a formal ceremony.

rider alert

Number of Female Motorcyclists in Virginia Nearly Doubles while Fatalities Drop

The number of female motorcycle riders in the nation and in Virginia has soured in the past decade while crash fatalities, at least in Virginia, are thankfully going the other way. Could it be that lady riders are safer? AAA and RAA say the numbers prove it and that it is no surprise.

According to the Motorcycle Industry Council, the number of female operators shot up from 4.3 million in 2003 to 7.1 million in 2009 (latest numbers available).

In the Commonwealth of Virginia, from 2011 to 2013, female motorcycle endorsements increased by nearly twice (10.37%) that of male endorsements (5.74%) while fatalities in that same time period were down by 33%, according to preliminary crash data provided by the Virginia Department of Motor Vehicles (DMV). Furthermore, female riders in 2012 died at the rate of about one in every seven thousand (6,902), while male rider death rates were much higher, at one in about every five thousand (4,732).

“Females are naturally protective, nurturing, often take less risks than males and many are mothers who want to be around to raise their children. While not all women fit this description, those who do are not only more cautious riders but would likely take safety classes and wear protective gear when riding,” said Martha Mitchell Meade, Manager of Public and Government Affairs and a licensed motorcycle rider.

It’s not, however, just the women who are strapping on their helmets and paying attention to safety; there is more good news report. Overall, motorcycle endorsements (male and female) in Virginia have increased 6.3% in Virginia since 2011, while the overall percentage of motorcycle-related fatal crashes to total fatal crashes stand at just nine percent (a 30% decrease). Injury numbers related motorcycle crashes are also at their lowest in four years, at three percent of all injury crashes in Virginia. Those numbers are the lowest in at least four years and have safety advocates cheering.

“I am encouraged that serious injuries and fatalities among motorcycle riders in the commonwealth are down and hope to continue to work long and hard to ensure that this encouraging downturn continues,” said Rob Lawrence, Chief Operating Officer, of the Richmond Ambulance Authority. And their message is simple, “AAA and the Richmond Ambulance Authority are shouting their safety messages once more as we enter the busy summer driving season when more motorcycles are on the road. Motorists and motorcycle enthusiasts must Share The Road to help further the effort of reducing fatalities and injuries on Virginia’s highways.”

Each year, AAA Mid-Atlantic partners with the Richmond Ambulance Authority (RAA) to promote motorcycle rider safety. In April 2011, RAA launched Rider Alert to help reduce motorcycle fatalities by providing first-responders with medical information needed to help injured motorcyclists. Through identification data cards placed inside helmets, first-responders have access to vital, life-saving information on injured riders involved in accidents, so they can provide faster and more accurate medical assistance, thus saving more lives.

“We are very pleased to learn motorcycle fatalities have reduced dramatically since the start of the Rider Alert program and continue this year on their downward trend,” said Lawrence. “Motorcycle safety is the responsibility of everyone, from motorists and motorcyclists to first responders. Motorcyclists must be properly trained, follow traffic laws and wear visible clothing. Motorists need to remain alert at all times and give motorcyclists plenty of room. First-responders need access to vital, life-saving information. That’s why the Richmond Ambulance Authority spearheaded the Rider Alert program,” added Lawrence.

With the motorcycle riding season well underway, safety advocates across the Commonwealth ask all drivers to remain alert and share the road equally with the motorcycling community.

Tips for Motorists

  • Share the road. A motorcycle has the same privileges as any other vehicle on the road. Be courteous and give the motorcyclist a full lane of travel.
  • Position your mirrors to minimize blind spots. Adjust the rearview mirror so it shows as much of the rear window as possible. While in the driver’s seat, place your head near the left window and adjust the left side-view mirror so you can just see the side of your vehicle. Then, position your head near the middle of the vehicle, above the center console, and adjust the right side-view mirror so you can just see the side of your vehicle.
  • Look out. Look for motorcyclists on the highway, especially at intersections when a motorcyclist may be making a turn or changing lanes. Clearly signal your intentions.
  • Anticipate a motorcyclist’s maneuvers. Obstructions (debris, potholes, etc.) that you may ignore or not notice can be deadly for a motorcyclist. Anticipate their possible evasive actions.
  • Allow plenty of space. Do not follow a motorcycle too closely. Allow enough room for the motorcyclist to take evasive actions.
  • Keep your cool. Even if you get agitated seeing a motorcyclist making unsafe moves, do not attempt to play games on the road.

Safety Tips for Motorcyclists

Make yourself visible. Choose protective gear that provides visibility and protection. This includes wearing bright colors. If riding at night, wear clothing with reflective materials.

  • Allow space. Position your bike in the lane so that you can be seen. Allow additional space for emergency braking and room to maneuver. Avoid riding in a motorist’s blind spot. Make lane changes gradually and use appropriate signaling.
  • Never share a lane beside a car. A driver may be unaware of your presence. Most drivers are looking for larger vehicles, not motorcycles.
  • Clearly signal your intentions. Use turn signals before changing lanes and never weave between lanes.
  • Don’t speed. Obey the posted limits and adjust your speed to the changing road conditions.
  • Wear protective gear.
    • Helmet – Always wear a U.S. DOT-approved helmet. It can save your life and it is the law in Virginia.
    • Eye protection – Visibility is key to riding safely. Many motorcycles do not have windshields. Riders should protect their eyes with goggles that can shield the face from wind and debris, both of which can cause tearing and blurred vision.
    • Body Protection – Jackets with long sleeves and trousers protect limbs from injury.
    • Gloves – Durable gloves should be a non-slip type to permit a firm grip on controls.
    • Footwear – Proper over-the-ankles footwear should be worn to help prevent injuries.
  • Complete a motorcycle rider education and training course. The overwhelming majority of motorcyclists have had no formal training – they were self-taught or learned from family and friends. Before operating a motorcycle in Virginia, a rider must pass the motorcycle knowledge exam, hold a motorcycle learner’s permit for 30 days and pass the motorcycle road skills test. Completing a Virginia Rider Training Course exempts the rider from taking the exams.

The Rider Alert motorcycle safety program distributes free identification data cards that help first responders to provide rapid and accurate medical assistance to motorcyclists involved in serious accidents. Launched by the Richmond Ambulance Authority, Bon Secours Virginia Health System and Motorcycle Virginia! In April 2011, Rider Alert is the first program of its kind in the United States. The Rider Alert card is placed inside a rider’s helmet and contains vital life-saving information, emergency contacts and important medical history. When first responders arrive on the scene of a motorcycle accident, a sticker on the outside of the helmet will indicate that the biker has a Rider Alert card. The sticker also warns bystanders not to remove the helmet, which could cause further injury. For more information, please visit www.rideralert.org.

AAA Mid-Atlantic serves nearly 808,000 members in the Commonwealth of Virginia and is the nation’s fifth largest auto club with nearly 4 million members in Virginia, Maryland, Delaware, the District of Columbia, Pennsylvania, and New Jersey. It provides a wide range of personal insurance, travel, financial and automotive services through its 50-plus retail branches, regional operations centers, and the Internet. For more information on AAA Mid-Atlantic, please visit our web site at www.AAA.com. Persons wanting to comment on this issue can go to AAA Mid-Atlantic’s Community pages at http://www.AAA.com/community and post comments. The organization is anxious to hear from travelers with their thoughts on this subject and others.

RAA's Little Free Library

RAA Unveils Little Free Library Ambulance

April 13–19 is National Library Week and the Richmond Ambulance Authority has opened its own branch of the “Little Free Library.”

Little Free Libraries are hand-crafted structures that contain constantly changing collections of books donated and shared by people of all ages and backgrounds. Most Little Free Libraries are placed in front yards, parks, gardens and easily accessible locations. The libraries are built to withstand all weather and hold 20–100 books.

Originally designed to look like a one-room school or a “house of books,” the libraries rapidly took on a variety of sizes, shapes, themes and other attributes. The RAA Little Free Library has been constructed and painted in the shape and style of an RAA ambulance, complete with flashing lights as the door to the library is opened.

The Little Free Library program has been in place since 2010 and the creation of the RAA library was the brainchild of paramedic Jennifer Norment. “As a member of the RAA Wellness Committee, I proposed the idea and partnered with RAA System Status Controller, Rebecca Szeles, who suggested that we construct an ambulance box. She volunteered her husband, Richmond police officer and wood worker Steve, to bring the project to life,” says  Norment. Once constructed by Steve Szeles, its electronics were installed by RAA Fleet Manager Dan Fellows. Fellows is also a published fiction writer and one of his books will be the first in the library.

The ambulance box is located at the south entrance of the RAA complex on Hermitage Road. Books are available to all on a “drop-off/pick-up” basis.

Crew Chain of Safety

How to Build the Crew Chain of Safety

The Richmond Ambulance Authority (RAA) is an organization embracing the EMS Culture of Safety in every department, from field staff to administrative offices.

New employees are told by everyone from the CEO to their field training officer (FTO) how our desire for them to be able to go home at the end of the shift is our inspiration. When it comes to vehicle operations, RAA takes its task to provide safe crews in safe vehicles very seriously.

Hard to believe, but statistically an ambulance in the wrong or poorly trained hands can become a weapon of mass destruction. Statistics have proven EMS workers in the United States are a “high-risk” population and have a fatality rate of 6.3 per 100,000 workers, 1.4% greater than the national average. Among the 65 fatalities for EMTs between 2003 and 2007, emergency medical technicians and paramedics accounted for 60 deaths, while “ambulance drivers” and attendants accounted for the remaining five deaths.

In addition to fatal injuries, around 19,900 nonfatal injuries requiring treatment occur to EMS workers each year.Against this backdrop, the RAA leadership team is committed to a “crew chain of safety,” establishing a level of safe and skilled vehicle operations. They are developed and sustained while also being measured and managed.

The “crew chain of safety” (CCS) is very similar to the American Heart Association’s Chain of Survival. Each link, although distinct and specific in nature, is only as effective as the next one. Their collaborative and overlapping efforts are what create the ultimate success. RAA’s CCS has a minimum of nine links. Each one contributes specific content; however, none is mutually exclusive of another.

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