SOW_-_EMSC_Expansion.pdf

STATEMENT OF WORK: Pediatric Emergency Care for American Indian and Alaska Native Children and Youth.

Project background: The purpose of this project is to improve and increase the capability of the IHS to provide pediatric emergency care to American Indian and Alaska Native (AI/AN) children and youth. The Emergency Medical Services Act of 1984 identified children and youth at risk for mortality and morbidity caused by severe illness or trauma in pre-hospital and hospital environments. In 1999, the Health Resources Services Agency (HRSA) identified AI/AN children and youth at risk for unintentional injuries which are the leading cause of mortality and morbidity in tribal communities. This led to the first Inter-Agency Agreement (IAA) with IHS and HRSA to bring resources, expertise and supported efforts to improve Emergency Medical Services for Children (EMSC) in IHS and Tribal Healthcare programs. It is mission critical to continue this collaboration to ensure that quality pediatric emergency care and resources continue to be improved for and accessible to AI/AN children.

Objective 1: Establish quality improvement initiative for IHS Emergency Departments (EDs) based on the National Pediatric Readiness Project Assessment Scores. The National Pediatric Readiness Project is a multi-phase quality improvement initiative to ensure that all U.S.

emergency departments have the essential guidelines and resources in place to provide effective emergency care to children based on updated guidelines by the American Academy of Pediatrics.

Activities: Review the previous cumulative survey responses for the IHS ED Pediatric Readiness Scores conducted in January 2013. The cumulative report was developed in March 2014, consisting of 45 IHS and tribal hospital respondents.

Activities: Develop key recommendations for quality improvement actions across all IHS EDs based on the previous survey responses and scores.

Activities: Develop site specific recommendations based on IHS ED Pediatric Readiness Scores with American Indian/Alaska Native (AI/AN) background(s) and experience(s) taken into account. These recommendations should demonstrate an understanding of the cultural component(s) and an analysis of their impacts.

Activities: Collaborate with HRSA EMSC and key stakeholders to examine ED Pediatric Readiness related to the availability of mental health guidelines and agreements. Collaborative efforts will enhance mental health services within IHS EDs to improve comprehensive, coordinated services for IHS patients.

Objective 2: Conduct site assessments for IHS EDs based on Pediatric Readiness Scores.

Activities: Conduct site visits with IHS EDs for onsite technical assistance (TA), in collaboration with interested EMSC State Partnership grantees.

Activities: Provide recommendations to the site visit recipients based on the National Pediatric Readiness Project toolkit (guidelines in equipment, supplies, medication, administration & coordination of care, patient safety, policies, procedures and protocols for EDs).

Objective 3: Provide specialized pediatric ED readiness training and technical assistance.

Activities: Provide national IHS Chief Medical Officer Grand Rounds session on pediatric readiness.

Activities: Conduct a pre and post assessment of training and technical assistance to assess the percent of increased awareness and education as a result of offerings.

Activities: Provide TA to EMSC grantees working to improve tribal and/or IHS emergency medical care, e.g. primarily the State Partnership or State Partnership Regionalization of Care (SPROC) grantees.

Objective 4: Explore opportunities to integrate pediatric improvements in tribal EMS agencies.

Activities: Collaborate with HRSA EMSC to explore opportunities to increase the number of prehospital Pediatric Emergency Care Coordinators in tribal EMS agencies.

Contractor Deliverables: Contractor shall provide IHS deliverables as described in subsequent task orders. Deliverables shall be specified by the government. Format and delivery schedule for deliverables shall be outlined in the Contract Data Requirement Lists (CDRLs) and/or other means TBD. The Contractor agrees to provide IHS with the following:

1. Meetings: Contractor will meet quarterly and as needed in person or via conference call with the IHS Maternal Child Health program to collaborate with IHS Program Officials, to provide updates on activities, challenges and planning site visits.

2. Site Visits: When appropriate, IHS EMS representative will travel to and assist with in improving pediatric readiness in IHS facilities in collaboration with the states EMSC State Partnership grant managers, EMS expertise from the EMSC Innovation and Improvement Center, and a HRSA EMSC representative. All site visits must be conducted by September 15, 2019.

a. Convene a multidisciplinary, expert group with representatives including but not limited to pediatric emergency medicine experts, tribal health administrators, general pediatricians with IHS/tribal experience, emergency medical technician/paramedic experts, other emergency room providers, tribal leaders and IHS representatives to review IHS/tribal site pediatric readiness scores, develop key recommendations for improvements based on pediatric readiness scores and create a site visit consultation guide/tool.

3. Site Visit Debriefings: Within 30 days of the site visit, organize and conduct a conference call to debrief on site-visit findings, recommendations, and future activities planned to address any gaps identified. Attendees will include HRSA EMSC staff and the site-visiting team.

4. Site Visit Reports: Contractor will provide site-visit reports within 30 days of the site visit, that includes findings, recommendations, and future activities planned to address gaps identified.

5. Copies of Technical assistance events (e.g. grand rounds, webinars, recommendations to improve pediatric readiness).

6. Plan for dissemination of evidence-based, best, and promising practices for replication in IHS and tribal pre-hospital EMS and EDs provided by the HRSA EMSC Program.

7. Reports: Submit an EMSC Annual Report by October 15, 2019, detailing the use of IHS funds, documentation of activities, site visits, accomplishments, and lessons learned. The final report will also include an After Action Plan with findings, recommendations, and future activities planned in FY2020 to address both pre-hospital and hospital based emergency medical services needs for children identified in FY2019.