Pulsara Blog

In the wake of the global pandemic, hospitals worldwide are struggling to cope with many challenges—chief among them, severe staffing shortages. Two years of pandemic conditions have barraged hospital staff, bringing new and unyielding challenges to the whole care system. Clinicians are facing longer hours, fewer resources, more responsibilities stretched between fewer people, the relentless pressure of pandemic stressors and mitigation measures, lack of support or understanding from the general public, and ultimately higher rates of burnout.

As a result, hospitals are grappling with severe staffing shortages. According to a recent survey by Hospital IQ, 90% of the nurses in their survey sample are considering leaving the nursing profession within the next year, with 71% of nurses with over 15 years of experience considering leaving either immediately or very soon. 

While there will need to be an influx of new nurses to regain balance, not all strategies for coping with the shortage have to do with recruitment. Technology can help make complex and frustrating tasks more simple. And according to the Hospital IQ survey, that might just be the determining factor in whether or not nurses decide to stay in the profession.

By streamlining workflows, technology can save a great deal of time and energy for hospital staff, making cumbersome and stressful processes smooth and efficient. Here's how.

The COVID-19 pandemic has lengthened response times for ambulance agencies worldwide, making it much more difficult to find placement for patients. A recent report released by Australia’s Ambulance Victoria confirmed that this trend has worsened significantly in the state of Victoria during the last three months of 2021, showing a significant increase in response times across the region.  

The new data from Ambulance Victoria shows that paramedics’ ability to respond to code 1 emergencies within the recommended standard of 15 minutes dropped by 12% over the previous 12 months, going from 79% in October to December of 2020 to 67% during the same period in 2021. This means that around one-third of code 1 emergencies waited more than 15 minutes for responders to arrive. Melbourne’s suburbs have been disproportionately affected by the delays, owing to distance. Towns like Melton and Cardinia averaged around 53%. 

As Lead Implementation Project Manager at Pulsara, I help manage the implementation of our software at hospitals. My background is not clinical. Like the rest of the global population, I’ve been reacting, adjusting, and trying to comprehend the results of precisely what COVID-19 has done to our society, and especially our healthcare system. As the Delta variant surge began mid-summer, I had yet to get an inside personal look at how the COVID-19 pandemic affected our healthcare system.

And then, in early September, I got the eye-opening chance to visit a hospital.

It has been a rough eighteen months for all disciplines within healthcare. Since the start of the pandemic, call volumes have increased. More people need help. And yet, as the pandemic drags on, there are fewer and fewer providers still on the job. Emergency services agencies around the world are experiencing staffing shortages. Headline after headline after headline has demonstrated that the problem is both severe and widespread.

Many factors have contributed to staffing shortages in EMS across the United States, as well as ambulance services in the UK and Australia. These factors will need to be addressed soon. In the meantime, however, those still on the job are left looking for ways to continue providing care for their patients. Staffing shortages are hard enough but are made even worse for those left behind when the lack of providers starts to impact the level of care they can provide. 

Over the past year, telehealth became a favored tool in non-emergent care for helping clinicians treat patients from a distance. However, many EMS agencies are now discovering that leveraging telehealth as a part of normal practice can actually help save time, preserve resources, and increase the output of smaller crews. 

If you're struggling with staffing shortages, here are a few ways telehealth may be able to help you work with the resources you have. 

Editor's Note: On August 11th, EMS1, Fitch & Associates, and the National EMS Management Association released their fourth annual EMS Trend Report, proudly sponsored by Pulsara. Because the articles and advice found within contain such critical subject matter, we've elected to publish each segment one at a time here on our blog. Read, enjoy, share, and take to heart the following information brought to you by the most prestigious thought leaders in EMS. Today's entry is written by Pulsara's very own Chief Marketing Officer, Kris Kaull.

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As COVID-19 continues to shape the landscape of healthcare, many profession-altering changes are here to stay. The most impactful of these is the paradigm shift to the “connected worker.”

While this may be a new term in healthcare, it has been covered extensively in manufacturing. As Natan Linder wrote in Forbes, “For years, we interpreted poor manufacturing outcomes to poor human performance (as much as 70% of mistakes in factories occur on human-centric processes). But things changed with the fundamental insight that humans aren’t actually the problem. Badly designed or overly complex work systems are.”

Healthcare faces even greater challenges. There was a time where a healthcare professional may have shined based on their clinical expertise alone. But this is no longer the case. I met with a neurologist in Seattle who told me that she makes, on average, 17 phone calls before she sees a stroke patient. Consider the time-sensitive tasks and coordination that need to be completed by a team in order to properly treat a critical patient: multiple phone calls, pages, answering services, handwritten notes, and radio communications.

When COVID-19 struck Texas in early 2020, Montgomery County Hospital District suddenly faced a whole host of new problems. Patients were still calling 911 and needed emergent care, but not all of them needed—or wanted—to be transported to the hospital. Paramedics were daily putting themselves at risk as they entered environments that could expose them to COVID-19. 

“Early on, we didn't know what was going to happen,” said Rob Dickson, MD, FAAEM, FACEP, FACEM, and EMS Medical Director at MCHD. “And we were all—across the nation, across the world—struggling with procedures and PPE and how we could best look after our employees.”

MCHD had a brief window to come up with innovative solutions. They had been using Pulsara to streamline care team communication around stroke and STEMI patients. But in response to the crisis, they began using Pulsara for a completely different purpose: regularly checking in with their employees who had contracted or had been exposed to COVID-19.

When the COVID-19 pandemic flared in the state of Texas in early 2020, the state struggled to load balance their COVID-19 patients. Some areas of the state experienced overwhelming waves of surge, while other areas had available beds and resources. Matching the particular needs of complex patients with available beds and other resources necessary for each patient was difficult.

They sought out a solution that would help create a virtual placement center for smooth patient transfers—supporting effective COVID-19 management and surge mitigation and a 75% reduction in excessive phone calls.

Teller County, CO develops a first-of-its-kind telehealth program using Pulsara as the backbone for rural health communications

BOZEMAN, Mont., August 16, 2021 — Pulsara, the leading mobile telehealth, communication, and logistics platform that unites healthcare teams and technologies across organizations during dynamic events, published new details on Teller County, Colorado’s groundbreaking community paramedicine and telehealth program. Reporting on their initial challenges, the solutions they found, and results, the “911-INITIATED TELEMEDICINE: Next-Level Patient Care for Rural Colorado” case study reveals a new pathway forward for EMS agencies across the globe.

As COVID-19 escalated across the country in early 2020, EMS and hospital leaders in Teller County, CO identified that residents were reluctant to seek care—for any condition—at the hospital. “Up to 40% of our EMS volume does not want to go to the hospital once 911 arrives,” said Dr. Jeremy DeWall, EMS Medical Director for the Teller region. “Looking at our numbers, the fear was that we were missing a large group of people who were without healthcare or afraid to go to healthcare because of COVID-19.” 

Leveraging their already thriving community paramedicine program, Teller County’s Ute Pass Regional Health Service District and Emergency Medical Specialists, PC set in motion a new 911-initiated telemedicine program, utilizing Pulsara’s telehealth capabilities to address the acute needs of the community. 

As the pandemic subsides, EMS leaders and organizations are not just in recovery mode; they are also reevaluating and restructuring their care systems based on what they’ve learned. From routine patient transports to the largest pandemic of our lifetime to managing Texas’s devastating winter ice storm in February 2021, Texas EMS clinical leaders are using scalable mobile technology to lay the foundation for the new reality of EMS—including Mobile Integrated Healthcare, Community Paramedicine, and Telehealth.

Are your systems of care flexible and scalable enough to handle daily operations and also quickly adapt to the next disaster, active shooter incident, or large-scale event?

2020 was a year of pivots.

Movies being released on streaming services and Netflix rather than in theaters. Peloton and home virtual gym sales through the roof. Zoom & Microsoft Teams replacing the office board room. All of these are shining examples of our ability to use technology to adapt during the perilous times of COVID-19. With our need to remain connected while isolated, we saw everything from your cousin’s baby shower to your favorite artist’s concert taking place online.

So what was the answer that Pulsara, a company already based in healthcare communication and connection, had for the sudden need for flexibility that the global pandemic demanded?

Enter: Pulsara PATIENT. 

With the signing of the American Rescue Plan Act of 2021 on March 11th, CMS will now be allowed to reimburse ambulance services for treating patients in place during the public health emergency caused by the COVID-19 pandemic. 

The measure comes in response to the widespread need for treatment-in-place caused by the pandemic. As hospitals reached capacity and it became clear that not every patient needed transport to the emergency room, many EMS agencies were directed to render services to patients in their homes, avoiding transport where possible. Traditionally, EMS has only been reimbursed for transporting patients to the hospital. 

Rob Lawrence, director of strategic implementation of PRO EMS and executive director of the California Ambulance Association, described the impact of the measure: "Specifically, this waiver would allow CMS to pay for ground ambulance services furnished in response to a 911 call (or equivalent in areas without 911) in cases where a patient was not transported but was instead treated in place in accordance with community-wide EMS protocols."

Wow! Was 2020 a doozie or what? COVID-19 took a toll on our healthcare system, resources, economy, and the way we do business. We survived rolling epicenters of virus surge on a national scale. Needless to say, it’s been a chaotic year. 

This past year has been a rough one for many, but perhaps none more so than the courageous physicians, nurses, EMS providers, and healthcare workers who have put their own safety on the line in order to help take care of COVID-19 patients.

This week, Ontario officials announced a second, more stringent stay-at-home order in an attempt to help mitigate the recent surge of COVID-19 cases in the province.

"According to officials, there is a real threat that the province’s hospital system could collapse under the pressure."

EDITOR'S NOTE: This article originally appeared on EMS1.com. Special thanks to our guest author, Marianne Meyers, BS, for EMS1 BrandFocus. 

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Preparation, vigilance and taking care of your mental health will be key strategies as we move forward

As 2021 begins, COVID-19 vaccines have recently been approved, and it appears that the beginning of the pandemic’s end is in sight. That said, we are still experiencing large spikes throughout the country, and hospitals and EMS systems are under immense strain.

We aren’t quite on the other side, but we can now see the light at the end of the tunnel.

Here are 10 things we’ve learned from the pandemic that can help improve other areas of EMS response:

EDITOR'S NOTE: This article originally appeared on EMS1.com. Special thanks to our guest author, Sarah Calams of EMS1 BrandFocus. 

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Telehealth applications can help expand the reach of out-of-hospital care to save more lives

In light of the COVID-19 pandemic, healthcare and EMS providers have found themselves relying on technology more than ever before.

To celebrate the 200th birthday of Florence Nightingale, the founder of modern nursing, the World Health Organization (WHO) proclaimed 2020 as the Year of the Nurse and Midwife. 

And what a year it's been. This year, the COVID-19 pandemic swept across the globe. Nurses everywhere have spent 2020 working through exhaustion, the daily risk of being exposed to the virus, and the stress of risking their family's safety as well as their own. According to a new study conducted in the UK, nurses are experiencing high levels of burnout and depression, and 28% of NHS nurses are quitting within three years—a 50% increase since 2013.

Summer blockbusters may have been cancelled, but this year, we've gotten to see what it truly means to be a superhero. 

As the COVID-19 pandemic spread around the world, doctors, nurses, paramedics, and emergency responders of every kind stepped up to take care of others. They’ve chosen to be there for us in our hour of need, sacrificing their own health, safety, and even the ability to go home to be with their families at the end of long, scary, and difficult shifts. That’s the true definition of heroism. 

To celebrate these healthcare heroes, Marvel Comics partnered with Allegheny Health Network (AHN) in Pennsylvania to help tell the stories of these real-life heroes. 

Emergency Medical Services—EMS, for short—is a branch of healthcare, public health, and public safety that responds to calls for help, 24/7, in almost every community in our nation. EMS encompasses a number of different services and roles, providing vital lifesaving care for patients during times of emergency. There are around 1.05 million licensed EMS professionals across the U.S. and nearly 623,000 of these are EMTs, while over 268,000 are paramedics.