April 2018
We have come a long way in EMS...
What’s next?
The Outcome Edition
Table of Contents 12 Direct to Neocortex Papers All our deep thinking and problem solving happens in the neocortex, it would make sense that this would be the part of the brain we feed most. Most of what we see never makes it into this powerful part of the brain. The Outcome Edition is changing this forever!
16 Time Binding
The key to better outcomes Take a moment to imagine what it would be like to be the first tribal doctor ever, the first person to bandage a wound after the hunting team party returns to the tribe. You lay the hunter on a rock, what next? Where do you begin? What is safe, or unsafe? And finally how do you avoid being killed by the hunters when you fail?
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19 Scientifically Designed Conferences For decades conferences and associations have been the keepers of mankind’s progress and innovation. What is the next step in the evolution of these events?
24 A New Second Income for EMTs How can EMTs help to save even more lives, and make a great second income? We proudly present our Outcome Ambassador Program!
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Letter From the Publisher
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Norma’s Story
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Addressing the Information Gap
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Business Training For EMS
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Hello & Welcome Welcome to The Outcome Edition, a medical journal dedicated to improving outcomes in medicine. Focus on outcomes is, in our opinion, the answer to the question on the cover "what's next?" A focus on improving outcomes through supporting EMS providers' health, medical education, and leadership. For those of you who are focused on improving outcomes, we’re here to tell your story, share your insights, and introduce you to the industry's latest innovation. In our experience, many, if not most, professionals working in EMS are too busy serving their communities to tout their contributions and accomplishments. But it’s our firm belief that you deserve to be noted for your innovation, work, and achievements in the industry. We also firmly believe that your personal experience holds the key to elevating outcomes around the world. We have spent seventeen years developing three systems we will refer to as Time-Binding, Innovation Farming, and DNCPs (direct to neocortex papers). These systems have been engineered to help you collect and share your insight with the world. In this issue, we will introduce these three concepts in more detail.
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We look to use our resources to invest in hardworking professionals like you. We will do this with high-level business training to help you advance your career, and new opportunities to increase your income. Two articles in this issue explain these programs and how they have been designed to support you financially. Here is to your continuing success, personal, professional and financial. Dana Friesen Publisher The Outcome Edition Summit Sciences Group
Norma’s Story The Reason The Outcome Edition Exists
2006 was a different time, wasn’t it? muttered to my partner “remember, never Backboards were all the rage, tourniquets stop compressions – even if I whine about had just started to make a comeback with it.” NREMT regulations, and AHA dropped a bombshell with their 2005 updates. The daughter was doing compressions Turns out minimizing interruptions in when we got there, she had witnessed compressions to maximize their benefit the arrest and called 911. We continued was now a thing. Most of us were the resuscitation giving two shocks completely satisfied and intubating in our data-free her. True to his The daughter was doing systems to run codes compressions when we got word, my partner the way they had there, she had witnessed the did continuous always been. Sure, arrest and called 911. compressions and most everyone died, made sure the team and very few had any prioritized never “good” survival stories. But, what we did stopping compressions. True to my word, have was the tradition. Despite Einstein’s I did whine a bit as it was hard to see the definition of insanity, we were dedicated rhythm on the monitor. Don’t judge; it to repeating our not-so-tried-and-true was 2006, and we took a while to stare efforts expecting a different result. thoughtfully at the monitor during codes. Like I said, a much different time. I was in the same rut of resuscitation tradition, but worse. I taught others our “traditions” and was applauded for my efforts. I likely would have continued towing the traditional line if it wasn’t for “Norma.” “Norma” went into cardiac arrest in her home a few days after the 2005 AHA updates were released. Striving to be a good teacher, I had read the updates and thought the “minimizing compressions” thing was interesting. So, on the way to the call, I told my partner to continue compressions no matter what, and get all the crews responding on the same page. As we were walking in the house, I 6
EMERGENCY MANAGEMENT EMS AND HOSPITAL LEADERSHIP SAFETY TRAINING RISK MANAGEMENT TRAINING peter.dworsky@outcomesolutions.org (732) 620-3563
We had just delivered the last shock, and to our absolute surprise, “Norma” was in sinus rhythm, with a pulse, and blood pressure. A good blood pressure.
and a family. For me, it is “Norma.” “Norma” benefitted from bystander CPR, early defibrillation and continuous compressions done within a cohesive team approach. As a result, she got to celebrate and enjoy another Thanksgiving with her family.
What? Well now, what do we do? We had 50 years of experience on the team, and we all stared at each other. Fortunately, the awkwardness was short-lived, and we prepared for transport.
2006 was a different time in EMS. And 2018 already promises more changes in healthcare. Heck, in 2006 we only At the hospital, “Norma” remained stable ordered books from Amazon; in 2018 and I thought she would be like all the we might order prescriptions. Striving to other codes. She would go to ICU, where improve outcomes will likely change your she would linger and die; I felt bad for perception of normal. But, improving the daughter and family. When it came to means change, and while that might bring codes, I had learned that you win very few some whining, “Norma” and her family and lose nearly all and had accepted that will tell you it is worth it. as usual. 98% resuscitation failure rate was…normal. According to a 2015 Institute of Medicine report, our prehospital cardiac arrest To verify my failure rate was on track, I survival data is pretty depressing. Nearly called ICU to check on her status. As I 30% of those who arrested survived to said, 2006 was a different time, a HIPPA hospital admission, unfortunately only lite version of EMS. One of my favorite 10.9% of those survived to hospital ICU nurses was about to be a part of discharge. 10.9% can hardly be called changing how I looked at resuscitation successful in a resuscitation system, and EMS, and she didn’t even know it. and certainly not in EMS. However, When I asked how “Norma” was, she there are much smarter minds that will replied “Great! She’s in there talking to discuss improving outcomes and creating her daughter.” solutions, and we’ll hear from them in upcoming issues.
What? Seriously? “Norma” is alive and talking?
About the writer Lori Gallian, is an educator and thought leader who has been helping improve outcomes in medicine her entire life. To arrange a consultation visit www.outcomesolutions.com
It wasn’t until I went to her hospital room and chatted with “Norma” (who did not remember me) and hugged her crying daughter that I realized what working to improve outcomes really meant. Improving outcomes is no longer an amorphous concept for me; it has a face 8
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Addressing the Information Gap
T
he geometric curve depicted below is a dominant sign of our times. It describes a host of today’s trends - the rate of growth of information produced daily, new technology, new systems, and the growing need to consume and implement knowledge. It represents the compounding forces bearing on each of us to abandon the known and comfortable, and accept the new - not once but again and again.
While the ability of man to innovate and produce information has been growing geometrically, the ability of man to consume this information has been all but static. How can we start to address the widening information gap between medical innovation and medical implementation? The answer lies in two parts. First in the way we present information, and second in the way we consume it. For this issue, we will focus on the way we produce information products such as reports and articles.
The Circle The idea of a 'circle' can be conveyed by sixty points or by six. The latter is a more efficient message since it uses less information to transmit similar meaning. Meaning lies in structure, not in the elements. 10
If we reduce this medical generation's most important information to the fewest possible elements necessary to be understood, we will be able to bridge the current information gap efficiently. While a medical director may decide to read a full clinical study, a paramedic who is coming off a 24-hour shift needs information in the clearest, easiest to read format possible. This is what we will aim to provide you each month. By giving you access to the “three circles� of information you can now narrow the information gap by considering precisely the amount of detail you need - no more, no less. With the information gap closed, we can improve outcomes!
The Outcome Edition
Direct to Neocortex Papers (DNCP) The Secret to Improving Outcomes Neocortex - The most significant part of the cerebral cortex, composed of sophisticated layered tissue, the site of most higher brain functions. Your most in-depth thinking, advanced problem solving, and thoughtful consideration occurs here.
information overload and going mad, it can make learning critical new procedures difficult. Here is how this process affects your outcomes.
When you start to learn a new medical principle in medicine, your filter takes all the latest information you see and makes The Neocortex and The Filter a judgment call on what gets into your deep-thinking brain. These small bits of If all our deep thinking and problem information we refer to as assumptions. solving happen in the neocortex, it would Here is where we run into trouble, make sense that this would be the part of much of what we remember from our the brain we feed most. This is not as easy education is only tiny bits and pieces of as it might seem. Our brain tries to save the presented information. To make this energy by filtering information, letting worse, many of the decisions on what only select information pass to the deepwe remember and choose to act on are thinking mind. While this protects us from happening subconsciously. 12
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The Outcome Edition
Yes, you are making medical decisions based on assumptions, assumptions that are made with only small bits of information, not your entire, medical education. Of course, over time your personal experience in the field has filled in the gaps to make you the person you are today. DNCPs The Next Stage of Medical Evolution DNCPs are written to give you the exact information you need to improve your outcomes in a format that is designed to bypass your mind’s filter - valuable, highly rendered gems of insight that contain exactly what you need to implant insight in the most potent part of your brain. How will we use this technology to improve outcomes? We will use these papers to attacking outcomes on the following three fronts: 1. Human Performance - Billions have been spent developing systems to help athletes, CEOs of large corporations and others build their peak capacity. This research has been used to help these elite to perform mentally and physically like no generation before. Every issue we will publish peak performance systems in DNCP format to help you perform better in every aspect of your personal and professional life. 2. Clinical Insight - The Outcome Edition collects clinical insight from industry leaders, conferences, and educators. This insight is then rendered with our proprietary system into DNCP format and published in the most straightforward, most effective format possible for you to read. The result is a simple, predictable way for you to consistently improve your outcomes in the least amount of time possible. 3. Medical Equipment - Medics and doctors have started many of the best small companies in medicine. We work to make sure that the independent companies you love get the promotion and respect they deserve. The goal of The Outcome Edition is to give you access to the absolute best information possible, in the easiest to consume format scientifically possible, free of charge every month. If you know of a conference, industry leader, or educator who is improving the industry and elevating outcomes, please introduce us so that we can bring their insight to the world.
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The Outcome Edition
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T I M E-B I N D I N G T H E K E Y TO B E T T E R O U T C O M E S Can you imagine being the first person to be responsible for a tribe’s health? Take a moment to imagine what it would be like to be the first tribal healer ever, the first person to bandage a wound after the hunting team party returns to the tribe. You lay the hunter on a rock, what next? Where do you begin? What is safe, or unsafe? How do you stop the bleeding? And finally, how do you avoid being killed by the hunters when you fail?
Today this process today is mainly accomplished utilizing our conferences, colleges, and university programs.
Many of the most pressing challenges confronting Emergency Medical Services today are problems that are new, and since prior generations have not faced them before the solutions cannot be passed down through the usual channels. You know this only too How did medicine evolve from that first well, these are the issues you face every day! patient to the profession it is today? The Over time these challenges will be solved by answer is straightforward; they used the our most accomplished medics transferring principle of time-binding. Each time an their knowledge to the system of higher early healer, like our friend above, made education delivered in our colleges and a right decision and saved a life, he would universities, where their solutions will be keep using that technique. Over time his passed on to the next generation. In 20knowledge progressed to the point where 30 years the Emergency Medical Services he could train a successor or apprentice. education system should have practical Each time a generation passed their skill, training to help graduates enjoy a higher experience, and techniques on to the next quality of life by addressing the needs of the generation, they added the insights they industry. Future generations will have these gained in their life course. Over the course of problems we face today solved, yet by that thousands of years, the body of knowledge time other issues will have presented. grew, and your current level of expertise in medicine is a direct result of this process. The time, effort, trial and error of If the system we have is going to solve predecessors was bound together to make a the problems you face, why should we body of expertise. This is the principle of change a system that has worked for time-binding or experience-binding to be thousands of years? more specific. The solutions and knowledge Most people would rather receive the of each generation are compiled and taught solutions to their problems before they to the next generation.
retire!
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The Outcome Edition
Contemporary time-binding is a new form of scientific progress What if instead of waiting, the top minds in Emergency Medical Services combined their time, knowledge, and experience to solve today’s problems today? Instead of time-binding between generations, this would be time binding between contemporaries. Consider what this would mean for progress in the industry, the solutions would present themselves 20-30 years earlier!
Your experience could be the missing piece to save lives... will you share it with the world?
There are EMTs, Chiefs, scientists, and other leaders in the field who have come up with solutions to most of the problems facing Emergency Medical Services today. Of course, no one person has the answers to every question. If these experts were to bind their knowledge, skills, and expertise - the result would be solutions that make your life better every day and instantly improve patient outcomes.
The top scientific minds in Time Binding or Experience Binding have chosen Emergency Medical Services as the focus of a 2-year project to improve outcomes and elevate the industry. This group is going to take and bind the best parts of the industry’s skill, expertise, and systems from around the world and give it to you free of charge with no obligation other than to pay it forward. When you see a way to improve outcomes, EMT wellness, equipment, or procedures we ask that you generously pass on these insights so we can share them with the world. In every issue of this magazine, there will be an opportunity for you to comment and add insight and perspective to the information we present. We appreciate your experience, your work in the industry, and look forward to learning from you. 18
Scientifically Designed Conferences
Combining Experience to Save Lives! In the picture below, we see illustrated the dangers of basing decisions on our own experience. Depending on where the person is situated around the ambulance the assumption of reality changes. When each person only considers his perspective, they make mistakes that seem juvenile.
In the modern world, leaders and executives of large organizations can no longer afford to make important decisions based only on their perspective. They need to include the aspect not only of the members of their organization but that of organizations across the country, if not the world. 19
One limitation we have as humans is we can only listen to one person at a time. When we get into a traditional conference or roundtable discussion, one or two people will dominate the conversation. In a perfect world, the loudest person in the room would be the smartest…this is not always the case, consider this in the context pictured below.
It does not matter how many of them are prepared to explain what they believe an ambulance to be, and the group only can consider one person’s perspective at a time. In this picture, after a full discussion, the group would decide that an ambulance is a moving truck, rescue unit or a taxi.
How can we address the shared information space issue in conferences and roundtable discussions? With a few small changes, the group of blind men could combine their perspective and get a much clearer understanding of an ambulance. Consider how this would work in the example below.
A specially trained time-binder collects the group’s perspectives, to create a much clearer perspective for the group. The combined perspective is then simplified into terms the whole group can understand and then presented again to the group. Everyone now has a complete understanding of the ambulance.
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Scientifically Designed Conferences
Solving the Critical Issues in Emergency Medicine in STEPS Step 1
Research the most vital issues facing Emergency Medical Services AKA: Finding the ambulance 1. Interview all levels of Emergency Medical Services for perspective 2. Ask key stake holders hard questions about where improvement is needed 3. Compile a list of the most vital issues to be addressed in the year
Step 2
Work with the most respected thought-leaders in the industry
AKA: Bringing in ambulance experts to share perspective 1. Invite top thought leaders to give their perspective 2. Research and assign them topics related to subjects they are passionate about 3. Provide assistance to speakers, helping them tailor their presentations to Emergency Medical Services
Step 3
Collect the perspectives of the attendees during the discourse
AKA: Combining attendees perspectives of the ambulance 1. Attendees send notes, thoughts and perspectives to the time-binding system during the presentations 2. Insights are collected, reviewed and refined
Step 4
Insights and ideas are turned into white papers and published 1. Recommendations are divided into subjects 2. Industry experts take ownership of ideas 3. Insights, solutions, systems, and templates are collected and published
Step 5
Distribute the insights and action plans to our industry
AKA: The clearest understanding of an ambulance in history is distributed
The Conference system tackles the most critical issues facing Emergency Medical Services. Building on a foundation of industry experts, we then time-bind thousands of hours of leadership insight and experience into the most innovative, actionable solutions in the world today. If you have a conference or event that could use our help, please contact The Outcome Edition for more information.
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BUSINESS IN EMERGENCY MEDICAL SERVICES “IN THE BUSINESS OF HEALING THERE IS NO HEALING WITHOUT BUSINESS” In this world of shrinking budgets and diminishing resources, every aspect of medicine is being forced to look at business and economics. For agencies to have the resources to invest in improving outcomes, we need to invest in business training and systems for the industry. In addition to business education, hardworking medics in the industry need to have the ability to earn extra income to supplement their salaries.
WE ARE HAPPY TO ANNOUNCE THAT WE WILL BE LAUNCHING SOLUTIONS FOR THE BUSINESS ASPECTS OF MEDICINE IN 2018!
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52 WEEK
BUSINESS
TRAINING PROGRAM
The Summit Sciences 52-Week Business Program is unlike traditional business programs. In addition to the highly practical and relevant content, it is, above all else, an incubator and accelerator for innovation in Emergency Medical Services. The program provides preparation for a broad array of opportunities, including: • EMS Innovation - Developing and launching innovative ideas, products, or processes within Emergency Medical Services. • Social Innovation - Implementing creative ideas which serve the good of Emergency Medical Services through business models. • Entrepreneurship - Commercializing an innovative product or service through the formation of a start-up venture. • Entrepreneurship & Innovation Ecosystem – From working for start-ups to careers with VC’s, Economic Development, Incubators, and Accelerators. This program is a combination of home study and live webinars with an instructor. Each week the home study portion will take between 2-3 hours, and the live webinar portion is approximately 1 hour per week. All webinars are recorded and can be viewed by students at a time that fits their busy work schedule. What is the cost of the program? We are proud to announce that this program is being offered free of any charge or obligation to all who are passionate about using business to improve outcomes! Who can apply for this program? Anyone who is dedicated to making a difference in Emergency Medical Services and is interested in using business to do it. EMTs, Paramedics, support staff, or anyone who currently provides an industry solution. How to apply? Just click on the button below, fill in your name, email, and how you plan to use a sophisticated knowledge of business to improve the industry. We will send you lesson one, and your startup package immediately. With no fees, obligations, sales pitches or other “catches,” this program is being offered to give you the power you need to make a difference in the world!
OUTCOME
AMBASSADORS
Real innovation in medicine presents itself in pockets. Solutions that are common in one agency are entirely unheard of in others. How do we introduce the world to the great companies that produce innovative products and services that elevate our industry and improve outcomes? We feel the answer lies in the hard-working men and women who use these products every day! Who could be a better fit to recommend solutions that elevate EMS and improve outcomes than the people that use them every day? The Outcome Ambassador program trains hard working people in Emergency Medicine to identify problems clearly, then to find the absolute best solution for the problem considering all the products and services available. The companies that provide these services and solutions have a budget for sales and marketing; this money is used to help support The Outcome Ambassadors and their families. Outcome Ambassadors Receive 1. Specialized training in problem-solving 2. Systems for peak performance and time management 3. Training in referral systems & techniques 4. An income based on a percentage of each problem they help solve Solving problems, not selling How is this different than a sales position? As a salesperson, you enter an agency trying to sell the group your solution, not trying to find the best solution for the agency. With Brand Ambassadors being trained in both problem solving and the solutions available, you can ensure that you only recommend what is truly best for your colleagues.
FINDING THE PERFECT SOLUTIONS TO PROBLEMS IN EMERGENCY MEDICAL SERVICES
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THESE ARE SOME OF THE GREAT COMPANIES LOOKING FOR OUTCOME AMBASSADORS TO INTRODUCE THEM TO ORGANIZATIONS THAT NEED HELP:
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MY BELOW MINIMUM WAGE JOB…
A
The Below Minimum Wage Executive
s a young man I was fortunate While I had a dollar value I attributed enough to have good work, and to my time; this number went out the even more lucky to have mentors window when I was volunteering to that would suffer the ignorance of a cocky raise money and working for nonkid who thought he knew everything. profits and NGOs. Two-dollars an hour These advantages led me to be more and selling baking, count me in! Cold calling more discerning about the work I would hundreds of potential sponsors for a take on and what wage I would accept. small donation, sure anything to help. As That is, of course, an executive, I was AS A VOLUNTEER, I WAS except for my discerning, valued below minimum SEVERELY UNDER COMPENSATED my time, and was wage jobs. Let me FOR MY WORK, AND WAS NOT highly efficient. explain a few of STRATEGIC IN MY USE OF TIME. As a volunteer, I these positions for STRANGELY ENOUGH, THIS DID was severely under you. compensated for my NOT BOTHER ME. work, and was not strategic in my use Rock Packerof time. Strangely enough, this did not Carrying dump truck loads of rock up a bother me. Working for below minimum hill to save on equipment costs wage somehow was alright in this context. Why? Cutting Grass With Machete – No money for a lawn mower, so we spent The Professional Penny Stretchers days cutting grass with a machete in 110 degree heat. Many small organizations can stretch a penny for miles. Small donations of Digging a Foundation With a Spade $500.00 - $1000.00 raised from a small Shovel- Digging three feet down through fundraiser made a difference in food for hard clay to lay a stone foundation in 110 the poor, CPR for school kids, or a new degree heat. piece of equipment for a local clinic. These group's ability to use money wisely made even the most terrible fundraising Cold Calling Sponsors – Making hundreds of phone calls and personal site activity tolerable because we were still visits to raise money for projects. making a difference.
What is Next? Summit Sciences is now working with software engineers to create a platform that will allow you to help the NGO or non-profit of your choice to utilize your time and talent at a reasonable rate. We will be using this platform to help you raise money for pre-hospital medical research, EMTs and their families, and dozens of other small associations and non-profits. The "penny stretchers" will finally have some real money to put to use. The completion and launch of this platform will incur additional expenses of close to $1,000,000. While this is a massive expenditure, the program will allow us to raise tens of millions for groups that have been struggling for years. The Outcome Edition and its Brand Ambassador Program have set a goal of raising $100,000 in EMS, and $150,000 in Emergency medicine to go toward the completion of this project. Summit Sciences has committed to raising the remaining $750,000 to complete the project. When you decide to use a company or service that is in our Outcome Ambassador program, you are helping to fund the future of small non-profit and NGO funding. The platform will be completed and be accepting new non-profits and programs into the fundraising platform in the spring of 2019. For more information on the program, who we are helping with the program, and how your organization can help, please email editor@outcomeedition.com About the writer: Dana Friesen is the Chief Philanthropy Officer of Summit Sciences and Editor of The Outcome Edition. Earning money to help good people do great things worldwide!
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