Overall, EMS providers should be an integral part of the healthcare system. EMS providers that have positive relationships and open communication with their healthcare system tend to be progressive and well accepted in their community. Therefore, to help facilitate further growth and development of the EMS system and increase the continuity of care for the patient, the Saginaw Valley Medical Control Authority would like to know your understanding of what an EMS system means to you.

When answering each question and/or statement, BE HONEST. Please support your answers in the comment section provided. Scoring low in an area does not mean the EMS system is doing a poor job. It simply focuses on the areas that may need more attention.

1.	An EMS System is defined as a comprehensive network of personnel, equipment, and resources established to deliver aid and emergency medical care to the community. Mark "yes" or "no" to indicate which of the following you feel are a part of an EMS System.

	Yes No	Community at large, especially those trained in first aid and CPR
	Yes No	Central Dispatch (911)/Medical Communications
	Yes No	EMS Personnel (MFR, EMT-B, EMT-P)
	Yes No	Ambulance Services Agencies
	Yes No	Fire/Rescue Agencies
	Yes No	Public Utilities (power or gas companies)
	Yes No	Resource Centers, such as regional poison control centers
	Yes No	Air Medical Services
	Yes No	Emergency Department Nurses
	Yes No	Emergency Department physicians and specialty physicians
	Yes No	Receiving Facilities
	Yes No	Specialty Care Units, such as Trauma, Cath Lab and Burn
	Yes No	Rehabilitation Services
	Yes No	Medical Control Authority (includes Medical Direction and regulatory oversight)

In questions 2-6, place a check in the box below the number you feel best fits the statement. If you are unsure, place a check below the box labeled DK (Don't know).

2.	I feel like I have a clear understanding of the level of care that patients should receive from our EMS agencies, consistent with their licensure level (MFR, EMT-B, EMT-P) and scope of practice.
	DK 1-Not at all 2 3 4-Average 5 6 7-Very Well
	Comments:

3.	I think a periodic joint quality improvement process led by the Medical Control Authority should be conducted within our EMS System including both the EMS agencies and the receiving facilities.
	DK 1-Not at all 2 3 4-Average 5 6 7-Very Well
	Comments:

4.	I know what to do to share feedback about patient outcome, review the prehospital care provided to patients, or share anything else that impacts our EMS system.
	DK 1-Not at all 2 3 4-Average 5 6 7-Very Well
	Explain:

5.	In my opinion, our EMS system personnel's (EMT, EMT-P, MFR) role in the pre-hospital setting is clearly understood by the ED staff.
	DK 1-Not at all 2 3 4-Average 5 6 7-Very Well
	Comments:

6.	I am familiar with our EMS System policies/procedures and practice parameters in place for the care of the patient in the pre-hospital setting.
	DK 1-Not at all 2 3 4-Average 5 6 7-Very Well
	Comments:

7.	These policies/procedures and practice parameters are developed by:

8.	In my opinion, the purpose of the pre-hospital radio report is:(Please mark all that apply)

		Alert receiving facility of incoming patient
		Give EMS permission to transport a patient
		Allow consultation with a physician
		Opportunity for physician to participate in patient care
		Obtain physician order
		Allow for receiving facility to formulate complete plan of care of patient

9.	Using 1-3 (1=Very Important, 2=Important and 3=Not Important), please rank the following components of a radio report for a Priority 1 patient according to what you feel would be your level of importance.

	1 2 3	Patient Priority
	1 2 3	Agency/Unit Identification
	1 2 3	Identification of person at receiving facility
	1 2 3	Age/Gender of patient
	1 2 3	ETA (Estimated Time of Arrival)
	1 2 3	Nature and duration of the problem/complaint relevant to call
	1 2 3	Treatment rendered or management interventions, with pertinent patient response.
	1 2 3	Complete set of vital signs including values (i.e. systolic/diastolic BP, pulse and respirations)
	1 2 3	History of Present Illness
	1 2 3	Brief, pertinent physical exam to patients problems
	1 2 3	Specify what "Medical Control" is needed for if known, or request physician's input as appropriate
	1 2 3	Confirmation of orders given by physician as appropriate

10.	Using 1-3 (1=Very Important, 2=Important and 3=Not Important), please rank the following components of a radio report for a Priority 2 patient according to what you feel would be your level of importance.

	1 2 3	Patient Priority
	1 2 3	Agency/Unit Identification
	1 2 3	Identification of person at receiving facility
	1 2 3	Age/Gender of patient
	1 2 3	ETA (Estimated Time of Arrival)
	1 2 3	Nature and duration of the problem/complaint relevant to call
	1 2 3	Treatment rendered or management interventions, with pertinent patient response.
	1 2 3	If patient is unstable, complete set of vital signs including values (i.e. systolic/diastolic BP, pulse and respiration's). If patient is stable, "vital signs stable" is sufficient for communication to receiving facility
	1 2 3	History of Present Illness
	1 2 3	Brief, pertinent physical exam to patients problems
	1 2 3	Specify what "Medical Control" is needed for if known, or request physician's input as appropriate
	1 2 3	Confirmation of orders given by physician as appropriate

11.	Using 1-3 (1=Very Important, 2=Important and 3=Not Important), please rank the following components of a radio report for a Priority 3 patient according to what you feel would be your level of importance.

	1 2 3	Patient Priority
	1 2 3	Agency/Unit Identification
	1 2 3	Identification of person at receiving facility
	1 2 3	Age/Gender of patient
	1 2 3	ETA (Estimated Time of Arrival)
	1 2 3	Nature and duration of the problem/complaint relevant to call
	1 2 3	Treatment rendered or management interventions, with pertinent patient response.
	1 2 3	Vital Signs without values. It is sufficient to communicate "vital signs stable" to receiving facility.

12.	In my opinion, the greatest strength of this EMS System is (are):

13.	In my opinion, the greatest challenge of this EMS System is (are):

Thank you for taking your time to participate in our survey!