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2021 AIMHI Excellence in EMS Integration | Washoe County, Nevada

18 Aug 2021 1:16 PM | AIMHI Admin (Administrator)

Excellence in EMS Integration Award: This award recognizes a non-EMS organization that has developed and implemented a partnership with EMS organizations that have demonstrated enhancement of patient experience of care, improved patient outcomes, or reduced the cost of healthcare.

In March 2020 as the COVID-19 pandemic arrived in northern Nevada, Washoe County municipal leaders identified the critical and immediate need to launch a resource that would connect residents to accurate information, provide answers to questions and triage callers concerned about possible COVID-19 symptoms. The county already had in place a 24/7 telephone line (311) for residents seeking information about non-emergency government matters. However, that line was quickly overwhelmed and not able to fully meet the needs of the callers.    

Washoe County manager Eric Brown reached out to REMSA Health’s president and CEO, Dean Dow seeking assistance. Recognizing REMSA Health’s experience as a secondary PSAP and its expertise as an internationally accredited medical dispatch center, Washoe County asked REMSA Health to stand-up a 24/7 call center for residents to have their symptoms triaged and  to facilitate testing and contact tracing. The request came on a Saturday and by Thursday - just five days later - the triage line was staffed and active.     

The COVID-19 Community Triage Line is an example of the problem-solving strengths that can develop from a public/private partnership. The Community Triage Line allowed residents to speak to non-medical call center representatives with questions related to symptoms, exposure, social distancing, where to seek testing and care, and other available pandemic-related community resources.    

With Washoe County’s approval, REMSA Health coordinated with the University of Reno, School of Medicine for staffing support. Since the medical school students had to rearrange their clinical and class time due to pandemic-related changes, they were available to assist with staffing while earning field credit for providing pandemic/MCI style triage. It is estimated that the students provided thousands of hours of call center coverage from March through September 2020.     

Washoe County’s Community Triage Line mobilized across several departments at the two agencies. Information Technology pros had to coordinate so that call center decision trees were accurate and that calls could be transferred appropriately if necessary. Clinical and epidemiological staff from REMSA Health and Washoe County respectively, worked together to develop meaningful questions about exposure, symptoms, underlying health conditions and whether the caller needed further patient guidance through REMSA Health’s Nurse Health Line.  Public Information Officers and Joint Information Center representatives worked with regional media, as well as created owned content to promote the triage line as the central spot for all COVID-19 symptom/exposure related information.    

Washoe County’s Community Triage Line is an outstanding example of how the industry-wide characteristics that EMS is known for can support municipalities and government agencies in times of extraordinary need. Mobile healthcare is nimble, responds with intention, is a community’s safety-net provider and is able to provide care and resources in austere environments - including over the phone. EMS is in a constant state of readiness and able to pivot. Expertise in emergency communication and the training to manage mass events sets apart EMS providers from other healthcare or municipal-based organizations. The willingness of Washoe County’s leadership to recognize REMSA Health’s ability to provide a solution in a time of crisis is to be commended. Washoe County was focused on protecting citizens, mitigating the possibility of overwhelming the regional healthcare system and navigating callers to the right resource. In the midst of a global pandemic, Washoe County leaders doubled-down on their value of Quality Public Service - they placed the needs and expectations of the public at the center of their response to COVID-19.    

REMSA Health’s expedient and comprehensive response to the Community Triage Line request demonstrated its agility resulting in Washoe County relying on them for additional pandemic-related mobile healthcare needs including COVID-19 testing for homebound citizens, the safe transport of COVID-19 positive patients between social service agencies, and COVID-19 vaccination of homebound citizens. This is further validation that government bodies and private organizations that share a commitment to innovation and excellence can achieve improved public health outcomes.

Organization Overview
Washoe County is the second most populous county in Nevada and covers more than 6,500 square miles. Narrow and tall along the western edge of the state, there are more than 470,000 residents and during busy special event years, it can welcome up to 5 million visitors a year. There are two incorporated cities within Washoe County - Reno and Sparks, as well as unincorporated county land. Washoe County’s mission is: Working together regionally to provide and sustain a safe, secure and healthy community. Their values are integrity, effective communication and quality public service.

Date of Implementation: March 20, 2020

Number & Demographics of Patients/Members

Description of Outcomes / Utilization / Change
The Community Triage Line allowed Washoe County to streamline its screening protocols. The phone call volume consistently trended upward and it closely matched the county's daily new cases metric data points indicating that as cases in the county increased, the need for the call center's resources increased.

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