Gary Cox, JD
Commissioner of Health
www.health.ok.gov
An equal opportunity
employer and provider
Timothy E Starkey, MBA (President)
Edward A Legako, MD (Vice-President)
Ronald D Osterhout
Terry R Gerard II, DO
Charles W Grim, DDS, MHSA
Coordinators Association and Resources (OSSCAR) group to discuss a prehospital
stroke triage guideline. As presented on the conference call, a window for
thrombolytic usage was set for four and one half hours. Mr. Sims had concerns that
the guideline did not address the logistical issues of moving the patient from the scene
to a hospital that is capable of administering the thrombolytic as well as the time it
takes to administer the drug. He recommended language that would account for that
so that the patient would be in a position to receive the drug before the four and one
half hour window passes. Liz Lambert stated that the hospital goals is to administer
the drug within sixty minutes from the patient’s arrival, and she recommended
language that stated the patient should arrive at the hospital before three and one half
hours after the last known well time. If that timeframe cannot be met, she
recommended that the patient be transported directly to a Level I stroke center or a
Level II stroke center capable of performing endovascular procedures.
D. Discussion, consideration, possible action, and vote to approve regional trauma
system goals to include planning and implementation by January 2021
A motion to have the Regional Planning Committee develop a plan to implement the
goals of reducing initial hospital length of stay for patients with Injury Severity Score
of sixteen or greater by three percent and to reduce the number of Priority 1 patients
delivered to a Level III or Level IV trauma center by ambulance by three percent by
the end of 2021 by Steve Moran. The motion was seconded by Eddie Sims. There
was no discussion, and the motion passed 10-0.
VII. Presentation
A. Process Improvement – Daniel Whipple, OSDH
Daniel Whipple spoke of process improvement steps based upon Lean Processing and
Six Sigma methodologies. He began by reviewing the OSDH Emergency Systems
mission statement of getting the right patient to right place getting the right treatment
in the right amount of time. The main goals of Lean processing are to eliminate or
reduce waste by improving process flow. This accomplished by using five principles
that include: defining the expectation from the customer’s perspective and removing
process steps that detract from achieving that expectation; identifying all steps in the
process and removing areas that incorporate waste; making the process meet the
customer’s needs; empowering employees; and creating a culture of continuous
improvement. Six Sigma utilizes a mnemonic to assist with process changes:
DMAIC. First, an issue must be defined; then the current state is measured;
opportunities for improvement are analyzed; the process is improved by
implementing those opportunities; and quality control processes are used to ensure its
success. Mr. Whipple then reviewed 2018 data pertaining to the number of Priority 1
patients that EMS delivered to Level III and IV Trauma Centers and the number of
patients with Injury Severity Scores (ISS) of ≥ 16 that were transferred from Region
6. Mr. Whipple expressed his desire for the region to use the tools discussed today to
