Livingston County Department of Health Injury and Illness Prevention Project

Traditional programs presume access to health and social services, limiting their availability to rural dwelling older adults. Failure to access these programs can result in unnecessary morbidity, institutionalization, and mortality.

In addition, an educational service was provided to EMS agencies in Livingston County. All were eligible, and we believe most active agencies took advantage of, the Geriatrics Education for Emergency Medical Services educational program. This program gave EMS providers education regarding the optimal care of the older adult, which was very helpful for them. An evaluation of this program was performed and is going to be published in the Journal of the American Geriatrics Society.

The funding for this project was, unfortunately, announced after the official grant start date. As a result, pre-preparation activities did not occur. To overcome the problems, immediately upon initiation, a general announcement of award was made via email and letters to participating individuals in the grant. Meetings were organized to begin work and lay the ground work for the funded project.

Data collection. Initially, to maximize the continuity of services and data, the project tried to work with Synergy Corporation to adapt the SAMS program used by the OFA to fit the needs of the project; however, after extensive attempts, it was determined that the SAMS program could not meet these requirements despite initial claims by the vendor. As a result, a Microsoft Access Database was developed to maintain the data in the project.

The database continues to work well for the project. As the project continues to develop on-going additions and improvements are made to maximize efficiency while maintaining a user friendly system. A number of sub-forms are regularly developed to address identified needs. The database continues to evolve and will be key component of a toolkit designed for others who may want to replicate this project.

Communication with Rural EMS Providers. As the project evolved and challenges were identified, we determined that we needed an efficient way to communicate with EMS providers. We decided to leverage the central nature of the EMS agencies and started sending monthly newsletters for the providers in the project. Each month the newsletter discusses a particular geriatrics EMS issue and includes the EMS screening results for that particular EMS agency. It is proving to be an effective communication tool as it provides feedback to the EMS agencies, educates them in the process, and appears to be improving the screening rates.

A number of methods were developed to continue the program. First, the geriatrics training has created an infrastructure of educators who can teach the course. Now, existing regional and state training dollars can be used to provide the geriatrics training to the EMS community. Second, the EMS screening has been built into the electronic medical record. Therefore, little manual work is needed to have EMS screen or to review the screening results. Third, the transitional case management structure is one that is being integrated into the OFA as the OFA prepares for the NY single point of entry system. Finally, the Synergy Now Harmony software/web tool will be used to integrate the operations of the program into existing infrastructure.