Accomplishments of successful reorganization of the EMS
With successful implementation of the reorganization of emergency service we managed to equalize the availability and improve the quality of emergency medical service (EMS) which means that we managed to provide equal standard of the EMS on the entire Croatian territory. We have developed a modern system with a well-equipped, excellently trained and highly motivated health workers. The vision of the Croatian Institute of Emergency Medicine is the establishment of an unprecedented system of emergency medicine in Croatia, based on the principles of comprehensiveness, continuity, availability, and an integrated approach to emergency medical services, supporting the need for a specialized approach both in out-of-hospital and hospital health care. Such system will ensure a better efficiency and better quality, more accessible and more even provision of emergency medical care for all persons on the territory of the Republic of Croatia. One of the main goals of the reorganization- emergency medical service response time up to 20 minutes in rural areas, and 10 minutes in urban environment in 80 percent of the cases and the patient disposal within the golden hour – is already showing the first results. These are world-recognized standards and we are extremely proud on these accomplishments.
Until now, all county institutes of emergency medicine started operating and among them we have distributed 128 newly equipped modern vehicles for the emergency response. Through the Health Care Act and the implementing legislation, we have created the legal regulations for the reorganization of emergency medicine. We have also purchased equipment and opened hospital emergency departments in Bjelovar, Karlovac, Zabok and Čakovec and the process of acquiring equipment for 10 other hospital emergency departments is in progress. Until the end of 2013 Croatia will have 21 hospital emergency departments which will provide 24-hour care to all patients with urgent and emergency medical, surgical and traumatic conditions, ranging from brain injuries to broken bones. We also made protocols for out-of-hospital emergency medical service and hospital emergency department and we conduct continuing education for all of our employees.
Emergency Medicine is a specialty based on the knowledge and skills required for the prevention, diagnosis and management of urgent and emergency aspects of illness and injury affecting patients of all age groups with a full spectrum of undifferentiated physical and behavioural disorders. It combines the urgency of all medical specialties, and because of its multidisciplinarity and the exceptional complexity of the activities and responsibilities in everyday situations of rescuing lives of emergency patients, it is necessary that emergency medical workers have training programs of lifelong/continuing education. Croatian Institute of Emergency Medicine has recognized the importance of education and continuous training of employees and that’s why we have, in collaboration with the Ministry of Health, founded a specialization in emergency medical care for physicians and created training programs for the emergency medical workers in the form of presentations, lectures, seminars, training workshops, etc. Since October 2011, 1.221 employees has completed one of our training programs. Ultimately, 2.000 employees of emergency medical service will pass through our educational programs.
To date, Croatian Institute of Emergency Medicine has so far organized five training programs: for emergency medical dispatchers, physicians, medical technicians, nurses and drivers from out-of-hospital emergency medical service; for the employees of the hospital emergency department; for the physicians from the islands and unavailable locations who are often forced to use emergency medical air transportation of sick/injured patients to the hospital; for all employees of the county institutes of emergency medicine; and for the family physicians, medical technicians and nurses who participate in the activities of emergency medicine.
For the purpose of education, we published a series of educational materials that are free and available to all employees in the emergency medicine service – The Croatian Index for Emergency Medical Assistance, books Emergency medical communication centre and Guidelines for working in out-of-hospital emergency medical service, handbooks Elementary procedures in emergency medicine, Triage in the hospital emergency department, Manual for drivers of emergency medical service and Manual of transport ventilators usage in emergency medicine, as well as DVDs Emergency medical procedures in out-of-hospital conditions and Emergency medical procedures in hospital settings. To this demanding work many expert working groups and a number of prominent experts from Croatia and abroad gave their contribution.