HomeMy WebLinkAboutCSD-005-09Clarington
Leading the Way
REPORT
COMMUNITY SERVICES DEPARTMENT
Meeting:
GENERAL PURPOSE AND ADMINISTRATION COMMITTEE
Date: March 9, 2009
Report #: CSD-005-09
File #:
Resolution #:rft-7 ~~~~
By-law #: o` 'O 50
Subject: PUBLIC ACCESS DEFIBRILLATOR PROGRAM -COLLABORATIVE
STATEMENTS
Recommendations:
It is respectfully recommended that the General Purpose and Administration Committee
recommend to Council the following:
1. THAT Report CSC-005-09 be received;
2. THAT Council authorize the Mayor and Clerk to sign the Collaborative
Statements provided by Central East Prehospital Care Program;
THAT Central East Prehospital Care program be advised of action taken; and
4. THAT the Orono Arena Board, Newcastle Arena Board and the Newcastle
Community Hall Board be advised of action taken.
Submitted by:
J PC/GA/wg
P. Caruana
of Community Services
Reviewed b~~' " "-" ~ ~~
Franklin Wu
Chief Administrative Officer
CORPORATION OF THE MUNICIPALITY OF CLARINGTON
40 TEMPERANCE STREET, 80WMANVILLE, ONTARIO L1C 3A6 T (905)623-3379 F (905) 623-5506
REPORT NO.: CSD-005-09
PAGE 2
1.0 BACKGROUND
1.1 The Municipality of Clarington has been involved with the Cardiac Safe Community
Program, coordinated by the Central East Prehospital Care Program (CEPCP),
formerly know as Lakeridge Base Hospital, since the first installation of a
defibrillator unit at the Courtice Community Complex in December 2005. Since that
time we have retained the CEPCP to provide the annual program support and
recertification for each of our AED units.
1.2 The annual cost for program support and re-certification is $2,000 per unit.
Included in the program support cost is;
. Medical oversight by CEPCP
. Biomedical engineering to ensure unit is maintained to
manufacturer's standards throughout the year
. Medical consultation throughout the year
. Follow - up support system for staff following an AED use
. Annual re-certification for staff at $60.00/person
2.0 PROGRAM
2.1 Since the installation of the first unit we have been working within the principles
of collaboration. However, now that we have completed the installation of units in
all recreation facilities, it is desirable to formalize the ongoing relationship through
the signing of collaborative statements between the two (2) parties. The
Principle Statement of the document reads as follows:
This agreement between the above parties will ensure thatthe
Municipality of Clarington and Public Access Defibrillator
(PAD) responders are working under the legal, medical
oversight of the Central East Prehospital Care Program
(CEPCP) Medial Advisory Board Physicians when providing
semi automated external defibrillation (SAED) to a victim of
sudden cardiac arrest (SCA). It also provides for the provision
of medically current training services in SAED & CPR to those
PAD responders by and under the direction of the CEPCP
Medical Advisory Board Physicians. These conjoint efforts are
focused on the provision of medically appropriate care for the
citizens in our community.
2.2 The CEPCP has prepared four (4) statements for signature including one (1)
statement for all seven (7) AED units in Community Services facilities and one (1)
each for Orono Arena, Newcastle Arena and Newcastle Town Hall.
2.3 In discussion with the Clerk's office staff have been advised that all statements are
within the authority of Council and as such are to be authorized by the Mayor and
Municipal Clerk.
REPORT NO.: CSD-00S.09
.
PAGE 3
3.0 COMMENTS
3.1 Since we initiated the AED program in 2005 we have had a close working
relationship with the Central East Prehospital Care Program and strongly
recommend the authorizing of the collaborative statements to formalize the
ongoing partnership we share.
Attachment #1- Sample Semi Automatic External Defibrillation Collaborative Statement
r~~~'~~---~~~-~~-~-~~~~~-~~~~-~~~~--~~~~~-~ To Report~~~~~~~~~
!
Central East Prehospital Care
Program at
Lakeridge Health Corporation
and
Municipality of Clarington
Semi Automatic External
Defibrillation
Collaboration Statement
For the Cardiac Safe Community Public Access
Defibrillation Program for Durham Region
,
I, ii
I~__~-~-~~~._~_._-~.~~-~--~~~~---~~--~~~~.~~~~._--_.--____._~_...._~~__~~___~ ---~-~-~~_.-~~_._~~~~_-_~J
2
Princiv/e Statement
This agreement between the above parties will ensure that the Municipality of Clarington
and Public Access Defibrillation (PAD) responders are working under the legal, medical
oversight of the Central East Prehospital Care Program (CEPCP) Medical Advisory
Board Physicians when providing semi automated external detibrillation (SAED) to a
victim of sudden cardiac arrest (SCA). It also provides for the provision of medically
current training services in SAED & CPR to those PAD Responders by and under the
direction of the CEPCP Medical Advisory Board Physicians.
These conjoint efforts are focused on the provision of medically appropriate care for the
citizens in our community.
PrOf!ram Comvonents and Recommendatiolls
The following items will be components of the annual program maintenance:
. Provision of medical oversight by the Central East Prehospital Care Program
(CEPCP) for the Cardiac Safe Community Program for Durham Region.
. Provision of initial certification training and testing for SAED for PAD responders.
. Provision of recertification testing for SAED.
. Provision of c.p .R. recertification testing and training of the PAD responder
employees as required.
. Development and provision of in-house reviews of SAED.
. Provision of Biomedical Engineering by the Lakeridge Health Biomedical
Engineering Program to ensure that the SAEDs are maintained according to the
manufacturer's standards, including biomedical direction for the replacement of
batteries and pads when mandated by the manufacturer or the Biomedical Department
(once per year or after each use).
. Method design for the collection of patient care outcome data by the CEPCP to
provide the basis for ongoing patient care quality assurance programs.
. A formal meeting between the Municipality of Clarington and the CEPCP to review
the program's goals, outcomes, and patient care protocols on an annual basis.
. Availability of the CEPCP staff and physician to consult on and review issues and
procedures as required, or at least on a minimum of once per year.
,.
3
.
Dedication of a designated CEPCP PAD Coordinator as a prime contact for the PAD
site.
.
CEPCP medical and logistical support for the development of Conjoint Public Access
Defibrillation Programs in our Community.
.
The CEPCP will provide instructors (Paramedics and Firefighters) to deliver SAED
training, using the principles of Adult Learning. The scope of this training will
include, but is not limited to the content of the Canadian Heart and Stroke
Foundations CPR & SAED recommendations. All curriculum content and instructor
training and qualifications will be approved by the Central East Prehospital Care
Program Medical Advisory Board Physicians.
.
To identify placement of such AED throughout the site to ensure time to defibrillation
can be achieved in 3 minutes or less from time of recognition of cardiac arrest;
.
To recommend the AED be placed in an Emergency Response Case that will audibly
and visually (flashing red light) alert staff that the emergency response case door has
been opened. When the AED is removed from the Emergency Response Case, a call
is automatically made to the alann company who in turn will notify 911 to activate
emergency services (Fire Service and Emergency Medical Service).
.
To establish an action plan in the case of an emergency and AED use. The action plan
is to be reviewed every year.
. To maintain quality assurance by establishing a collaborative environment between
the rescuers, CEPCP, Fire Service, and Emergency Medical Services (EMS)
Paramedics through training, feed-back, group sharing ofknowledge and learning
from experience, and to establish a follow-up support system for rescuers post-A ED
use (ie. critical incident stress intervention).
4
Al!reement Criteria for PAD Prol!ram
It is clearly understood and agreed to by both parties that medical direction and oversight
to the PAD Responder for the purpose of SA ED is provided under the following
conditions:
A. Direction and oversight of the Cardiac Safe Community PAD program is
provided under the auspices of the CEPCP Medical Advisory Board Physicians.
B. Direction and oversight is valid when the PAD responder is acting in the best
interest of a seA victim. This may include the utilization of a SAED in another
P AD site. Anyone who has been taught PAD under our program can assist citizen
responders in the use of a PAD response. The audio and text prompts from the
SAED must be followed exactly.
C. Non-targeted responders who use the AED in good faith and voluntarily are
covered from liability by the Chase McEachern Act (Heart Defibrillator Civil
Liability), 2007, S.O. 2007, c. 10, Sch. N (Appendix B) and the Good
Samaritan Act, 2001 S.O. 2001, CHAPTER 2 (Appendix C).
5
Trainill1! Develovment Academic Goals and Standards
A. All training materials and lesson plans in the initial and on-going
program development process will be scrutinized by qualified adult
educators. "Qualified Adult Educators" for the purpose of this agreement
are prehospital care professionals with practice qualifications of at least
the Advanced Care Paramedic Level and with formal certification in adult
education from a recognized community college or university.
B. Allleaming objectives and leaming outcomes for this program will be
approved by a physician who is qualified as a specialist in
Emergency Medicine and has experience providing medical direction in
the field of out-of-hospital Emergency Care.
A1!reement Term
This agreement is for a term of one year. By mutual agreement of the parties this
agreement will automatically renew for further one year terms on January I st of each
subsequent year. The agreement will be annually reviewed by both parties before the
end of the first quarter of the calendar year. Changes to this agreement will be made by
mutual consent.
Pro1!ram Fees and Services Provided
Fees
The program fees for the services described below are based on groups of I 0 certified
PAD Responders and one unit at one location:
1. 1nitial training and certification of providers-$700.00
2. Program Support - $1,400.00 for the initial and each subsequent year per unit.
Additional units at the same location require an annual fee of $400.00 per unit.
3. Annual Recertification costs are $600.00
4. The support and training fees in this agreement will increase by 3% at the
beginning of each calendar year, the first increase for this agreement will be
applied in January of2010.
For PAD Responders requiring remedial continuing education from the CEPCP PAD
Coordinator or the CEPCP Physician over and above the instruction detailed the CEPCP
and the Municipality of Clarington will negotiate a fee for that service at that time. Fees
for a class of 10 or fewer students will be $700.00 per day. Minimum fees for an
instructor are $400.00 per half day.
6
Services
I. Emergency Action Plan Development:
site assessment
needs assessment to determine the number of SA ED's required
direct best placement for access to SAED
medical emergency response plan implementation (site specific
2. CPR Education Review (Canadian Heart & Stroke Foundation Guidelines):
placing 911 call (role of police, fire, and ambulance)
risk factors of heart disease
recognition of heart attack
choking emergencies
patient assessment
artificial respiration (pocket mask)
one and two person adult CPR
3. Defibrillation Training:
SAED shock & nonshockable protocols
scenarios (based on Emergency Action Plan)
trouble shooting
SAED weekly, monthly, and after use checks
communication/documentation
4. Advanced Care Paramedic makes presentation on:
concept of rapid defibrillation medical direction of defibrillation
medical legal liabilities and issues
questions and concerns
certifi cati on/ evaluation
5. Physician Review and Medical Oversight of:
program design
medical legal responsibilities
operational critique for every event
6. Newsletter for Targeted Responder (continuing educational topics for medical
emergencies)
7. Quality Assurance and Risk Management:
identify and provide ongoing training for site coordinators
practice scenarios and assignments
daily, monthly, and after use checks
7
Emergency Action Plan Audit
Begin development oflocal on site instructor/coordinators
to enhance initial certification process for new employees
8. Six month reviews (site visits) to:
evaluate skills retention and
review emergency response plan awareness
continue development oflocal on site instructor / coordinators
9. Office Administration:
maintenance of certification records
updates of protocol changes
clinical co-ordinator dedicated to Targeted Responder Program
10. Critical Incident Stress management services.
demobilization education is provided for the Site Co-ordinator and staff that
will be called in to talk with PAD responders immediately following a SCA
when Targeted Responder personnel involved in an event; the Cardiac Safe
Community Program will ensure incident debriefings are facilitated
the Cardiac Safe Community Program is affiliated with and supports the
Durham Region Critical Incident Stress Management Team Services
II. Biomedical Engineering Support and Operational Risk Management
check SAED once a year
change SAED battery as required
change SAED pads as required
ensure SAED meets operational needs
certification of machine safety and operation
Invoicinl!:
Each year the staff that are trained and/or certified, the number of AED sites along
with additional defibrillators will be adjusted and included as a component of the
invoicing process. Appendix A attached to this agreement lists the initial sites and
numbers of SAEDs covered by this agreement.
8
Hold Harmless Clause
TIle Municipality of Clarington agrees to indemnify and save the Central East Prehospital
Care Program at Lakeridge Health Corporation harmless from any court cost, expense,
judgement, loss damage, death or injury including court costs and legal fees in any way
caused by the negligence or wrong-doing of the Municipality of Clarington related to or
arising out of the PAD Program or other matters to which the agreement pertains.
The Central East Prehospital Care Program agrees to indemnify and save the
Municipality of Clarington from any court cost, expense, judgement, loss, damage, death
or injury including court costs and legal fees in any way caused by the negligence or
wrong-doing ofthe Central East Prehospital Care Program at Lakeridge Health
Corporation related to or arising out of the PAD Program or other matters to which this
agreement pertains.
9
LETTER OF AGREEMENT
THIS AGREEMENT made, this 24 day of October A.D. 2008
BETWEEN Central East Prehospital Care Program at Lakeridge Health
Corporation
and the
Municipality of Clarington
NOW THEREFORE THIS AGREEMENT WITNESSED that in consideration of the
mutual covenants herein contained and subject to the terms and conditions hereinafter set
forth the parties hereto agree to participate in the Central East Prehospital Care Program
Cardiac Safe Community PAD Program in accordance with the terms outlined in The
Lakeridge Health Central East Prehospital Care Program and the Municipality of
Clarington collaboration statement.
I. If either party is dissatisfied with the performance of the other party, the dissatisfied
party may give written notice of the dissatisfaction to the other party and shall
provide the other party with 30 days within which to rectify the matter of
dissatisfaction.
Where the matter is not corrected to the satisfaction of the party giving notice within
the ninety (90) day period, the dissatisfied party may terminate this Agreement by
giving the other party ninety (90) days written notice of the party's intention to
terminate the Agreement. The ninety (90) day period of notice shall commence five
(5) business days after the notice has been mailed to the other party or twenty-four
(24) hours following delivery of the notice by hand or by facsimile transmission.
2. The parties mutually agree that this Agreement will be reviewed and renewed
annually by the Central East Prehospital Care Program at Lakeridge Health
Corporation and the Municipality ofClarington. Any such renewal shall be based
upon such terms and conditions, including any or all of the provisions of this
Agreement, as may be mutually agreed to by the parties.
Municipality of Clarington
Print
Date
fcrr
Marty Epp
Print
8~f/~Otf'
Date
1
10
APPENDIX A
Prol!.ram Support Providinl!.:
. Medical Oversight . Yearly Site Audits
. P AD Co-ordinator Contact . Biomedical Services
. Quarterly Reviews . Event Reviews
For the followinl!. sites:
. Gamet B. Rickard Recreation Complex $1400.00
. Courtice Community Centre 1400.00
. South Courtice Arena 1400.00
. Bowmanville Indoor Soccer Facility 1400.00
. Clarington Fitness Centre 1400.00
. Newcastle Recreation Centre 1400.00
. Darlington Sports Centre 1400.00
Sub Total 9800.00
GST 490.00
Total $10290.00
This is NOT an invoice.
'.
II
Appendix B
Chase McEachern Act (Heart Defibrillator Civil LiabilitvJ, 2007, 5,0.
2007, c. 10, Sch, N
Citation: Chase McEachern Act (Heart Defibrillator Civil Liability), 2007, S.O.
2007, c. 10, Sch. N
Information about this text Consolidation: No Amendments.
URL: http://www.canlii.orglonilaws/sta/2007c.IOsch.ni20070717/whole.html
Version downloaded by CanLlI on 2007-07-17
Chase McEachern Act (Heart Defibrillator Civil Liability), 2007
S.O. 2007, CHAPTER 10
Schedule N
Definitions
1. In this Act,
"defibrillator" means an automated external medical heart monitor and defibrillator that is
capable of,
(a) recognizing the presence or absence of ventricular fibrillation or rapid ventricular
tachycardia,
(b) determining, without intervention by an operator, whether defibrillation should be
performed,
(c) automatically charging and requesting delivery of an electrical impulse to an
individual's heart as medically required, and
(d) satisfying any other criteria that may be prescribed by regulation; ("defibriliateur")
"emergency" means a situation during which the behaviour of an individual reasonably leads
another individuai to believe that the first individual is experiencing a life-threatening event
that requires the provision of immediate care to assist the heart or other cardiopulmonary
functioning of that person; ("situation d'urgence")
"health care professional" means,
(a) a member of a College of a health profession set out in Schedule 1 to the
Regulated Health Professions Act, 1991,
(b) such other persons or classes of persons as may be prescribed. ("professionnel de
la sante") 2007, c. 10, Sched. N, s. 1.
Protection from civil liability, user of defibrillator
2. (1) Despite the rules of common law, a person described in subsection (2) who, in
good faith, voluntarily and without reasonable expectation of compensation or reward uses a
defibrillator on a person experiencing an emergency is not liable for damages that result from
the person's negligence in acting or failing to act while using the defibriliator, unless it is
12
established that the damages were caused by the gross negligence of the person. 2007,
c. 10, Sched. N, s. 2 (1).
Persons covered
(2) Subsection (1) applies to,
(a) a health care professional, if the health care professional does not use the
defibrillator at a hospital or other place having appropriate health care facilities and equipment
for the purpose of defibrillation; and
(b) an individual, other than a health care professional described in clause (a), who
uses a defibrillator at the immediate scene of an emergency. 2007, c. 10, Sched. N, s. 2 (2).
Reimbursement of expenses
(3) Reasonable reimbursement that a person receives for expenses that the person
reasonably incurs in using a defibrillator shall be deemed not to be compensation or reward for
the purpose of subsection (1). 2007, c. 10, Sched. N, s. 2 (3).
Protection from civil liability, owner or operator of premises
3. (1) Despite the Occupiers' Liability Act and the rules of common law, any person who
owns or occupies premises where a defibrillator is made available for use and who acts in good
faith with respect to the availability or use of the defibrillator is exempt from civil liability for
any harm or damage that may occur from the use of the defibrillator. 2007, c. 10, Sched. N,
s. 3 (1).
Exception
(2) Subsection (1) does not exempt the person who owns or occupies the premises where
a defibrillator is made available for use from civil liability if,
(a) that person acts with gross negligence with respect to making the defibrillator
available;
(b) that person fails to properly maintain the defibrillator; or
(c) the premises where the defibrillator is made available for use is a hospital or other
premises used primarily for the purpose of providing health care to individuals. 2007, c. 10,
Sched. N, s. 3 (2).
Regulations
4. The Lieutenant Governor in Council may make regulations,
(a) prescribing criteria for the purpose of the definition of "defibrillator" in section 1;
(b) prescribing persons or classes of persons for the purposes of the definition of
"health care professional" in section 1;
(c) governing standards for the proper maintenance of defibrillators;
(d) respecting any matter necessary or advisable to carry out effectively the purposes
of this Act. 2007, c. 10, Sched. N, s. 4.
Applies to the Crown
5. This Act applies to the Crown and any agency of the Crown. 2007, c. 10, Sched. N,
s. 5.
13
6. Omitted (provides for coming into force of provisions of this Act). 2007, c. 10,
Sched. N, s. 6.
7. Omitted (enacts short title of this Act), 2007, c. 10, Sched. N, s. 7.
Reference:
Chase McEachern Act (Hearl Defibrillator Civil Liability), 2007, S.O. 2007, c. ! 0, Sch. N;
http://www.canlii.orglon/laws/sta/2007c.!Osch.n/200707!7 /who!e.html.
!1
I
,
14
Appendix C
Good Samaritan Act, 2001, S.O. 2001, CHAPTER 2
No amendments.
Definition
1. In this Act,
"health care professional" means a member of a College of a health profession set out in
Schedule I to the Regulated Health Professions Act, 1991. 200 I, c. 2, s. I.
Protection from liability
2. (1) Despite the rules of common law, a person described in subsection (2) who
voluntarily and without reasonable expectation of compensation or reward provides the
services described in that subsection is not liable for damages that result from the
person's negligence in acting or failing to act while providing the services, unless it is
established that the damages were caused by the gross negligence of the person. 2001,
c. 2, s. 2 (1).
Persons covered
(2) Subsection (1) applies to,
(a) a health care professional who provides emergency health care services or first aid
assistance to a person who is ill, injured or unconscious as a result of an accident or other
emergency, if the health care professional does not provide the services or assistance at a
hospital or other place having appropriate health care facilities and equipment for that
purpose; and
(b) an individual, other than a health care professional described in clause (a), who
provides emergency first aid assistance to a person who is ill, injured or unconscious as a
result of an accident or other emergency, if the individual provides the assistance at the
immediate scene of the accident or emergency. 2001, c. 2, s. 2 (2).
Reimbursement of expenses
(3) Reasonable reimbursement that a person receives for expenses that the person
reasonably incurs in providing the services described in subsection (2) shall be deemed
not to be compensation orreward for the purpose of subsection (1). 2001, c. 2, s. 2 (3).
3. Omitted (provides for coming into force of provisions of this Act). 2001, c. 2, s. 3.
4. Omitted (enacts short title of this Act). 2001, c. 2, s. 4.
Reference:
Good Samaritan Act, 2001, S.O. 2001, CHAPTER 2; http://www.e-
laws.gov.on.ca/html/statutes/englishlelaws _statutes _ 01 g02 _ e.htm.