NM MEMS Framework

The New Mexico Modular Emergency Medical System (NM MEMS) Framework

The NM MEMS model is built around two core functions: Alternate Outpatient Care Areas (AOCAs) and Alternate Inpatient Care Areas (AICAs). These temporary patient care areas located within or adjacent to existing patient care facilities serve as the operational backbone of the response model. Other key functions and response assumptions must be considered during overwhelming patient surge to support the complex and connected activities necessary for an effective response and are also a significant part of NM MEMS. Those additional functions are also described within the NM MEMS Framework. Many of the functions and assumptions described in the Framework will apply only during the implementation of NM MEMS response plans and are to be considered only under described conditions. Further, not all NM MEMS functions or assumptions will apply to every situation. NM MEMS is modular and scalable, and addresses the mobilization of key resources to respond to an incident depending upon patient numbers, acuity type(s) and required medical services.

Since the utilization of NM MEMS functions imply that both the quantity and the quality of resources are inadequate to meet patient care needs resulting from the incident, it is likely that “normal” health care delivery will need to be modified. This modification is addressed in the function titled “Delivery of Care Under Overwhelming Patient Surge Conditions.” These conditions will compel the state regulatory bodies, health care system administrators and the individual health care professional to consider adjustment of scopes of care and practice in order to ensure the delivery of a reasonable level of care. There are two major premises of NM MEMS utilization in response planning. They are:

• The “best” place (economy of personnel and availability of specialty resources and infrastructure) for sick or injured patients to be treated is within the existing health care infrastructure. As such, NM MEMS functions and concepts will rely heavily upon an existing healthcare infrastructure-based response that utilizes existing resources and space to create “alternate” areas of care. While these new alternate areas will challenge the overall healthcare infrastructure operation, this approach ensures that patients are best positioned to receive reasonable care under the prevailing circumstances with available resources and personnel.
  
  
• For a community to adequately plan for a response to an incident of overwhelming medical or patient surge, there must be an accurate and realistic initial assessment of the community’s resources that are routinely and predictably available; as well as, a measurement of the capability to “surge” within the existing patient care infrastructure. To develop a response plan to overwhelming medical or patient surge and identify the threshold(s) for activation, a pre-determination of existing capacities and capabilities must occur. This determination or assessment will require the coordination, collaboration and understanding of the NM MEMS Framework and its purpose by all local responders and planners.
  
  

All response begins at the local level. Effective local incident planning or emergency preparedness activities must consider overwhelming patient surge conditions. Experience with medical response to incidents has shown that all local healthcare system partners must be able to adapt to an overwhelming number of patients in a relatively short time. Experience also indicates that the majority of patients resulting from an incident are not critically injured or ill. Most are without immediate life-threatening injuries or illness, yet are still in need of medical screening and care. This large number of minimally to moderately injured or ill patients represents the greatest impact of the surge that must be accommodated and managed by existing resources.

The NM MEMS Framework will guide local response planning and will be implemented at the local level, which is dependent upon accurate resource assessment, coordination, and management among all response partners. Hospitals, primary care clinics, other health care institutions and emergency planners, using the NM MEMS Framework to develop medical surge capacity within an emergency operations plan, must identify and coordinate with all health system response partners to plan and exercise prior to an incident in order to maximize the use of available personnel and health resources and assure plan’s effectiveness.

Each local emergency operations plan must identify and describe the thresholds at which NM MEMS functions will be activated. Tools to guide appropriate NM MEMS function utilization in response plan development will be provided within the Implementation Manual. The decision to implement any medical surge response plan will be jurisdictiondetermined and based upon the assessment of available capacity, resource management and incident demands.

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