The Heart of High Performance EMS
By Alan Perry
3/10/2015
What makes a High Performance
EMS system work? It’s not just the mechanics of the operations and program
development, but also its culture –the people and attitudes that make it work. It is not new and
innovative practices, advances in the field of mobile healthcare, a charismatic
Chief Officer or a dedicated OMD. These are influential, however I doubt any
system could effectively support that type of change and progression without
the firm foundation of a strong and supportive organizational culture. If you
examine the most proactive, progressive and respected organizations providing
EMS in the nation; such as MedStar in Fort Worth, Texas, or The Richmond Ambulance
Authority in Richmond, Virginia, you notice something very special right away.
No one sitting in easy chairs watching TV, No sloppy facilities, everyone
embraces, and can articulate the mission, goals and achievements of the organization,
what is this? It is pride, empowerment and accountability, all things born out
of a positive organizational climate. This is the foundation these
organizations build upon to be leaders and innovators in Emergency Medical
Services.
This is not an idea that can
be mandated as a performance criteria on an evaluation, it must be supported throughout
the organization by effective leadership, administration, training, logistical
support, public relations, public education, medical direction and healthy
relationships with allied professions in hospitals, public health and nursing.
Several of the most effective systems sprang from collapse of failed delivery
models, taking the opportunity to rebuild the EMS delivery system from the
ground up to be focused on performance and delivery of quality care. Common
features include an organization focused solely on delivery of EMS services and
related health and public education programs, Dedicated dispatching facilities,
training facilities on par with a good community college, a full-time OMD(s),
In-house vehicle maintenance, supplies and logistical support, use of system
status management and call prediction software, and a nearly flat
organizational structure with liberal and frequent lateral communication. Such
a design promotes rapid response to any threats or opportunities that present
themselves, allowing the organization to be nimble and proactive in meeting the
needs of the public and its providers.
These organizations value
efficiency as their responsibility to patients and the general public. Efficiency
improves patient care as much as it makes effective use of public funds, if
they are used at all. Every aspect of EMS system design and delivery has been
carefully thought through and implemented to maximize utilization, reduce
waste, and maximize the use of precious resources. Providers are supported with
adequate training, field support, and career progression. There is
accountability and questions/problems are solved or addressed quickly. The cost
of providing this type of service to traditional, Fire-based EMS or EMS-based
Fire systems is not a monetary one; it may be the dismantling of existing
command and management structures, and drastic changes to the organizational
culture. This is the future of EMS, high-performance EMS is here to stay and is
what the public and providers deserve.
Be Safe, AP
MedStar 911
Richmond Ambulance Authority
Wake County EMS
King County Medic One
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