Expert Analysis & Management Services

Leaders today have virtually instant access to an overwhelming amount of
information. The challenge lies in transforming that information into true
insight – and then turning insight into actions that improve an
organization’s performance.

Our extensive hands-on experience and wide-ranging expertise has earned us a
reputation as the think-tank of the EMS/public safety profession and air medical community. When municipal leaders, healthcare executives, researchers, authors, attorneys, and members of the media have questions, they turn to us for reliable answers.

Fitch & Associates also offers a broad range of turnkey management services through MedServ, a Fitch-owned company created in response to client requests for management and operations support. MedServ provides temporary leadership/transition services and long-term solutions alike.

How We Work

Fitch & Associates’ time-tested approach to system review includes both quantitative (objective/data related) and qualitative (interview/observation related) research methods. This process is designed to deliver options to enhance performance—clinically, operationally, and financially—while improving the stability and accountability of the system. 

A well-reasoned assessment is as important for the larger EMS system as it is for an individual patient. It is essential to understand what is happening, why it’s happening  and how to facilitate improved outcomes.

To fully evaluate any specific aspect of the system, a more detailed approach such as Logic Model Analysis can be utilized.

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A trademark of our approach is that we blend national expertise with local resources, working collaboratively with local leaders to take full advantage of their knowledge and ideas. This approach not only results in better outcomes, but it also builds strong support for the ultimate recommendations.

Benchmarking

Evaluation of any EMS system takes on special validity when viewed with a profession-wide perspective. That’s why we not only identify performance levels for a specific system, but we also compare the attributes of a system with the profession’s best practices.  The following metrics, developed exclusively by Fitch & Associates, provide an overview of how we evaluate and compare EMS systems:

SERVICE LEVELS

• Provides service level suitable to the organizational mission
  
• Responds to all requests or utilizes a recognized non response protocol

COMMUNICATIONS

• Public emergency access via 9-1-1
• Technology supports interface between dispatching and administrative processes
• Priority evaluation tool and pre-arrival instructions
• Communications center accreditation
• Sophisticated quality processes

CERTIFICATION LEVELS

• Match the organizational mission and exceed minimum regulatory requirements
• Cardiac life support
• Trauma life support
• Pediatric life support
• National Registry

CLINICAL SERVICE DELIVERY MEASURES

• System tracking of Utstein-defined resuscitations
• Sophisticated pharmacological agents available
• Sophisticated ALS procedures available
• Sophisticated ALS equipment available
• Sophisticated quality processes utilized

MEDICAL OVERSIGHT

• Medical director with specialized training
• Breath and depth of clinical practice/protocols
• Medical community support/advisory board

FIRST RESPONSE

• AED first response
• Responders integrated into QI processes
• Administrative responsiveness to and from responders

RESPONSE TIME RELIABILITY

• Fractile compliance standards for emergency and non emergency responses are set and fully transparent
• Defined fractile compliance achieved
• Response times requirements based upon call density
• Response clock measured from correct intervals
• Vehicle & personnel safety are measured in benchmark format
• Vehicle reliability is measured and managed

ECONOMIC AND OTHER VALUE MEASURES

• Level of tax subsidy
• Independently audited financial statements accurately reflect situation
• Full activity-based costing is used to construct budgets
• Per capita costs do not exceed similar system mean by 10%
• Fully loaded unit hour costs do not exceed similar system mean by 10%
• Transport costs do not exceed similar system mean by 10%
• UhU measured and hours effectively deployed
• Satisfaction levels of key stakeholder groups
• Community value-added service matched to system role
• External administrative oversight and transparency
• Disincentives and  termination provisions for noncompliance are defined

Work Plan

We typically organize our work into nine phases, beginning with confirming the project’s key stakeholders and gaining agreement about what and how key elements of the system will be measured. This is followed by comprehensive data collection and analysis using a variety of methods that are appropriate to the size and scope of the project. We typically prepare multiple options for the future state before outlining recommendations and concluding with the presentation of the report. 

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To learn more about how our methodologies and experience can be used to enhance the clinical, operational, and financial sustainability of your service, call Sharon Conroy at 816-431-2600 to schedule a no-obligation, confidential discussion with one of the firm’s three partners.   

Highlighted Case Study

Turnkey Management of an Emergency Medical Services System, Charlotte/Mecklenburg, N.C.

“Battlefield Charlotte: The War Over EMS,” JEMS, March 1997

“Battlefield Charlotte Revisited,” JEMS, July 2006

Sample Reports

International City/County Management Association IQ Report: EMS in Critical Condition: Meeting the Challenge
By Joseph J. Fitch, PhD; Richard Keller, BS; David M. Williams, MS; et al

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KCMO Demand Deployment Schedule Analysis, April 2004
KCMO EMS System Design Report

Fitch & Associates/JEMS 200-City Survey
By David M. Williams, MS

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To view additional reports, visit our Reports & Resources page.

For the Media: Fitch partners and consultants are available for interviews and backgrounders. Contact Sharon Conroy at 816-431-2600 or sconroy@emprize.net.