I’d rather listen to your troubles than your eulogy
By Jay Fitch, PhD The medic’s eulogy was moving. Patrick was a great guy. A rock-solid clinician. A loving father. A faithful husband. And, as the funeral service progressed, my mind could not be quieted as I kept thinking why? Why did Patrick commit suicide when he had so much to live for? Read the...
The ‘M’ in EMS Stands for Medical: Tackling Fire/EMS Challenges
By Jay Fitch, PhD As I pulled on my bunker pants, I started whining about taking a middle-of-the-night, low-priority ambulance call. It was early in my career, and an older firefighter leaned over and said, “Son, remember that the M on your EMS patch stands for medical, so quit whining and just get on with...
Ambulance Services: Build Your Own or Contract Out?
Fiscal things that can go bump in the night
By Anthony W. Minge, EdD “From ghoulies and ghosties and long-leggedy beasties and things that go bump in the night, Good Lord, deliver us!” — Scottish saying Have you ever heard that noise in the middle of the night? You know, the one just when you are dozing off and there it is … thump! And...
Taking the Load Off
By Steven Knight, PhD Many fire departments that have traditionally used 24-hour shifts to staff response units have begun looking to alternative staffing models, recognizing that call volume does not remain constant throughout the day. Long shifts can be especially grueling for providers on ambulances because of an increasing demand for medical services in many...
3 Ways EMS Leaders Make or Break Paramedic Training Programs
Many EMS agencies realize that new employees, whether new graduates of pre-service paramedic programs or employees with experience in other organizations, are not fully prepared to climb into an ambulance and head out to serve the community.
8 tips for talking about sexual harassment with caregivers
5 significant risks to your development as a fire service leader
Don’t let your professional network, or yourself derail your career path: Examine these five perspectives to map out your path to being a great leader
The value of CE and an advanced degree for fire leaders
Higher education can help firefighters tackle the five biggest challenges facing emergency services today
CHIEF CONCERNS: How to Talk to Local Officials About Standards of Cover
The Standard of Cover planning process requires communication and collaboration between fire department officials, local leaders and the community.
Getting the Most Out of Your EMS Billing: An Interview with Anthony Minge, EdD, Fitch & Associates
City and county officials, EMS agency directors and fire chiefs who struggle to balance budgets may want to analyze the efficacy of their EMS billing operations to recover additional revenue.
7 things you should be doing to engage your medical director
Nurturing one of the most pivotal positions in your agency will create a more engaged and aligned workforce
Forty years in, Jay Fitch reflects on leadership in EMS
A veteran EMS leader shares some of the most valuable leadership lessons he has learned in more than four decades of serving patients, communities and the profession
The Value of CE and an Advanced Degree for EMS Leaders
Higher education can help EMS providers tackle the five biggest challenges facing emergency services today By Steven Knight, Ph.D. As leaders, we both desire and have an obligation to leave our organizations and people better off than when we started in our roles. But clearly not all leaders succeed at achieving this goal, despite best...
Fatigue, Scheduling are Critical EMS Challenges
EMS Trend Report 2017 findings highlight the importance of fatigue management as a safety issue for both caregivers and patients By Jay Fitch, PhD Caregiver fatigue and increasing negative performance associated with longer shifts are often the underlying reasons for changing schedules that we hear from clients and colleagues. More than 50 percent of the...
EMS and Evidence-Based Medicine Solutions
Challenging ALS and BLS standards of emergency medicine to improve patient outcomes and satisfaction By Guillermo Fuentes The term “evidence-based practice” has been used in EMS for more than a decade. The reality is, as a profession, we fail to understand what implementing an evidence-based practice actually means. One of the most influential thinkers on...
EMS Budget Planning Primer for New Paramedic Chiefs
Climbing the ranks of EMS often fails to prepare new chiefs to discuss financial issues with local elected and appointed officials By Dianne Wright Local government budget processes may seem daunting at first, especially for new leaders whose focus has just recently shifted from EMS operations and patient care. Whether you recently took over as...
Blind Spots: Distracted Driving in EMS
If the EMS profession truly wants to prioritize safety, we must address distracted driving and all the ways we currently make it worse By Meg Chandler and J. Todd Sheridan Motor vehicle collisions continue to pose a significant risk to EMS providers and our patients. Some agencies have responded to this risk by addressing factors...
9 Steps to Fostering EMS Community Support
Being a reliable and engaged community partner takes your EMS organization to lead agency status and makes you the authority when it comes to community health care By Thomas L. Little Every EMS service has many opportunities to build and maintain community support. Providing top-notch patient care is a priority, but public education and outreach pay big...
Give EMS Compliance Training the Respect it Deserves
It’s time for EMS leaders and educators to take compliance training as seriously as clinical training – caregivers’ careers and patients’ lives depend on it By Anthony Minge It seems like you can’t go a day lately without seeing a report or article related to compliance issues in health care. The statutes, guidelines, regulations and...
7 EMS Trends Affecting Cities
Many municipalities are pressured by shrinking budgets, how can leaders do more with less for EMS? Learn about the issues and how to proceed with expert intel.
2016 EMS Trend Report: The forces shaping the present and future of EMS
As the EMS adage goes, "If you’ve seen one EMS system, you’ve seen one EMS system." While that statement reflects the diversity of EMS systems across the United States, it also creates the false sense that every EMS system is entirely different and that EMS leaders can’t learn from each other. Clearly that is not the case. As we see in the premiere edition of the EMS Trend Report, EMS systems across the country share many traits. On the other hand, significant differences do exist in everything from clinical care to salaries to operational benchmarks to hiring requirements.
How hospitals can steer clear of fraudulent transport billing
Rarely does a week go by without another news report about an ambulance service or hospital under investigation by the federal government for fraud or abuse related to billing for transport services. Whether willful or unintentional, negligence that results in the billing of transport services at inappropriate levels is leaving many hospital-operated ambulance services at risk. And the scrutiny is only increasing.
Learning to Dance with an Elephant: 10 Harmful Realities of Modern EMS
We asked the members of the National EMS Management Association (NEMSMA) what they thought were the most critical issues plaguing EMS. Though members acknowledged significant concerns, including patient safety, fiscal sustainability and caregiver well-being, there were still some unrecognized elephants in the room that no one wants to see, hear or talk about. Here are those 10 harmful realities of modern EMS and proposed strategies to overcome them.
Chief Concerns: Three Things A Fire Chief Should Know About Evidence-Based Fire Suppression
Evidence-based practice in emergency services is typically associated with medical care; but the term refers to the application of research methodology to guide operational practice and departmental priorities—something that should apply to fire suppression and rescue operations as well. Historically, however, fire service protocols and procedures have developed through trial and error, best practices and tradition.
Chief Concerns: Fire Service Fatigue- A Problem You Can’t Afford to Ignore
In the hours after a train derailed in Philadelphia, killing eight people, news reports were already stating that the engineer’s recent work schedule would be examined. This wasn’t surprising, given that just weeks earlier, the National Transportation Safety Board stated that operator fatigue was partially to blame for another train crash that occurred in Chicago last year. Anyone who’s worked in the fire service knows that fatigue can impact one’s work performance. In the aftermath of major incidents, we don’t always focus on fatigue as a factor—and it’s often extremely difficult to know just what role it plays when it comes to vehicle crashes, fireground injuries, or medical errors. One thing is clear, however: employee fatigue impacts every fire department, no matter how big or small, or what type of shift schedule. It’s an issue that no fire chief should ignore.
Chief Concerns: How is your Communications Center Performing?
What the question really means: Evaluating your communications center’s performance is about more than whether the center is private or public, staffed with sworn or civilian personnel, or a single-agency or multi-agency dispatch center. The cornerstone of assessing your communications center is the use of evidence-based standards rooted in industry best practices—and analyzing the impact they have on your department’s operations.
Scrutiny of Ambulance Operations Highlights Need for Compliance
Increased attention on ambulance use demonstrates the need for compliance plans to include emergency and non-emergency ambulance operations. The HHS OIG has published voluntary compliance program guidance for ambulance suppliers. Ambulance billing should reflect the care provided by the EMS personnel, not the hospital diagnosis of the patient. Training for billing personnel and EMS providers on documentation and billing for ambulance services is often inadequate. Ambulance suppliers should conduct regular claims reviews to ensure problems are identified and corrected prior to an audit.
Trauma Takes Its Toll: Addressing the mental health crisis in emergency services
Amidst growing concern about the mental health of EMS professionals, a Fitch & Associates’ Ambulance Service Manager Program Project Team recently surveyed more than 4,000 EMS and fire professionals about critical stress, suicide, and available support and resources.1 The results were stark.
Building Organizational Agility in Fire & EMS Agencies
This report is part of a continuing leadership series developed for Best Practices in Emergency Services. It shows leaders of emergency medical services (EMS) and fire departments how the concept of organizational agility can be applied in their agencies. Organizational agility originated in the context of flexible manufacturing and later emerged as a business model in service industries and healthcare. Researchers from diverse disciplines approach organizational agility from a variety of perspectives. Most agree that when organizations are not agile, they become less effective and “fragile,” or susceptible to factors that can impair their ability to survive.
Chief Concerns: Preparing for Scrutiny
Scrutiny. It may arrive at your doorstep in a variety of forms and perhaps when you are least prepared to deal with it. Increased scrutiny could arrive in the wake of questionable performance, like when a victim dies after a delayed response to a fire. It could be the result of a probing investigation by the media during budget debates. Perhaps your agency is in the middle of a contract negotiation that raises the level of interest in its internal operations. Or the heightened scrutiny could come even with the arrival of a consultant that you or your supervisors invited to appraise and advise the agency. As the Fire Chief—think of yourself as the CEO of the department—you cannot afford to be surprised or ill prepared for any of these events.
Chief Concerns: Community Risk Reduction
Good fire chiefs understand the importance of assessing risk in their communities. But the most progressive chiefs are actively working to reduce that risk by implementing Community Risk Reduction programs. They are shifting their stance on risk from reactive to proactive—all in the name of better service to their communities.
The New EMS Imperative: Demonstrating Value
Despite a tremendous diversity in how emergency medical services (EMS) are provided in municipalities around the country, most U.S. EMS systems share one commonality: They remain primarily focused on responding quickly to serious accidents and critical emergencies even though patients increasingly call 911 for less severe or chronic health problems.
Breaking through the Shadows
EMS in the Era of Health Care Reform
Despite a tremendous diversity in how emergency medical services (EMS) are provided in communities around the country, most U.S. EMS systems remain focused on responding quickly to serious accidents and critical emergencies, even though patients increasingly call 911 for less severe or chronic health problems.
5 Changes to Health Care and How they Impact EMS
EMS leaders need to focus on continually improving quality, efficiency and innovation to add value as health care undergoes dramatic changes By Roxanne Shanks Health care policy seems to be in constant change with little clarity on where it is headed. Several policy changes being considered in Washington, from repeal of Obamacare to other, less...
How Strategic Regional Organizations Increase EMS Efficiency
Forming a partnership with other EMS organizations in your region can improve the bottom line and provide better service to the community By Christine Zalar, MA Consolidations, mergers and acquisitions continue to hold value in today’s complex health care marketplace, often delivering favorable economies of scale, increased operational efficacy and improved financial results. At the...
4 Ways to Manage a Thriving Volunteer EMS Organization
Research into non-profit and public sector organizations can help leaders of volunteer and combined EMS departments understand their members’ motivations By Michael Ward Volunteer EMS and fire agencies throughout the United States have increasingly turned to paid or paid-on-call staff to supplement volunteer staffing. This has created an us-versus-them situation that interferes with the delivery...
6 Steps for EMS Leaders to Better Engage Millennials
Engaging millennials is about more than simply welcoming a new generation to the workplace; it’s about accepting a seismic shift in how we view careers, technology and innovation By Jay Fitch, PhD Our profession has become preoccupied with millennials over the last few years. The number of magazine articles, conferences, books and blog posts dedicated...
7 Effective Communication Steps for EMS Leaders
Whether implementing a major initiative or making small policy shifts, two-way communication with every level of the organization is critical By Chip Sovick “Change is the law of life. And those who look only to the past or present are certain to miss the future.” President John F. Kennedy spoke these words in 1963, but...
Basic Deployment Metrics EMS Leaders Should Know
In order to efficiently and effectively run an EMS system, leaders need to understand indicators of their organization’s health By Todd Sheridan Deployment metrics enable EMS administrators to demonstrate the productivity of their agency, show a return on investment and effectively use resources. Since many new EMS leaders lack familiarity with deployment metrics, they may...