Emergency Medical Services: Decisions, Decisions

We’ve heard that life is all about choices, and we're often faced with making all kinds of decisions. Some are easy, some are difficult; some carry little consequence and others can result in life or death.

If you’re in EMS, you know we're currently facing a large number of issues that are going to require some pretty significant decisions. In this article, I’m not going to make the decisions for you, but I am going to ask the questions you should be asking.

Response Times

Are you measuring these? Should you be?

Is response time making a difference in your patient outcomes?

Has your agency suffered a negative consequence, such as an accident, while trying to meet a response-time standard?

Transport Times

Are you measuring these?

Are you consistently returning to the hospital under red lights and sirens to shorten your transport times? Is it making a difference in your patient outcomes?

Are you using helicopters to transport patients? Is it effective and efficient?

Accountable Care Organizations

Do you know what accountable care organizations (ACOs) are? Have you contacted the ACOs in your service area? Do you need to partner with them?

Cost Recovery

Do you bill for EMS response? What about for transports? Should you be?

Do you know what your collection rate is? Is your ACO going to reimburse you?

EMS Safety

Do you have the EMS Culture of Safety document? Are you familiar with Just Culture?

Are you providing your members with appropriate PPE, including body armor? What about health and wellness?

EMS Planning

Are you prepared to deal with a pandemic? An active-shooter incident?

Do you have the ability to receive EMS/response intelligence from your local law enforcement or state fusion center?

Do you have plans in place that address supply shortages, including medications and drugs?

… And Many Other Issues

These are just a few items from a very long list. Other issues you need to consider, or at least look into, include:

  • Repercussions and requirements of the Patient Protection and Affordable Care Act
  • Diversifying into community paramedicine, community clinics and mobile integrated healthcare
  • Alternative service-delivery models
  • Professional development for you and your staff 
  • Potential partnerships with your neighboring fire, law and EMS agencies

Finally, have you considered how all of this affects your basic mission of providing the best possible patient care?

That’s right, taking care of our patients. It’s easy to forget about the patient when you’re crunching budget numbers, attending classes, reviewing regulatory materials, upgrading software, purchasing equipment and apparatus, and conducting hiring processes.

It’s these decisions that ultimately determine whether you succeed or fail, so hopefully I’ve provided enough points to ponder to put you on the right track. At the very least, your patients are depending on you to make the right decisions, because their lives depend on it.

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