Emergency Medical Services: Improvise, Adapt and Overcome

As we start 2015, one of the goals this year for On Scene is to look at the wicked problems facing fire and EMS. Operational issues, funding challenges and legislative concerns are just a few examples of all kinds of wicked problems that will crop up this year.

We need to either be prepared for, or at least be able to respond to, each and every one of these. Our hope is that we have the foresight to see problems coming, but sometimes, we get blindsided when we least expect it. In these situations, we may just have to improvise, adapt and overcome.

A recent example involves 25 fire and EMS agencies in the Denver Metro area. During the last week of October, HealthONE/HCA notified these prehospital agencies that they'd no longer receive medical direction from any HealthONE/HCA hospital as of January 1.

For my agency, this was reminiscent of the late 1990s when a large corporate ambulance company notified us they would no longer provide ambulance service to our town. We had no prior indication this was coming, but at least the ambulance company gave us six months' notice. HealthONE/HCA only gave us two months, and of course, it was after our 2015 budget cycle was already well underway.

HealthONE/HCA advised that these Denver Metro hospitals were the only remaining entities in their corporation that were still providing medical direction. To standardize their business practices, medical direction was being eliminated at these Denver hospitals. Our challenge was to find another hospital or medical director by the deadline in Denver that could easily absorb us into its system.

However, there were also 24 other prehospital systems trying to do the very same thing.

To make things worse, a significant portion of our population may be at risk if these agencies didn't find a medical director by January 1. Even though we voiced this and many other concerns to HealthONE/HCA, they stood by their January 1 deadline. It's unfortunate that the almighty dollar outweighs the best interests of the patient, but I guess it doesn't surprise me.

There are a whole host of other issues surrounding this problem, and fire and EMS will overcome this issue so our customers won't see any interruption in service.

My point in sharing this story is that you should be prepared for any wicked problem that may arise. Things that can help you prepare include surveying your environment; paying attention to what's going on locally, regionally and nationally; conducting a SWOT analysis to determine potential weaknesses and threats; and staying engaged with your business partners.

While these should help you to be prepared, there will always be a problem that appears out of nowhere, like our medical-direction issue. This is when you'll truly be put to the test, but success can still be achieved if you can improvise, adapt and overcome.

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