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Emergency Medical Services: I Spy with My Little Eye?

Another article in this issue of On Scene asked a number of fire and EMS leaders what they felt the biggest issues, challenges and opportunities will be in 2012, why these are important and what you need to know or do to prepare for these.

When I was asked these same questions, I thought these would be fairly easy to answer. However, the more I thought about this, the more I wished I had a crystal ball that could provide the answers. Why? There are so many issues facing EMS that it’s pretty hard to provide a clear picture, much less an answer.

But here’s a short list of issues and challenges, in a slightly different format than you usually see:

  • A lead federal EMS agency – Will there be one? What will this agency look like? What will EMS look like once under this system? Is there funding for this? If so, where will it come from?
  • Budgets – Will they get better? Will they get worse? Is your current budget the new norm? Will we be expected to do more with less? Will we still exist? Will we see an increase in consolidations and mergers to try to become more efficient and survive?
  • Volunteers – Will we continue to see a decline in these ranks? Will volunteers be able to maintain a continual increase in training requirements? Can they still afford to volunteer in these economic times? Will career or combination departments look to augment their ranks with more volunteers? If we have them, how do we keep them?
  • Technology – Hardware is being developed faster than software; legacy systems are having a hard time keeping up. Do you buy the latest gadget? What do you do when it’s outdated in six months? Do you have the funding to pursue new technology? Is it really making a difference?
  • Drug shortages – Is your agency being affected by this? Have you changed protocols to accommodate the shortage? How is this affecting patient care? Are we going to see a more widespread shortage of more medications? Will patients increase their use of EMS because they don’t have the meds available to address their medical issue?
  • Patients – Baby boomers are continuing to age; what are your demographics? Is this going to increase your call volume? Can you handle this increase on your same budget? With your same personnel? And still provide quality care?

Some of these issues and challenges are also opportunities. How?

  • A lead federal EMS agency – This is our chance to help influence our destiny. We need to work with all of the players to create a system that works for the majority while not forgetting that our patients are the reason we exist. We may also be able to address funding here that will ultimately help the next item.
  • Budgets – We continue to learn how to do more with less. Some areas are seeing some relief while others continue to struggle. We know federal funds are tight and grant funds continue to shrink. Are there opportunities to collect fees for other services? Is a public-private partnership possible for some services? This may also be an opportunity to explore the use of part-time employees and volunteers to potentially fill gaps by the loss of full-time positions.
  • Technology – Technology will continue to rapidly advance and will certainly offer fire and EMS a whole host of opportunities to improve the level of service we provide. From improved monitoring and care abilities of patients to NG911 and the D block, the opportunities before us are almost unlimited. Great things are coming. Just think back to what technology looked like 10 years ago. We’ll see that same level of advancement in two years, if not sooner.
  • Patients – Patients will remain our customers, and we should continue to serve them with the highest level of service possible. These patients are also voters, and when they feel they have been treated well, they typically respond in kind. Continue to educate your community on the services you provide, stay involved and make sure your employees understand the importance of this. When our budgets are under attack, our customers are our best allies.

So, these are just my predictions for next year. Don’t place any bets on this, since we all know how rapidly our environment changes.

But I think the calendar does end next year, doesn’t it? Wait, doomsday was supposed to happen this year. Twice, I think.

Hmm—Maybe I do need to find that crystal ball.

Norris W. Croom III, EFO, CMO, is the deputy chief of operations for the Castle Rock (Colo.) Fire and Rescue Department. He’s been a member of the EMS Section since 1998 and currently serves as the section’s director at large.

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