Leaders Meet on Top EMS Issues

More than 60 national emergency services leaders gathered in Washington, DC, in May to identify and discuss challenges facing EMS today and in the near future.

The invitation-only summit meeting, sponsored by the American College of Emergency Physicians (ACEP), was attended by representatives from all the major national EMS, fire and emergency healthcare organizations, as well as representatives from federal agencies, including the National Highway Traffic Safety Administration, EMS for Children, the Centers for Disease Control and Prevention, the Health Resources Services Administration and the U.S. Fire Administration.

Over two days, the group identified seven primary areas of concern, including:

• Workforce
• Legislation and funding
• Safety
• Leadership
• Quality of care
• Data collection
• Systems integration.

After in-depth discussions of each area, the group identified specific needs and challenges for each topic, as well as possible strategies for addressing those issues. It was the group’s belief that the summit meeting and subsequent report would be important at all levels of EMS, including national, state, local and tribal.

According to ACEP EMS Manager Rick Murray, “The summit’s deliberations will provide guidance to federal agencies, national organizations and to the development of national EMS reports and studies, such as the Institute of Medicine study on the future of emergency care in the U.S. health system or other national studies.”

The summit report is anticipated this summer and will be made available to the public on the ACEP website (www.acep.org). The group discussed reconvening in six months, but no decision was made if that will happen.

Issues Identified

Specifically, the EMS leadership summit identified the following issues as most important to the future of EMS:

Workforce: Leaders reported anecdotes about paramedic shortages and problems with recruitment and retention of EMS workers; however, it was agreed that there is a general lack of data to support this perception. The group agreed that a better understanding of EMS workforce issues was needed, as well as an understanding of the needs of the future workforce.

Legislation and funding: The group agreed that EMS has not been successful in obtaining sufficient federal funds because EMS lacks empowerment and identity in Washington, lacks clout in the political process and fails to speak to legislators with a single voice. The group identified a need to move toward creating a single voice with clear goals and talking points.

Safety: The group identified a general lack of national safety standards to guide training, equipment, worker ergonomics and working conditions such as shift length. It also agreed that, in general, EMS lacks an effective feedback system to collect, review and use safety data to guide safety improvements.

Leadership: The group identified a need for EMS to cultivate, support and encourage leadership development at all levels. It explored the development of leadership forums, the creation of leadership training fellowships and what it called leadership “toolboxes.”

Quality of care: Issues identified by the group related to patient care included patient safety; diversity of systems, geography and patients; and the need for a standardization of system performance measures.

Data collection: The group agreed that the ongoing need for data cut across all areas of concern. It noted the lack of federal and state funding to collect and analyze data and a lack of literacy in using data-collection technology. It also addressed regulatory barriers to data collection, such as patient privacy laws, and the lack of incentives for data collection. The group made a strong recommendation for more support of the National EMS Information System project.

Systems integration: The group addressed a lack of vision about EMS systems integration, a lack of modern communication tools and a voice-centric system that limited advancement.

In summing up the group’s efforts, ACEP EMS Committee Cochair Bill Jermyn, DO, reminded the group that “this was just a beginning” and that the value of the meeting was not only in identifying issues, but also in developing a new level of collaboration.

—Source: Best Practices in Emergency Services