The End of EMS

The National Association of Emergency Medical Technicians (NAEMT) and EMS World, in conjunction with the National EMS Management Association (NEMSMA) and National Association of EMS Educators (NAEMSE), established the National EMS Awards of Excellence program to recognize outstanding achievement in the EMS profession. The 2013 awards will be presented on Tuesday, Sept. 10, at EMS World Expo in Las Vegas.

We would like to thank the following sponsors:

• The NAEMT Paramedic of the Year Award is sponsored by Nasco;
• The NAEMT EMT of the Year Award is sponsored by Braun Industries;
• The Dick Ferneau Paid EMS Service of the Year is sponsored by Ferno;
• The Impact Volunteer EMS Service of the Year is sponsored by Impact Instrumentation, Inc.; and
• The NEMSMA Executive of the Year is sponsored by EMS World.

Winners receive a $1,000 award stipend, a three-day core program registration to EMS World Expo, and $1,000 for travel and lodging to attend EMS World Expo and the NAEMT Annual Meeting.

The nomination period for next year’s awards will open [when]. Visit EMSWorld.com/awards.

This year’s Dick Ferneau Paid EMS Service of the Year is MedStar Mobile Healthcare of Ft. Worth, Tex. There are a lot of reasons for that, and we’ll get into them, but if you want a short answer or single thumbnail act to explain why, take its name.

Earlier this year MedStar EMS became MedStar Mobile Healthcare, a change intended to reflect the service’s burgeoning role as a full-fledged provider of a broad spectrum of community healthcare services that transcend traditional emergency care.

The paint is still wet on mobile healthcare as an industrywide concept, and while a few big systems have embraced it aggressively, MedStar was the first to make such an unreserved public commitment as breaking with the name EMS. This new approach, the move announced, is who we are and will be our future.

“We feel it’s putting our money where our mouth is: If we’re going to preach this stuff, then we should brand ourselves to represent our beliefs,” says MedStar’s executive director, Doug Hooten. “We’ve believed for a long time that we’re not just an ambulance transportation company; we practice medicine and healthcare every single day, and we need to be viewed in that venue.”

MedStar’s been involved in mobile healthcare types of efforts for four years now, and its belief in the concept approaches the evangelical: “One of our primary missions,” service leaders said in applying for the Ferneau award, “has been to educate our entire industry on the benefits of becoming more involved in the delivery of healthcare.” To that end its leaders have hosted more than 64 agencies from 29 states and four countries in two years for visits to learn about new roles and opportunities in EMS’ future, and presented on it at more than 30 conferences.

Similarly, the service has been unafraid to change, innovate and improve across all areas of its operations and medicine. The name change was but a shorthand representation of its entire organizational approach.

“We try to create a culture here that allows people to bring innovative ideas to the table and come up with new ways to do things,” says Hooten. “We work very collaboratively across lines. In our area there’s a tremendous collaborative spirit among all the healthcare and public safety providers unlike I’ve seen anyplace else. It’s one of coming up with solutions to things that plague our communities every day.”

In the realm of community care and mobile healthcare, here are some of the solutions MedStar has found:

• 9-1-1 nurse triage for low-acuity callers—Certain callers can be referred by a dispatch-certified in-house RN to resources more appropriate to meet their nonemergency needs. More than 40% are successfully steered more suitable help, care coordination and follow-up.
• Congestive heart failure program—Hospital patients at risk for 30-day readmissions get home visits and education, medication compliance checks, and weight and diet compliance monitoring. In some cases MedStar providers can give diuretics. The program has reduced readmissions in its target population by almost half.
• Hospice revocation avoidance—Hospice patients may risk disenrollment for violating rules regarding their use of 9-1-1. MedStar works with hospice authorities to supplement their care and prevent this. Of 35 patients enrolled in this program, just one has had their hospice status revoked.
• Observation admission avoidance—Working with its local ACO (accountable care organization), MedStar visits the homes of certain patients who may otherwise be held for observation to ensure they’re OK without being hospitalized. Providers conduct risk assessments and help patients follow up with their primary physicians. The program has saved more than $7,000 per patient in overnight-stay costs, with no ED readmissions prior to follow-up with docs.
• “EMS loyalty” program—Patients who call 9-1-1 15 times or more in 90 days get regular home visits from mobile healthcare providers who work to connect them to needed resources and help them better manage their healthcare.

Beyond all this are many more traditional prehospital innovations and best practices. Some high points:

• No-transport follow-ups—When patients refuse transport, crews leave informational brochures about their condition with signs and symptoms that should prompt a call-back; the service then follows up by phone.
• Tissue donation—A new plan will let medics suggest and facilitate tissue donation when resuscitations are terminated in the field.
• Physical ability testing—MedStar has worked with researchers on a physical ability testing process for new hires and those returning to work. It’s also adopted the NAEMT Safety Course.
• Safe Communities initiative—MedStar has been a key player on several local task forces (e.g., drowning prevention, crash safety, domestic violence prevention) that have helped Ft. Worth earn a coveted “Safe City” designation from the WHO.
• It has also joined the NAEMT’s efforts to develop a Principles of Ethics and Personal Leadership (PEPL) course and create “ambassadors” for the profession. It provided an expert to help develop the curriculum and hosted an initial beta-test in May. National rollout is due this fall.

For more: https://www.medstar911.org, https://www.medstar911.org/community-health-program.