Honoring the Best in EMS

EMS World and the National Association of Emergency Medical Technicians (NAEMT) established the National EMS Awards of Excellence program to recognize outstanding achievement in the EMS profession.

The 2013 awards will be presented on Monday, September 9, at the NAEMT Annual Meeting in Las Vegas, held in conjunction with EMS World Expo 2013, and at the EMS World Expo Opening Keynote on September 10.

We would like to thank the following sponsors of this year’s awards: NAEMT/Nasco Paramedic of the Year Award sponsored by Nasco; NAEMT/Braun Industries EMT of the Year Award sponsored by Braun Industries; NAEMT/Jones & Bartlett Learning Educator of the Year sponsored by Jones & Barlett; Dick Ferneau Paid EMS Service of the Year sponsored by Ferno; and the Impact Volunteer EMS Service of the Year sponsored by Impact Instrumentation.

Award recipients receive a monetary award, a three-day core program registration to EMS World Expo, plus $1,100 for travel and lodging to attend EMS World Expo and the NAEMT Annual Meeting.

The nomination period for next year’s awards will open in early 2013. Visit EMSWorld.com/awards for more information and to read profiles of past recipients.

2013 NAEMT/Nasco Paramedic of the Year: Shawn Mease, NREMT-P, Richmond, VA.

Mease is a paramedic with the Richmond Ambulance Authority in Richmond, VA. He was nominated by his colleague Anna Ailstock, NREMT-P, PNCCT, ALS field training officer, who states that Shawn’s dedication to maintaining and improving Richmond Ambulances Authority's reputation for world class EMS is second only to his dedication to patient care and compassion.

Mease is the current chairman of the Richmond Ambulance Authority’s Clinical Services Committee. As chair, he is responsible for assessing needs for clinical change through evidence-based practices in collaboration with clinical and operational departments.

He evaluated the need for revision of patient care protocols and produced a protocol book that was adopted as standard for the Old Dominion Emergency Medical Services Alliance (Virginia) region. Shawn’s project list on the committee included the implementation of Per-Trache kits (Pediatric and Adult) on every ambulance; use of nasal capnography on patients other than respiratory, including seizure patients; and development of a critical care course of study and Richmond Ambulance Authority’s first comprehensive preception manuals and associated field training officers manuals. In addition, Mease coordinates and instructs courses in PHTLS, AMLS, ACLS, PALS and CPR.

Patients and coworkers comment on Mease’s focus during difficult situations. “Shawn has a natural ability to bring calm to frightening situations and ease the minds of confused and scared patients and family members,” Ailstock says. “Shawn strives to instill in each new provider the skill, professionalism and compassion that he shows every day to patients and their families.”

2013 NAEMT/Braun Industries EMT of the Year: Paul Schueth, Adv EMT, Winner, SD

Schueth is an Advanced EMT with Tripp County Ambulance in Winner, SD. He was nominated by Katheryn Benton, a state training officer in Chamberlain, SD. Schueth started his EMS career as a volunteer for Tripp County Ambulance more than 35 years ago. In his early years as an EMT, he served as the unofficial ambulance director with a couple of other volunteers. He was later elected to serve as the official director, a position in which he continues to serve with pride, honor and compassion.

During his tenure at Tripp County, Paul has been actively involved in securing funding for technological upgrades for the ambulance service, as well as in planning training workshops. He regularly works with local healthcare agencies to ensure continuity in patient care. He is known for his resolute and careful work during “worst-of-the-worst” situations such as the blizzards and thunderstorms so often seen in South Dakota.

“Paul is always willing to go above and beyond the call of duty and takes great pride in his profession. He has given continuous and selfless service to the citizens of Tripp County in their time of need,” says Benton. “He has an excellent work attitude, which radiates to his fellow employees and colleagues and is an asset to his team, county and the community in which he proudly serves. His desire to serve without an expectation of honors or recognition clearly demonstrates his unselfish commitment to community. Paul is truly deserving of this award.”

2013 NAEMT/Jones & Bartlett Learning Educator of the Year: Robert Ditch, EdD, Mesa, AZ

Ditch is an educator at the Arizona Academy of Emergency Services in Mesa, AZ. He was nominated by Taylor Bradford, director of operations for the academy.

A retired, highly decorated Colonel, having served for over 32 years in the Air Force Medical Service, he has more than 40 years of EMS experience and completed a doctorate in education with a specialization in Emergency Services Higher Education. Ditch is also an adjunct assistant professor in the School of Medicine and Health Sciences at George Washington University in Washington, D.C.

Ditch is a nationally registered paramedic, licensed in Arizona, Virginia and Texas. Since leaving the military, he has dedicated his retirement years to focusing on bringing quality EMS education to the nation’s EMS providers. Much of his time is unpaid, with travel and instruction funded out of his own pocket as a volunteer EMS educator. Although he teaches over 30 different curriculums, he is most recognized for his voluntary development/instruction of terrorism response courses for EMS responders.

In addition to his time training others in emergency management, Ditch has been deployed to numerous in-need locations, including 14 national-level disasters such as Hurricanes Katrina and Rita in 2005, the 2010 earthquake in Haiti, and Hurricanes Isaac and Sandy in 2012.

Ditch’s long list of accomplishments and contributions to EMS education nationwide exemplifies the spirit of volunteerism and unbridled passion for pre-hospital care training and education he personifies. “Dr. Ditch is the quintessential champion of EMS education excellence,” Bradford says. “I cannot think of anyone else who deserves this recognition more than Dr. Bob.”

2013 Dick Ferneau Paid EMS Service of the Year: Medstar Mobile Healthcare, Ft. Worth, TX

This year’s Dick Ferneau Paid EMS Service of the Year is MedStar Mobile Healthcare of Ft. Worth, TX. 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.

2013 Impact Volunteer EMS Service of the Year: Kiowa County EMS, Greensburg, KS

Lots of small, rural volunteer EMS agencies are forced to do more with less. That’s often the result of budget cuts, or declining revenue. In the case of Kiowa County (KS) EMS, it was also due to a tornado.

On May 4, 2007, a series of tornadoes began tearing across the central U.S., the most destructive of which hit Greensburg, KS, home to Kiowa County EMS. About 95% of the city was destroyed by the EF5 tornado. At least 13 people were killed; at least 60 were injured. And Kiowa County EMS was left with just one surviving ambulance and a fifth-wheel trailer with which to care for its community and rebuild its service.
In just six short years the turnaround for KCEMS has been nothing short of remarkable.

The Impact Volunteer EMS Service of the Year now boasts three ambulances and two quick response vehicles, which its 13 crew members use to cover more than 300 requests for service in a 720-square-mile service area each year. The credentials of those providers also stand out. Of the 13, seven are paramedics, along with four EMTs, one RN/first responder and one first responder. More than one third of KCEMS’ calls are trauma-related and another quarter are interfacility transfers, while the rest are either medical-related or standbys for various events or fires, according to KCEMS Director Chad Pore, MS, IC, paramedic.

KCEMS, which is managed by Kiowa County Memorial Hospital, benefits from dedicated funding through the county and user fees. But Pore notes a problem plaguing many volunteer agencies: “While this is nice in years where our collections are higher than projected, it’s difficult when collections are decreased. We worked with $30,000 less in 2012 and are projected to work with $20,000 less in 2013.” KCEMS’ overall operating budget in 2012 was $278,000, with $165,500 dedicated from the county and remaining funds coming from a combination of user fees, grants and donations.

As with most agencies, Pore says, KCEMS’ number one expense involves its crew members, whether it’s payroll, education and training, uniforms, etc. “To ensure we can reduce costs and maximize limited funding we have focused on finding funding from other avenues,” Pore says. “We’ve received grants for vehicles, cardiac monitors, power cots, education/training and smaller equipment purchases—including EZ-IOs, King Vision video laryngoscopes and even AEDs for the community. These grants have allowed us to utilize our primary funding on crew members. We have also sought and received donations for specific equipment from places like the Lions Club and our regional community foundation.

“One thing we have focused on is reducing cost on our actual purchases,” Pore continues. “For instance, our first new ambulance purchase after the tornado was a Sprinter ambulance. This was significant because we typically have around 60–70 transfers each year, with most of those going two hours away to Wichita. We saw an opportunity to save money up front and long-term by purchasing the Sprinter. It was $40,000 less than our newest Type-III ambulance and saves us about $3,000 each year on fuel and maintenance costs. While these numbers may not seem big to many agencies, they’re huge to rural agencies.”

Another example of how doing more with less doesn’t have to be a burden is KCEMS’ recent reduction in the number of medications providers carry, according to Pore. “Many EMS agencies carry a slew of medications for the ‘just in case’ scenario,” he explains. “While it is beneficial to have a large number of medications available to cover many situations, we’ve found our patient care has improved by removing many medications. Last year we reviewed all of our medications to see how often and how much of each was used. What we found allowed us to remove over 15 medications. This allowed our crew members to become more familiar with the medications we were actually using and improved their confidence to manage patients. It can be difficult in smaller services to ensure crew members retain all of their skills and this includes thorough knowledge of medications. By reducing the number of medications we carry we’ve witnessed an increase in competence regarding medication administration.”

That increased confidence is also one reason KCEMS is working on revising protocols to allow more freedom to its providers, Pore says. “One example would be the new pain management protocol. This protocol simply states, ‘administer fentanyl or morphine as needed for pain control, while maintaining level of consciousness and hemodynamic stability.’ This change shows we understand every patient encounter is different. It’s difficult to put all patients—or even the majority of patients—into one basket, as it hampers the ability of our technicians to care for all patients. Giving them flexibility and trust to fully assess and care for their patients is a high priority for us. Having protocols that create “monkey medicine” or limit the abilities of our technicians is unacceptable.”

Like other volunteer agencies, community outreach is a big part of what KCEMS does, too, Pore says. The agency is committed to providing free CPR and AED training throughout the county, including training students in grades 6–12 in CPR every two years. The focus, Pore explains, is primarily on compression-only CPR, with the long-term goal of improving bystander CPR given the limited resources and large size of the county.

Additionally, KCEMS began its own child car seat program and started Safe Kids Kiowa County. A couple of years ago, Pore says, a 4-month-old child in the county died in a car accident due to incorrect placement of a car seat. KCEMS sent two providers for training as Child Passenger Safety Technicians and implemented a car seat program. “Twice a year we have car seats provided to us free from the state of Kansas,” Pore says, “and we provide those car seats free to people in Kiowa County. The only catch is the child has to be here in person so our CPSTs can fit the right seat to the child and ensure proper installation. Part of the installation is also providing education to the parent on how to properly fit and install the seat. Since this program started we have not had any major incidents with children in car seats being critically injured or killed.”

The goal in starting a county Safe Kids program was to provide safety education for kids in the hopes of decreasing unintentional injuries. Since starting the program KCEMS has been named Kansas Safe Kids Coalition of the Year and, more important, provided safety education to every child in Kiowa County between kindergarten and 8th grade. “Our most recent event was a summer safety program where kids moved between eight stations, including ATV safety, lake safety, fireworks safety, lawnmower safety, fire safety, Airsoft gun safety, pool safety and poison prevention.” Previous events also included bicycle rodeos, where KCEMS distributed free bicycle helmets, and Child Passenger Safety Week, with programs specific to various age groups.

KCEMS also continues to strive for ways to help its crew members maintain their skills. “We’ve been working on improvements to our education and training programs,” Pore says. “Currently we’re working to finalize an opportunity for our crew members to ride with a busier service twice each quarter so they can get more run volume while improving/maintaining their skills. We’re always looking for ways to help our technicians get more opportunities.”