Maryland EMS Task Force Recommends New Staffing Strategies

As in many jurisdictions throughout the country, Maryland is struggling to attract EMS personnel, especially those certified to provide advanced life support.

That was one of the conclusions reached by a task force that studied the state's EMS system in an effort to develop strategies for recruitment and retention programs.

While Maryland has seen a 10 percent increase in the number of EMS calls in the past four years, the number of serious incidents declined 13 percent between 1999 and 2003. The group suggested that protocols be reviewed regarding the dispatch of ALS units. In some instances, they are being sent on what should be a BLS transport.

Surveys were made available to the state's 19,551 certified providers from EMT-B to EMT-P, and 15 percent participated. Among the issues addressed were reasons for providing care, things they felt are important and factors that had them thinking about quitting.

The lack of recognition for their service was listed as a major issue that had people thinking about getting out of EMS. Volunteer and career personnel said they don't feel the public understands or appreciates their contributions. "Providers expressed frustration with the number of unnecessary calls... The end result is a service that burns out its human resources on calls that do not require an advanced level of care."

A requirement in some jurisdictions that EMS providers become firefighters also was cited as a serious issue that needs to be revisited. "The demands of cross-training... were highlighted as a barrier for recruiting EMS providers," the report stated.

The task force also pointed out that there are few women and minorities involved in EMS compared to the state population, and specific recruitment programs should be established.

Those who complained about the hours involved for recertification may be hearing news soon as the Maryland Fire-Rescue Institute is reviewing the program, and may offer online courses soon, said Steve Edwards, director.

Among the task force's recommendations are:

• EMS officials should evaluate the current delivery system to develop new approaches for more efficient use of ALS providers.
• Take every opportunity to educate the public about Maryland's EMS system and the relationships between providers, hospitals, trauma and specialty centers.
• Funding should be provided for a statewide wellness program that monitors the health and fitness of all EMS personnel.
• A program should be developed to encourage school systems to implement EMS cadet programs for high school students.

The executive director of the Maryland Institute for Emergency Medical Services Systems (MIEMSS), Dr. Robert Bass, called pre-hospital providers a vital component of the state's EMS network.

"Retention and recruitment is an issue that we know we need to address. We looked at trends to see what we can do to help," he said.

"The very nature of the work, possible exposures as well as the time constraints involved... there are a lot of strains on providers."

Dr. Bass said the report has also made officials more aware of budget, dispatch and salary issues as well. "We need to make sure that we're using our paramedics more efficiently."

The task force was established by Dr. Bass, and included representatives of the Maryland Fire-Rescue Institute, Maryland State Firemens Association, Maryland Council of Academies and the Metro Fire Chiefs Association.

Officials and members of volunteer, career and commercial EMS companies as well as educators also were part of the panel.