Recommendations Made by EMS Advisory Council to Enhance Pre-Hospital Care

WASHINGTON, D.C. -- The National EMS Advisory Council has made a number of recommendations it feels may enhance the country's pre-hospital care system.

To say the 26 members and ad hoc advisors hit the ground running would be an understatement, said Dia Gainor, who served as NEMSAC chair.

After reviewing more than 400 applications from stakeholders from around the country, the Secretary of Transportation selected 26 people in 2008 in to tackle the mission of advising NHTSA's office of EMS.

Gainor, Idaho's EMS director, said she heard a common theme emerge during that inaugural meeting. "Everyone sees the need for safe, reliable, capable and accountable EMS systems."

NHTSA's EMS Director Drew Dawson has been impressed by the group's commitment, adding that they understood their input could impact the future direction of EMS.

He refers to the council as some of the "Who's Who" in EMS.

After an initial brain-storming session to identify the most important issues facing EMS, the council narrowed them down to about 10 specific topics. Then, the group was divided into committees -- safety, education and workforce, systems, oversight, analysis and research and finance.

Ad hoc members with expertise in those fields were appointed to participate in the process.

In addition to the full council meetings held in the Washington area, the committees held teleconferences to work on their issues, Gainor explained.

Gainor, who has applied for re-appointment to the council, called it a life-changing experience. "It was an honor to be working with leading thinkers in every walk of EMS...It was awe-inspiring..."

In addition to the recommendations, the council also developed a white paper and issued two position statements.

Dawson said no words can explain his appreciation to the council. "They did just an outstanding job. They spent considerable time and effort to develop the report and recommendations..."

In addition, the group also made suggestions on how the next council should proceed or issues that need to be addressed.

Just as with the original group, it will be up to them on what concerns to research.

He said some of the NEMSAC members have applied for re-appointment. The selection process is currently underway, and he is confident that some continuity will be maintained

"The council was very dedicated. We were fortunate to receive this quality of work..."

Among NEMSAC's recommendations to NHTSA and FICEMS include

• NHTSA work with FICEMS to assure integration and utilization of EMS illnesses, injury and fatality surveillance databases across federal agencies.
• NHTSA encourage and develop relationships between federal and non-federal partners utilizing existing reporting systems to improve consistency of terminology ad access to data sources on EMS illnesses, injuries and deaths.
• FICEMS should identify opportunities for enhanced federal collaboration to expedite the implementation of the EMS Education Agenda for the Future by the states.
• NHTSA should publish a regular report card on the national implementation of the EMS Education Agenda for the Future.
• Support federal effort to expand, enhance and fund EMS research based on operation, financial and medical outcomes criteria
• Develop and publish key performance indicators for EMS systems to measure and monitor performance.
• Share recommendations of the various agencies so EMS is not left out of the discussion on health care reform.
• Support federal effort to expand EMS grant funding so that EMS agencies can implement NEMSIS compliant recording and reporting.
• FICEMS should adopt the EMS Culture of Safety as a core value and support it in their agency grants, programs and policies.
• FICEMS should help identify and engage with safety expertise and resources in other Federal agencies. (NTSB, FDA, etc)
• NEMSAC recommends that NHTSA support efforts to raise the baseline national ambulance fee schedule to end the discrepancy between cost and reimbursement as identified in the GAO report.
• As with any change in a system, changes in clinical practice and reimbursement policy have system impacts. NEMSAC recommends that NHTSA utilize whatever governmental entity is best including but not limited to FICEMS, CEMC and the Office of Health Care Reform to support systems and cost effectiveness research so as to evaluate the efficacy and the economic effect of these recommendations. Such research could develop "Utstein-like" research and reporting criterion for each of the disease states identified as being effectively treated by EMS.