Monthly Archives: July 2012

Quick Thoughts from Pinnacle EMS 2012

Last year one of the Pinnacle attendees was quoted to say it was ‚Ä?the most innovative and thought-provoking event of the year.‚Ä? This year, I will have to admit that this truly has been one of the best conferences I have attended in a while for the quality of the discussions and relationships it has initiated. From the pre-conference power seminars to the keynote and concurrent general sessions, attendees have consistently been challenged with new ideas relating to the future direction and operations of EMS.

On Monday, I attended the session on ‚ÄúEffectively Using Social Media‚Ä? with¬†Greg Friese,¬†Carissa O‚ÄôBrien, and Skip Kirkwood. Even though I work with social technology every day, I still heard many practical and well thought out approaches such as learning to leverage social technology internally first before trying to promote it outwardly ‚Äď especially as a large organization. Aetna was a great example of how some organizations are really doing social right. Relating it more directly to EMS services, there was talk of developing not just a social media ‚Äúpolicy‚Ä? of ‚Äúdos and don‚Äôts‚Ä? but a ‚Äústrategy‚Ä? of what you hope to accomplish with it. Social is also not something you simply assign to the young intern because they might be comfortable with technology, but must be directed as a strategic corporate resource. Listening is the best way to begin, but this is not just how you need to get started in social media, but more importantly how you stay engaged. There are several listening tools that can help you know what is being said about you and to help you take appropriate action which may, or may not, involve a ‚Äúsocial‚Ä? response. There were several other points I found worth noting and they can be found in my¬†Twitter feed¬†going back to July 16. Opposite this session was the wildly popular ‚ÄúCommunity Paramedicine‚Ä? session facilitated by Kevin McGinnis, Chris Montera, Anne Robinson, Brent Myers, and Gary Wingrove. This was clearly a topic of interest to many throughout the week.

Tuesday brought several more good pre-conference sessions such as the ‚ÄúImplementing ‚ÄėJust Culture‚Äô to Improve Safety in Your Organization‚Ä? with Paul LaSage, Larry Boxman, and Michael Greene as well as user group meetings including¬†FirstWatch¬†and¬†MARVLIS. Finally, the ‚ÄúLeadership Under Fire‚Ä? keynote presentation by Navy SEAL Lt. Cmdr. John ‚ÄúJocko‚Ä? Willink really fired folks up. Many interesting parallels were drawn between military operations in Ramadi and the daily operations of EMS across the country. The concept of ‚Äúextreme ownership‚Ä? seemed to strike a chord with every manager in the room. While it can be difficult to try to summarize all of the details Jocko shared with us, he helped make it concise in his own summary admonishing us to ‚ÄúCover & Move‚Ä? (translated as working as team), Simplifying operations for maximum effectiveness, Prioritizing and Executing sequentially on those most important objectives, and Decentralize command through empowering your workers with ‚Äúextreme ownership‚Ä?. If this session was recorded, I suggest trying to find a copy of it to watch.

Wednesday began with the tradition of topical breakfast discussions and was followed by an address from Jay Fitch asking ‚ÄúIs Your Organization Agile or Fragile?‚Ä? After literally breaking some metaphorical ‚Äúdinosaur eggs‚Ä?, Jay introduced some of the drivers of change in our industry and described the foundation of agility to include effective Leadership, appropriate Processes (use of data and technology), and cultivating a Performance-based culture. Using a Star Trek metaphor, Jay suggested we keep focus on our ‚Äúprime directive.‚Ä? His ‚Äúhomework assignment‚Ä? to everyone was to think of at least 2 or 3 ‚Äústupid‚Ä? things your agency as non-value-added processes to be removed in order to improve the customer experience.

The most “provocative” session of the day had to be the ‚ÄúGame-Changers for EMS & Fire Deployment‚Ä? with Mike Ragone and Guillermo Fuentes which was an abbreviated version of the longer pre-conference session the day before entitled ‚ÄúThis Changes Everything: Future Operational Models for Public Safety.‚Ä? There were several jabs taken at traditional fire services questioning our attitude toward response and how it is likely to change with the pressures of decreasing numbers of actual fire calls, increase in the number of medical responses, and decreasing budgets causing politicians to reconsider current funding levels as well as basic business models for emergency response. My tweets on several of these sometimes ‘irreverent’ statements drew immediate and interesting debate on Twitter. Probably my favorite discussion was centered around the deployment of heavy fire equipment for medical calls. For comparison, a responding SUV has a per mile cost of $3.42 while an engine has a mileage rate of $28.22 and trucks are up to $33.05 per mile. In many cases, these ‚Äúfirst responders‚Ä? arrive only one minute before advanced medical assets so what is the real value of this substantial cost? These questions were meant to evoke some passion as a recognition that political changes due to economy and lower tax revenues is causing local governments to re-evaluate public safety spending in general. ¬†The real question was about how do Fire and EMS services adapt to these new realities?


Filed under Administration & Leadership, Conferences, EMS Topics, Training & Development

A Bibliography on EMS in a State of Change

Most scientists agree that earthquakes are difficult to predict, but last Thursday should have been a “gimme” regardless of how the Supreme Court would have ruled. †Independent of your perspective on the ruling, we now know how health care reform will play out – at least until the next major shift changes the landscape again. †There are some fine articles that have looked specifically into the basics of U.S. healthcare, reform and the high court, or†How Health Reform Could Hurt First Responders, even†What the†Supreme Courtís health care decision doesóand does notómean. †Also, hospitals are seeing the†healthcare ruling as a new challenge and suggest that†Federal Proposals Would Limit Aggressive Hospital Collections Practices. †So I have no intention to try to argue any of those contributing factors. †There are still many other factors affecting the future of emergency health care delivery that aren’t getting as much press attention even though their impact is at least as important. †Make no mistake, reform is coming to EMS!

Steve Whitehead at The EMT Spot blogged on the 7 Myths About Fixing Our EMS Systems. †It is a well-thought out article focusing on how to improve the system, but doesn’t approach the underlying causes. †From my perspective, one of the most important influences I see making an impact is politics. †In the article†Ambulance debate rough road: Government could grow, it is clear that local politics specifically regarding government is driving too many decisions. †The Mayor of†Columbus appears to be favoring a significant initial investment along with an annual subsidy to expand the local fire department rather than award a contract to one of the service providers claiming no subsidy would be required. †This also brings to mind the case in Utica, New York where the city sees an opportunity to actually generate municipal revenues through an ambulance service even though they could not certify a need as the†Revised bill on ambulance plan still a bad policy†opinion article suggests. †Which brings me to my second primary factor of money. †There are too many differences in how EMS is funded. †Unlike the fire and police department, which are so-called “free” services paid completely through your taxes, most EMS agenices charge for their services, going through your health insurance where they can. †Some operating costs are also covered by various combinations of property taxes, usage fees, or subscription fees without any consistency between jurisdictions. †There are many ongoing debates including this one by Letter: Emergency Medical Services In Great Neck. †But as long as there are such diverging funding schemes, Continue reading


Filed under Administration & Leadership, Dispatch & Communications, EMS Dispatch, EMS Topics, News