I am pleased to announce the availability of my latest paperback book. As a consultant working with agencies across the nation that are representative of many distinct models of service, as well as being an EMS provider and a chief fire officer myself, I feel highly invested in the process to improve strategic dispatch and deployment decisions. It is my unique collective experience gained over more than 13 years of consultation and experimentation that is shared through these pages. Even in these years spanning the pandemic crisis followed by an ongoing paramedic shortage, I have witnessed multiple significant changes of focus within the industry providing emergency medical care.
Still, the prime objective “to provide each critical patient the best possible chance of survival without disability or medical complication, given the current state-of-the-art of prehospital care technology,” professed so eloquently by Jack Stout in his articles published by JEMS in the 1980’s, remains a guiding light. However, the details necessitate some update to truly achieve this directive while juggling a growing list of constraints and corporate objectives in an environment of highly advanced computing capabilities.
The foundational concept that drove the development of this book is that any agency who responds to emergency requests from the public needs to thoughtfully consider where their resources are located when they are not actively engaged on a call. It is not just about response times for outcomes, safety, or even efficiency that drives operations. The consistent idea across the many diverse strategies discussed in this book is that the place these units wait to respond clearly communicates the values that a service prioritizes. This work challenges the traditional thoughts of simply automating the tasks of deployment and dispatch by looking at ways to leverage them instead as tactical opportunities specifically to coordinate successful organizational strategies beyond just immediate responses.
As a result of the increasing constraints on high-demand emergency resources, our crews must be used wisely and with special attention to their distribution over both space and time. And, further, we must acknowledge that each deployment or dispatch decision, whether we follow a formal plan or not, has an impact on the crews and the patient as well as any performance metrics of the agency. These three constraints are inextricably intertwined and often mutually contradictory.
I am particularly proud to have Jack’s son, Todd Stout, the Founder and President of FirstWatch, say this about my efforts, “This book is a thoughtful and detailed examination of my father’s work and shows ways it can be applied and updated for modern concerns and technology. Dale has done a masterful job of combining EMS history, SSM theory, practical information and explanations of real-world implementations using the MARVLIS system. Definitely worth a read!“
As much of the implementation of these ideas involves the telecommunicators within the communications center, I also received valuable advice from Jerry Overton, who serves as President of the IAED who also addressed my work saying, “With limited resources, it is appropriate to reflect on the way we deploy and dispatch ambulances. In these pages you will find valuable discussions to help improve patient care as well as the efficiency of your operations. In my own experience, MARVLIS just works.“
I hope that the time and effort I poured into these pages causes each reader to think deeper and reflect upon the conscious or unconscious choices being made each minute that impact our patients and our providers. The fact that we can do better ought to drive us to make improvements, not for the mere sake of change, but to improve whatever goals are important in the moment to provide better outcomes regardless of how they are measuered.
High Performance EMS 