So far all the planning and data crunching has been devoted to the first 10 minutes or approximately 1/6th of the patient response episode. It is ironic that some organizations set their store in, and are judged on, their response times alone. It’s not “high performing” if you are good at racing to the scene only to be incapable of delivering the clinical goods on arrival. A well-trained workforce that has sufficient preception, mentoring and training, and is clinically current, is an absolute requisite for success. To achieve this, the involvement and active engagement of the Operational Medical Medical Director (OMD) must occur (often).