Episodes
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In this episode of the EMS One-Stop podcast, Dr. Edward Racht and Matt Zavadsky join Rob Lawrence to discuss their recent attendance at the U.S. House Committee on Ways & Means hearing on “Access to Health Care in America: Ensuring Resilient Emergency Medical Care,” which took place in an off-site hearing in Denton, Texas, on March 18, 2024.
Dr. Racht, chief medical officer of Global Medical Response; and Zavadsky, chief transformation officer for the Metropolitan Area EMS Authority (MedStar Mobile Healthcare) discuss the evidence and the key issues they conveyed to the committee.
Dr. Racht's testimony included:
The significant advancements made in emergency medicine over the past decades, leading to reduced mortality and disability rates for patients.
The importance of updating Medicare reimbursement rates for ambulance services, which have not been revised for over 20 years.
Advocating for wholesale reform of Medicare's coverage of emergency medical services to align with contemporary practices, such as covering treatment in place and transportation to alternative healthcare sites.
Matt Zavadsky's testimony included:
The impact of CMS payment policies on EMS, which incentivize unnecessary transportation of patients to the emergency room.
Innovative programs initiated by EMS agencies to prevent unnecessary 911 calls and navigate patients to appropriate care settings.
Legislative changes required to provide EMS with flexibility in patient navigation, including treatment in place and transport to alternate destinations.
The challenges faced by ambulance services nationwide, especially in rural areas, exacerbated by the COVID-19 pandemic.
Top quotes from this episode“We are the front of the frontline in medicine.” — Dr. Ed Racht
"Our coordinated and integrated EMS and healthcare system now gives gravely injured patients ... the opportunity for rapid surgical intervention and a chance at full recovery." — Dr. Ed Racht
"Emergency healthcare professionals pride ourselves on our ability to dramatically decrease morbidity and mortality from unexpected and sudden illness and injury." — Dr. Ed Racht
"CMS payment policy is such that we are incentivized to transport every 911 patient to the ER because that is the only time we get paid." — Matt Zavadsky
"Ambulance services are a vital component of our local and national healthcare and emergency response systems." — Matt Zavadsky
"Innovative EMS agencies ... have initiated patient-centric programs designed to prevent 911 calls and navigate patients to the most appropriate care setting." — Matt Zavadsky
"Ambulance services across the nation, especially in rural areas, are facing unprecedented challenges." — Matt Zavadsky
Episode contents0:05 – Introduction
0:55 – Guest introduction
1:40 – Explaining the Ways and Means Committee
2:30 – We are being noticed!
3:40 – Preparing for a congressional hearing
5:40 – The impact of having a congressional hearing in an EMS location
5:58 – The genuine interest of the committee members
9:00 – Dr. Ed Racht testimony to the Congressional Ways and Means Committee
14:24 – Matt Zavadsky testimony to the Congressional Ways and Means Committee
20:52 – Dr. Racht and Zavadsky’s reactions to the evidence they gave and the feedback
29:00 – Zavadsky’s key points he wished to reinforce during his evidence session
31:45 – Balanced billing, patient protections and removing the patient from the middle of the process
32:50 – Independent Dispute Resolution (IDR) and its challenges.
38:29 – Questions for Secretary Becerra on Capitol Hill
44:00 – Final thoughts
45:00 – A call to action to become one and present a united front “When we unify, we are unstoppable.”
48:00 – You the listener are the great politician
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Editor’s note: This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
“Honorable but Broken: EMS in Crisis” is a documentary film exploring the world of EMTs and paramedics, the collapse of the EMS system, and what needs to be done to save it. Narrated by six-time Golden Globe and two-time Primetime Emmy award winning actress, Sarah Jessica Parker, “Honorable but Broken” raises awareness of the systemic collapse of EMS and advocates for change.
In this episode of the EMS One-Stop podcast, host Rob Lawrence chats with producer Bryony Gilbey about the documentary that is now completed and available for streaming. Gilbey hopes the impactful, hard-hitting documentary will serve as a briefing and education tool for our elected officials and members of the general public.
As Gilbey notes, “It’s no good any longer just throwing up your hands and saying that’s just the way EMS is; it’s no good saying it’s someone else’s problem; it’s something we all need to work on, as a civilized society we need to address this issue and we need to do it quickly.”
The 60-minute documentary is now available on demand, streamed by Prodigy EMS and it is hoped that it will be used at local, state and national levels to bring attention to the issues we are facing.
Top quotes from this episode
“I expected to tell a story; I did not think that it would have quite this reaction” — Bryony Gilbey“We now all have not many degrees of separation to somebody who has had some sort of PTSD, who has had to leave the job because of the pressures of work and dare I say ultimately taken their lives and that is incredibly sad.” — Rob Lawrence“It all comes down to three words – all in favor – if we don’t get the vote, we don’t get the money, we don’t get the change.” — Rob LawrenceEpisode contents
00:48 – Documentary teaser
01:18 – Introduction/Bryony Gilbey
02:16 – The “Honorable but Broken” back story
05:46 – How did Gilbey view EMS and its issues
08:15 – The finished product and how can we view it
10:24 – A federal screening on Capitol Hill
11:30 – Reaction from elected officials
13:16 – John Mondello/emotional trauma
14:00 – Eileen Mondello – John’s mother
15:25 – Reaction to Eileen Mondello – “It never gets easier’
17:00 – He wasn’t the first, he isn’t the only and sadly he won’t be the last
22:00 – Other featured speakers in the documentary and their powerful messages
22:30 – Recruitment, retention and retirement
24:35 – What is the cost of a human life to a politician?
26:25 – Educating the legislators and the public
28:00 – The cost of readiness
29:05 – Reimbursement doesn’t add up
31:00 – The hospital side of things – Beckers Review on Hospital closures and adding to ambulance and hospital deserts
31:30 – Call to action and the legislative agenda
35:30 – Sarah Jessica Parker
39:00 – How and where to view via Prodigy EMS
39:50 – Final thoughts
About our guest
With a prolific career spanning several decades, Bryony Gilbey is a seasoned director, producer and freelance writer/editor, distinguished for crafting compelling narratives across various media platforms. As the director/producer for the impactful EMS documentary, “Honorable but Broken: EMS in Crisis,” Gilbey has showcased an unparalleled ability to guide projects from inception to completion.
Gilbey previously worked with the Nexstar Media Group, Inc. as a freelance writer/editor. Here, she demonstrated versatility by producing feature pieces on health and lifestyle topics for Tribune Publishing and contributing to BestReviews.com.
Gilbey also served as an associate producer at Mary Murphy & Co. from 2005 to 2012. During this period, she played a pivotal role in the production of the PBS American Masters documentary "Hey Boo," centered around Harper Lee. In the early 2000s, Bryony worked as a Producer/AP at ABC News Productions, where she produced documentaries on medical breakthroughs in neonatal care for Discovery Health.
The foundation of Bryony’s career was laid during her time as an associate producer at “60 Minutes,” CBS News, from 1995 to 2000. Working closely with producers and correspondents, she contributed to the creation of original news stories.
Throughout her extensive and diverse career, Bryony Gilbey has consistently demonstrated a passion for storytelling, a keen journalistic instinct, and an unwavering commitment to delivering content that informs and resonates with audiences worldwide.
Resources
“Honorable but Broken: EMS in Crisis”NAEMT's Advocacy programAAA’s Advocacy programRATE AND REVIEW THE EMS ONE-STOP PODCAST
Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.
Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.
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Collecting and communicating the big EMS news of 2023
The American Ambulance Association and the Academy of Mobile Healthcare Integration (AIMHI) collect, collate, categorize and share weekly EMS-based news stories widely with many national organizations and associations, including NHTSA, USFA and NAEMT.
The information contained in the news tracker allows officials and EMS leaders to brief and educate journalists and elected officials, as well as the public as to the current plight of EMS. EMS is delivered on a local level and those experiencing issues with their service can believe it is just them suffering funding shortages, staffing challenges, hospital delays or general poor performance. The tracker can be used to demonstrate that the issues are occurring on a wider regional, state, national and, in some cases, international level.
In this episode of the EMS One-Stop podcast, host Rob Lawrence, who also heads up the AAA-AIMHI news collation effort, welcomes fellow news collator, Rodney Dyche of Patient Care EMS; and AIMHI Education Committee Chair, Matt Zavadsky, chief transformation officer at MedStar Mobile Healthcare. Rob, Rodney and Matt examine EMS news and current trends, and discuss how these themes can be used to inform, influence and educate.
Top quotes from this episode
“There's a perverse ‘incentive’ about response time … if you have the target of 8:59, you arrive on time and the patient dies; that's a success. If you arrive in 9:01 and the patient lives; that's a failure. That's absolute garbage” — Rob Lawrence“There was a quote from Dr. Clawson in a news story that was done in Minneapolis, and I love his quote. He says, ‘there is no evidence that using red lights and sirens have saved more lives than they've taken.’” — Matt Zavadsky“Every week in this great country, an ambulance is stolen either from hospital or from scene – that's avoidable.” — Rob Lawrence“Stop being timid. Stop licking your wounds. Get out in your community, talk to your elected officials. Talk to your city managers or county administrators – very factually, not emotionally. There will be time for emotions, but give them the facts and let them know what it's gonna take to resuscitate their EMS delivery system.” — Matt ZavadskyEpisode contents
00:23 – Guest introduction
02:06 – AAA/AIMHI News Tracker and story categories
04:22 – A resource to brief the press and elected officials
04:30 – Operational challenges across many states
05:50 – Massive sign-on bonuses – robbing Peter to pay Paul
06:30 – Staffing and funding issues
08:40 – Communities/local governing bodies facing the fact that they are running out of money, and their EMS isn’t free
09:40 – Transitioning from a volunteer to a paid system
11:00 – Explaining EMS economics to your elected officials
11:50 – Has anyone died? Bring data
13:30 – EMS systems closing
15:30 – “Elected officials get nervous deciding to allocate funding to a service that they haven't had to fund or haven't, haven't had to fund to this certain level in the past.”
18:40 – Response time
19:25 – Increase in low acuity calls
20:30 – Service design
22:50 – Single- versus double-paramedic crewed trucks
25:04 – MEDIC Charlotte – Taking bold steps within categories of response
27:00 – The rate of ambulance crashes across the county at intersections
27:47 – If you are not the ambulance driver … who is?
29:49 – There is no evidence that using red lights and siren have saved more lives than they've taken!
30:30 – Stolen ambulances
32:59 – Supply chain and vehicle availability
34:00 – Rurality and ambulance deserts
35:00 – Violence against providers
37:00 – Responding to patients in crisis/agitated patients
38:00 – How to use the media log in your locality to good effect
40:00 – Final thoughts
About our guests
Matt Zavadsky is the chief transformation officer at MedStar Mobile Healthcare, the exclusive emergency and non-emergency public utility model EMS system for Fort Worth and 14 other cities in North Texas that provides service to 436 square miles and more than 1 million residents and responds to over 170,000 calls a year with a fleet of 65 ambulances. MedStar is a high performance, high value EMS system, providing advanced clinical care with high economic efficiency.
Zavadsky is also immediate past president of the National Association of EMTs, and chairs their EMS Economics Committee. He is an appointed committee member to the Joint Commission’s Home Care Professional and Technical Advisory Committee (PTAC), and the Lewin Group’s Hospital Outpatient Quality Reporting (HOQR) Program Stroke and AMI Expert Work Group developing metrics for use in value-based purchasing measures for emergency departments. He is also the co-author of the book “Mobile Integrated Healthcare – Approach to Implementation.”
Rodney Dyche is director of compliance and responsible for risk management with PatentCare EMS Solutions. PatientCare EMS Solutions is a multistate EMS solution, and additionally provides a hybrid online training program and owns a remount facility. As a teenager, Dyche began his EMS career in rural Missouri. He has had multiple system experiences in addition to rural EMS, including MAST (Kansas City, Missouri), REMSA (Reno, Nevada) and Mercy (Las Vegas). In 2010, he became an internal consultant to Paramedics Plus until its sale in 2018. During that time, he led several high-level projects, to include the timely transition of the purchase of Paramedics Plus. Rodney resides in East Texas and in his spare time is a licensed HAM radio operator, and enjoys fishing, off-roading and reading.
Resources
AAA-AIMHI news collation trackerAnalysis of Ground Ambulance Crash Data from 2012 to 2018 -
This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
The American Ambulance Association recently held its annual AAA Stars of Life event in Washington, D.C. The American Ambulance Association’s Stars of Life program celebrates the contributions of ambulance professionals who have gone above and beyond the call of duty in service to their communities or the EMS profession.
While in Washington, EMS One-Stop Host Rob Lawrence interviewed AAA President Randy Strozyk, on the aims and objectives of the stars program and the 2023 Legislator of the Year. Rob also spoke with AAA Medical Director Dr. Gerad Troutman, who is AAA’s first medical director. Finally, Rob chats with AAA Immediate Past President, Shawn Baird, on the Federal Balanced Billing legislation and the role that AAA and others are playing in protecting both the patient and EMS agencies.
Top quotes from this episode
“Every provider is out to make a difference, but to actually be recognized for it, which you don’t often get the opportunity to have, makes it that much more of an honor to be selected for something like this” — Paramedic Erica Brockman
“AAA stars and hundreds of thousands of people like you are the beginning of the healing process. When somebody is hurt, somebody is wounded, somebody is scared, it is the EMT that first touches that patient and then begins to transport into the healthcare system when the rest of the healthcare system can then kick in to what it does, but it would not start unless it begins with you.” — Senator Bill Cassidy
“Think about when Covid hit, at 0200 in the morning, we were the ones that came, we were the ones that had to deal with a whole new level of challenges, not only Covid, but we had to deal with the fact that people didn’t want to go to the hospital, so we were providing levels of care, interfacing, making sure that people had connections. I see that as a bright future to how EMS will progress in the next decade” — AAA President Rany Strozyk
“I’m really passionate about patients called 911 looking for solutions to a problem and that solution is not always an ambulance to take them to an emergency department, so we try to impact their care differently, especially lower acuity patients, because we now have all the technology and tools to treat them in place with our paramedics or EMTs on site of even treating them utilizing a navigation program from the 911 system, the PSAP and maybe get them to an urgent care or virtual care doctor, where they can be cared for right in their home. Patients love it and the best thing is it really puts the ‘E’ back in EMS and allows us to save those emergent resources that need those most.” — Dr. Gerad Troutman, AAA medical director
“We will be coming back to Congress with a recommendation that ground ambulance not be rolled into the No Surprises Act. That (if we were included) would be devastating to access for care.” — Shawn Baird, immediate past president, AAA
Episode contents
00:21 – Opening: Erica Brockman
01:02 – Introduction: Rob Lawrence
01:36 – Randy Strozyk, president, American Ambulance Association
05:12 – Key areas of legislation for 2023/24
08:07 – Presentation of Legislator of the Year: Senator Bill Cassidy
11:00 – Dr. Gerad Troutman, AAA medical director
17:00 – Federal Balanced Billing Committee: Shawn Baird
18:35 – Summary and close
Additional resources
The full bios for all of the AAA Class of 2023 Stars of Life can be found here.
Listen to next: Alexia Jobson, Dr. Peter Antevy, Brian Maloney, Doug Wolfberg and more join the EMS One-Stop podcast to discuss takeaways from the show
About our guests
Randy Strozyk brings to his leadership of the American Ambulance Association more than 34 years of experience in EMS operations and management. He has been part of the American Medical Response leadership team for 16 years, and currently serves as the company’s executive vice president of operations.
Strozyk earned his EMT/paramedic certification and worked on an ambulance while studying microbiology at Washington State University. He later earned an MBA from California State University. He has been heavily involved in the American Ambulance Association for nearly two decades and is the current president of the organization.
Gerad Troutman, MD, MBA, FACEP, FAEMS, is the national medical director for innovative practices at Global Medical Response. He is an assistant professor of Emergency Medicine at Texas Tech University Health Sciences Center in Lubbock, Texas, and serves as a mentor to the Texas Tech Innovations Hub. He is a past president of the Texas College of Emergency Physicians and currently serves on the Governor’s EMS & Trauma Advisory Council of Texas.
Rate and review the EMS One-Stop podcastEnjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.
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This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
On October 7, 2023, the Palestinian group Hamas launched a surprise attack on Israel at dawn during the Jewish holiday of Simchat Torah – with armed assailants breaching security barriers and a barrage of rockets fired from Gaza. The attack came 50 years and a day after Egyptian and Syrian forces launched an assault during the Jewish holiday of Yom Kippur in an effort to retrieve territory Israel had taken during a brief conflict in 1967.
As the world has seen, terrorists entered Israel. Militants burst into houses, shooting residents begging for their lives and taking others – including women, children and the elderly – hostage, driving the terrified captives back into Gaza.
Operating as part of the initial and ongoing response to the events unfolding in Israel is United Hatzalah, a network of more than 6,500 EMS volunteers, with a fleet of emergency medical vehicles, who in peacetime, are able to respond to more than 2,000 medical emergencies per day in an average response time of less than 3 minutes (and in major cities, often less than 90 seconds). Since October 7, United Hatzalah has been pushed to its absolute limits and has expended the majority of its disposable medical equipment.
In this special edition of EMS One-Stop, Rob Lawrence speaks with Dov Maisel, United Hatzalah’s Vice President of Operations.
Donate to support United Hatzalah’s EMS response: United Hatzalah – Israel is at War | The Chesed Fund
TOP QUOTES FROM THIS EPISODE
“We are a multi-faith organization, but we are an organization of human beings. What we've underwent here in the past week has nothing to do with human beings. This is barbaric. This is something that I've never witnessed. And I've been through terror waves here in my 30 years of EMS. I've seen buses blown up. I've seen suicide bombers in dozens. Nothing on this scale. This is something that Isis did, we all remember watching the videos of what ISIS did, years ago. This overcomes all of that.” — Dov Maisel
“I would say that the amount of tourniquets that we put out in the first 36 hours was in the thousands ... thousands of tourniquets. We treated over 3,000 victims on the ground. The amount of tourniquets, bandages, chest seals, trachs, chest drains, needle applications, tubes that were put out in this first 36, 48 hours of operation is more than what we use, I would say in half a year.” — Dov Maisel
“Our ground rule is in EMS, you don't enter a danger zone, but the volunteers getting on the radios with me, I was in HQ when it started, before I headed actually down to the field – they’re calling and screaming for help … the IDF soldiers that started the defense process were understaffed and they had no capabilities to rescue the victims out from the scene. And our volunteers simply, I told them, ‘it's up to you. Literally, it's up to you;’ and they all went in.” — Dov Maisel
“There were so many, just try to wrap your thoughts around having 3, 4, 5, 10 gunshot wound patients thrown at you – at one or two medics with one ambulance. You can't pile them up one on top of another. You had volunteers going with their private cars, throw them in the backseats, literally with tourniquets on them. Imagine – tourniquets on all extremities, all extremities, needle in their chest, chest seals – thrown in the back seats of cars driven out two, three kilometers out to the ambulance crews that were waiting there that can treat them.” — Dov Maisel
ABOUT OUR GUEST
With 30 years of experience, Dov Maisel has dedicated his life to saving the lives of others. When Dov was just 9 years old, he was walking home from school when he witnessed a horrific accident in which a 6-year-old girl was hit by a bus. He decided he never wanted to be helpless when someone in his vicinity so desperately needed lifesaving treatment.By the age of 14, he began volunteering on an ambulance. Maisel has served as a combat paramedic in the Israeli Defense Forces (IDF) in four different wars. After his army service, he began working as an EMT, dispatcher and driver for Israel’s national ambulance service. During the 2000-2003 terror wave in Israel, Maisel personally responded to and managed EMS teams at thousands of terror attacks.
Maisel is the inventor and developer of numerous medical devices, including a pocket BVM airway management device, which is used internationally in many armies, including the U.S. Military. In 2006, he was one of the founders of United Hatzalah, Israel’s first all-volunteer EMS organization. He serves as the director of operations, managing national and international operations along with the Israeli police, IDF and Ministry of Health as well as other government bodies. He invented what is now United Hatzalah’s Uber-like GPS-based dispatch system which locates and sends the EMT closest to the medical emergency.Maisel graduated from several NATO- and Red Cross-led international workshops on disaster management and led international relief missions in Haiti, Nepal, Mumbai and, most recently, in both Houston and Florida, after the devasting hurricanes, as the head of international operations of United Hatzalah.
He continues to serve as a volunteer, instructor and mass casualty incident manager. He has received the Israel President’s Award for volunteerism and sits on the International Editorial Board of JEMS Magazine.
RATE AND REVIEW THE EMS ONESTOP PODCAST
Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.
Listen on Apple Podcasts, Amazon Music, Spotify and RSS feed.
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This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
This edition of EMS One-Stop was recorded in New Orleans at the 2023 EMS World Expo. Host Rob Lawrence is joined by a range of guests who discuss the sessions they presented and the latest developments in clinical medicine.
Alexia Jobson, director of public relations at REMSA, discusses top tips for dealing with the media, and she then interviews media pre-con student Katherine Robillard.
Peter Antevy, MD, describes his conference session, titled “Five protocol changes you're too afraid to make.”
Brian Maloney of Plum EMS, in Pennsylvania, talks culture of safety, and lights and sirens reduction (and their results within the NEMSQA L&S reduction program).
Doug Wolfberg, Esq., of Page, Wolfberg & Wirth, steps in to discuss leadership lessons from the Beatles and his new book – "Beatles FAB but True."
The episode concludes with veteran EMS podcasters Chris and Anne Monterra, who offer tips on the art of podcasting.
TOP QUOTES FROM THIS EPISODE
“‘No comment is a comment!’ So you really want to avoid that as part of your media strategy and work to develop some transparent and honest information when those tough questions come.” — Alexia Jobson
“Anything that you say to a reporter is considered on the record and can be used in a news story.” — Alexia Jobson
“Top tips for going on camera: You want to make sure that they are knowledgeable about what they are going to be talking about, you want them to be a willing participant and able to re-frame and be positive about the content they are going to cover.” — Alexia Jobson
“It's important for you to just spend a little time looking inside your organization, recognize those important stories that you want to share, and then make sure that you commit some time and resources to building those relationships with your audiences ... having that positive relationship in place will go a long way. And it's also important as a profession that we work together to kind of raise the profile of out of hospital healthcare and EMS.” — Alexia Jobson
“Getting out the door, our shoot time is the No. 1 thing that can decrease our response times. It's not driving lights and sirens; it's not driving recklessly or speeding or not obeying the laws ... it's getting out that door quick from the time of dispatch to the time our truck's pulling out of the garage.” — Brian Maloney
“When we first started looking at the use of lights and sirens during transport to the hospital, which is right there, that increases our chance of getting in a wreck threefold and so it's very dangerous. When we first started it, we were at 26% of the time using lights and sirens during transport; we're down to almost 2%, for transport to the hospital. For response to calls, we were about 46-48% of the time using lights and sirens; we’re down to 7% of the time now.” — Brian Maloney
“Antibiotics for sepsis, so a lot of people are fearful of giving antibiotics, and why? Because the hospital says we need to have a culture, a blood culture. Turns out that's not true. If the patient's hypotensive, they're fixing to die, as they say. And we in Palm Beach County can give the antibiotics within 12 minutes of the 911 call. And our own data shows that the hospital is giving antibiotics at 120 minutes. That's a 10-fold difference in that. So, antibiotics for sepsis are, I think, a major item.” — Dr. Peter Antevy
“There's a story about how the Beatles had a drummer for a couple of years before Ringo. He wasn't quite the right fit for that band. He's a good drummer. But when they got Ringo in, they took off, right? So, in EMS, we tend to think if somebody has a pulse and a patch, let's hire them or let's bring them in. But we need the right people.” — Doug Wolfberg
“Recognize your own limitations, I tell a story about how the Beatles sort of came on hard times when their manager died, but weren't quite wise enough to know what they didn't know. They thought ‘we can manage ourselves,’ and so it’s to also recognize your limitations and get the skills that you need, if you don't possess them yourself, with your team.” — Doug Wolfberg
EPISODE CONTENTS
01:15 – Media management with Alexia Jobson (REMSA)
09:22 – Alexia Jobson interviews Katherine Robillard (LA Office of EMS)
11:37 – Brian Maloney (Plum EMS) talks culture of safety and lights and sirens reduction
20:15 – Dr. Peter Antevy on the five protocol changes you're too afraid to make
23:54 – Doug Wolfberg Esq. (Page, Wolfberg & Wirth) on leadership lessons from the Beatles
28:13 – Chris and Anne Monterra on the art of podcasting
ABOUT OUR GUESTS
Alexia Jobson REMSA
Alexia Bratiotis Jobson is the director of public relations and serves the organization by expanding opportunities for engagement, promotion, communication and relationship-building. She has more than two decades of business and communications experience. Prior to joining REMSA Health, Alexia worked as a senior account director with KPS3, where she managed REMSA’s client account, as well as accounts related to industrial real estate and higher education. She held communications-related positions with Renown Health and the Nevada Museum of Art. She holds an Accreditation in Public Relations (APR). This certification asserts professional competence, high ethical standards and mastery of progressive public relations industry practices. She is a Nationally Registered Emergency Medical Technician and is a graduate of the University of Nevada, Reno’s Reynold’s School of Journalism. She serves as the immediate past president of the board of directors for Western Industrial Nevada (WIN), Chair of the Public Relations Committee of AIMHI and chair of the American Ambulance Association Communications Committee.
Dr. Peter Antevy
Peter M. Antevy, MD. is a pediatric emergency medicine (EM) physician practicing in-hospital emergency medical care at Joe DiMaggio Children’s Hospital, a level I trauma and tertiary care center in South Florida. Board-certified in pediatrics, emergency medicine and the complex subspecialty of EMS, he is also the founder and chief medical officer of Handtevy – Pediatric Emergency Standards, Inc.; and he serves as the medical director for Davie Fire-Rescue, Coral Springs-Parkland Fire Rescue, Southwest Ranches Fire Rescue and United Medical Transport, all in South Florida. Dr. Antevy also serves as associate medical director for several other agencies, including Palm Beach County, Florida, and he is also the longstanding medical director for two highly regarded paramedic training programs as well as several mobile integrated healthcare (MIHC) programs in greater Broward County, Florida.
Brian Maloney
Brian Maloney has been working in EMS for over 24 years as a practitioner, educator and leader. His EMS career began while attending the University of Pittsburgh, where he obtained his paramedic certification and bachelor’s degree in emergency medicine. Later, he continued his education and achieved his Master of Science degree from Carlow University. He has spent most of his career working in the field and had the opportunity to teach with the Center for Emergency Medicine and the University of Pittsburgh. Currently, he is the director of operations of Plum EMS, where he has been for the past 5 years. His love and appreciation for the EMS profession run deep, and he continuously strives to help make it that much better.
Doug Wolfberg, Esq.
Doug Wolfberg has been a well-known national EMS leader for decades. He is an EMS attorney and consultant, and a founding partner of Page, Wolfberg & Wirth. He has served as an EMS practitioner and has held positions at the county, regional, statewide and federal levels in his EMS career prior to becoming an attorney. He has written hundreds of articles and has been one of the most highly rated presenters at EMS conferences throughout the U.S. He earned his law degree magna cum laude from Widener University School of Law and holds an undergraduate degree from Penn State University. Doug also serves as an adjunct professor of law at Commonwealth Law School and as an adjunct professor at the University of Pittsburgh.
Chris Montera
Christopher Montera has more than 34 years of experience in paramedic services, public health, and the fire service. He is the director of State and Federal Programs for ESO and the former chief executive officer at Eagle County Health Service District and holds a master’s degree in health leadership. Chris is serving as the National EMS Museum Treasurer for 2023.
Anne Montera
Anne Montera received a master’s degree in health leadership from Western Governors University and a BSN from Bethel College. She has over 20 years of nursing experience in public health, labor and delivery, patient safety/quality improvement, and EMS coordination in urban and rural hospitals and community settings, including the use of telemedicine. In her previous role as the senior VP of quality for Ready Responders, she worked to research, develop and implement quality matrix to demonstrate program cost savings and health impact. She was also the executive director for the Central Mountains RETAC, supporting a 6-county EMS and trauma region in Colorado. She is the co-creator and public health partner for the first National Community Paramedic Pilot Program in rural Eagle, Colorado. She received the State of Colorado EMS Region of the year in 2019 and Colorado Nightingale Luminary Award for Innovation work on the Colorado community paramedic program in 2011.
ADDITIONAL RESOURCES
Team-driven improvement in the use of lights and sirens – Plum EMS use cases demonstrate when the risk of using L&S is lower than the risk of delaying a lifesaving intervention
RATE AND REVIEW THE EMS ONE-STOP PODCAST
Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.
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This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
In August 2020, Shawky S. Amine Eddine, MD, became the EMS commander for the Beirut Port Explosion – the largest non-nuclear explosion in history. The blast killed 200, injured 6,500, and resulted in excess of 300,000 people suffering home damages and losses.
In terms of medical facilities in the blast area, four hospitals we rendered totally out of action, with eight further healthcare centers damaged.
The explosion added to an already pressurized healthcare system, as the country was at the height of the pandemic, as well as hosting over 900,000 refugees from war-torn Syria.
In this episode of EMS One-Stop, Dr. Eddine joins host Rob Lawrence to discuss the backstory and devastation of the explosion, as well as the challenges to access, hospital capacity, communication, record keeping and the management of the dead.
Tune in as Dr. Eddine shares 10 takeaways and lessons for responding to a large-scale MCI both identified from that eventful day (discussed in full in the broadcast):
Don’t fish in the same lakeFactor emotionsLeadership tokens are earned in management and spent in commandEven in crisis … planThe importance of dataDecision makingYou are not alone – coordinate and communicateRescuers’ wellbeing is a priorityDon’t forget yourself and don’t lose yourself amidst the crisisWe make mistakesAbout our guest
Dr. Shawky Amine Eddine, MD, is a medical doctor with special interest in prehospital care, healthcare quality management and disaster management. He has served as an EMT in the Lebanese Red Cross (LRC) since 2007 and as head of station for Damour EMS Station, and is currently acting as LRC director for learning and development, assistant EMS director for training and quality, and COVID-19 response coordinator.
Dr. Amine Eddine has commanded multiple crises including Lebanon fires in 2019, Lebanon floods in 2019, protests in 2019-2020, COVID-19 outbreak in 2020 and the Beirut port explosion in 2020. He has led the real-time evaluations of COIVD-19 response. Dr. Amine Eddine is also a disaster management instructor in the Humanitarian Leadership Diploma, offered by Global Health Institute at AUB, an assistant professor at the Faculty of Nursing of the Lebanese Red Cross and a consultant for multiple local, regional and global NGOs.
Connect with Dr. Amine Eddine:
Twitter: @SAmineeddineLinkedInEPISODE CONTENTS
1:00 – Introduction Shawky S. Amine Eddine, MD
1:30 – Description of EMS in Lebanon
04:43 – The role of Jerry Overton in the development of EMS in Lebanon
06:18 – Setting the 2020 scene in Lebanon.
09:00 – Ammonium Nitrate – a bomb in the warehouse
12:00 – Gathering the situation: The fog of war!
14:00 – Loss of medical infrastructure due to the blast
17:00 – EMS resources deployed
18:00 – Command and control: The UK GOLD, SILVER and BRONZE system
23:00 – Lessons identified versus lessons learned
23:50 – Don’t fish in the same lake
28:00 – Factor emotions
30:00 – Leadership tokens are earned in management and spent in command
33:00 – Even in crisis … plan
37:00 – The importance of data
40:00 – Decision making
41:40 – You are not alone: Coordinate and communicate
43:00 – Rescuers’ wellbeing is a priority
45:30 – Don’t forget yourself and don’t lose yourself amidst the crisis
48:00 – I make mistakes
Additional resources
Rapid Response: Beirut blast serves as stark reminder of the power of energetic materialsBeirut and beyond: Planning for explosives in your communityForensic review: The Beirut port explosionUN Report: Beirut blast -
“Instead of responding to the majority of 999 calls we receive every day, we want to flip that so we only go to those patients who really, really need a double staffed paramedic emergency ambulance quickly.”
This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
It’s very clear that Ryan Reynolds and Rob McElhenney have raised the profile of the country of Wales with their “Welcome to Wrexham” football (soccer) team and series, but one Welsh organization – the Welsh Ambulance Service NHS trust – has a vision and world class level of service delivery that should receive equal attention. In this audio and video edition of the EMS One-Stop podcast, Host Rob Lawrence speaks with Professor Jason Killens, Chief Executive of the Welsh Ambulance Service.
As the 999 emergency system that serves over 3 million Welsh citizens emerges into a post-pandemic world, Jason describes service delivery, the training and education of its medics and the fact that it is a about to operate without a medical director – in itself a move that identifies that clinical and academic paramedicine has come of age. As Jason tells Rob, “We are transforming the way we deliver our service here in Wales, looking to tip the service model on its head essentially. Instead of responding to the majority of 999 calls we receive every day, we want to flip that so we only go to those patients who really, really need a double staffed paramedic emergency ambulance quickly … car crashes, broken legs, falls from height, cardiac arrest; and the rest we would service by the means of telephone or video advice, upstream with clinicians in our contact center or with advanced practice clinicians in the community.”
TOP QUOTES FROM THIS EPISODE
When a patient calls 999, “you could see a traditional road ambulance, but increasingly here in Wales and in other services across the UK, you could see a disposal which includes telephone or video triage and advice from our clinicians in our contact centers – they could be either nurses or paramedics … and we are closing now here in Wales about 15% of all of our emergency calls every day by way of telephone or video consultation without turning a wheel or sending an ambulance” — Jason Killens
“If we do respond to the scene, it could be a traditional ambulance or increasingly it could be what we call an advanced paramedic practitioner, so that is an experienced paramedic, who has a degree, who has gone on to masters/education – those advanced paramedic practitioners with a master’s degree, increasingly we are seeing a non-conveyance rate some 35-40% higher than a regular paramedic crew, so what that means is we are able to safely close episodes of care in the community and not respond with a double staffed ambulance/not convey the patient to the emergency department.” — Jason Killens
“Fire Brigades and Departments in the UK aren’t associated with medical response – It is the exception in the UK rather than the rule.” — Rob Lawrence
“We are not transport organizations anymore, we do transport, but increasingly, we are providers of great clinical care in our communities … but we are looking to stretch and grow so we provide better outcomes for all patients here in Wales, and only convey them to the emergency department when we really need to and we think the solution to that is advance practice in communities with our own people.” — Jason Killens
“We have just agreed with our board that when our medical director retires at the end of this year, we will not replace him. We will be the first ambulance service in the UK not to have a medical director on the governance board. Instead, here, we will have our senior clinician leadership provided by our executive director of paramedicine and we are the first ambulance service in the UK to have that role on the board. And we have taken that point of view simply because the paramedic profession has developed over the last two decades, to the point now where we believe we have sufficiently experienced senior clinicians in the paramedic workforce that are able to provide that senior level governance leadership, and direction for our clinical strategy. It is an important signal and message to our paramedic workforce that the glass ceiling is broken and paramedics to join us at 21/22 years old from university can absolutely see a pathway through to senior leadership, to a director on the board, and ultimately to jobs like mine as a paramedic if that’s what they aspire to.” — Jason Killens
EPISODE CONTENTS
1:10 – Introduction of Professor Jason Killens
3:30 – Recruiting Australian paramedics to work in London
4:30 – Explaining EMS organization and control in England, Scotland, Northern Ireland and Wales
8:30 – In the UK, healthcare is free at the point of delivery
11:30 – Geographical distribution of ambulance services in Wales
12:38 – The provision of helicopter emergency medical services (which are mostly charity based, relying on donations to operate)
14:30 – What happens when a citizen calls 999 – how call taking and response is organized
15:30 – Hear and treat and advanced paramedic practitioners
21:10 – The journey of continuous service improvement
23:00 – Paramedic degree and advanced degree education, and career pathways
27:49 – Co-responding agencies including police, fire, the military and citizen responders
29:59 – Future plans for the Welsh Ambulance Service
31:00 – Senior clinical leadership provided by paramedics and not a medical director
34:00 – Fantastic people doing fantastic stuff
ABOUT OUR GUEST
Professor Jason Killens has spent his career working in Ambulance Services in the UK and Australia. He progressed through the ranks in London Ambulance Service from an EMT to executive director of operations. He was appointed as the chief executive of the South Australia Ambulance Service in 2015 before joining the Welsh Ambulance Service as chief executive in September, 2018.
He is an honorary professor at Swansea University’s College of Human and Health Sciences, and the chief executive lead for operations at the Association of Ambulance Chief Executives.
About Welsh Ambulance Services NHS Trust
Welsh Ambulance Services NHS Trust (WAST) provides healthcare services for people across Wales, delivering high quality and patient-led clinical care, wherever and whenever needed
Services include:
The blue light emergency ambulance services: including call taking, remote clinical consultation, see-and-treat, and, if necessary, conveyance to an appropriate hospital or alternative treating facility.Non-emergency patient transport service: taking patients to and from hospital appointments, and transferring them between hospitals and treatment facilities.The 111 service: a free-to-call service which incorporates the NHSDW service and the call taking and first stage clinical triage for the out-of-hours GP service. The number was live throughout 2021/22 and the full service was rolled out in Betsi Cadwaladr, Cardiff and Vale University Health Boards in 2021/22, making the complete service universally available across Wales.WAST also supports community first responders, co-responders and uniformed responders to provide additional resources to respond to those most in need of help.During the pandemic, WAST provided the mobile PCR testing service for the whole of Wales.RATE AND REVIEW THE EMS ONESTOP PODCAST
Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.
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This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
In this EMS One-Stop international edition, Host Rob Lawrence welcomes Dr. Linda Dykes, an emergency medicine physician from the UK, and Rom Duckworth, fire captain and paramedic EMS coordinator for Ridgefield (CT) Fire Department.
The discussion begins with the demise of the U.S. ET3 program, and then the group examine how community paramedicine is thriving in the UK and the lessons to be taken away.
Rob and Linda also discuss the EMS World Expo “International Roundup” session they have jointly delivered together for the last 7 years and how they extract best practices from all international attendees. Rob, Rom and Linda then discuss the similarities and differences in emergency management tactics, techniques and procedures, and identify trans-Atlantic lessons already being exchanged.
About our guests
Dr. Linda Dykes
Dr. Linda Dykes qualified from Newcastle (UK) Medical School in 1996, trained in the northeast and Mersey regions, and is one of only a handful of doctors in the UK who are dual-qualified in both Emergency Medicine & Primary Care/General Practice. Even fewer remain active in both specialties, and she is believed to be the only dual-qualified EM/GP in the UK who has also gained experience working in acute community geriatrics, in a "Hospital at Home" service. Linda also spent 2 years working regular shifts in Ambulance Control, and has dabbled in the development of telephone algorithms via a short secondment to NHS111 Cymru/Wales.
Equipped with this unique skillset – plus a track record of successfully building up services – Linda sees the NHS through a unique lens, and loves to work at bridging the gap between hospital and community services.
Rom Duckworth
Rom Duckworth is a dedicated emergency responder, author and educator with more than 30 years of experience working in career and volunteer fire departments, hospital healthcare systems, and private emergency medical services. Rom is currently a career fire captain and paramedic EMS coordinator for Ridgefield (CT) Fire Department, the founder and director of the New England Center for Rescue and Emergency Medicine; and is the recipient of the American Red Cross Hero award, Sepsis Alliance Sepsis Hero award, and the JEMS EMS 10 Innovators award.
As the author of chapters in more than a dozen EMS, fire, rescue and medical textbooks, as well as over 100 published articles in firefighting and EMS magazines and websites, Rom is working to advance leadership in modern emergency services education.
Learn more
Rob, Linda and Rom will also be delivering an international seminar: “Major Incidents & Disasters – an International Masterclass” on Saturday August 5.
For most emergency services personnel, major incidents are a rare event – maybe a handful at most in a career; maybe none. Few will become experts from personal experience alone, so learning from events that have gone before is crucial to preparedness at national, organizational and individual levels.
This unique webinar brings you five world-class speakers, each of whom has operational, tactical and/or strategic experience (and some of them all of the above!) of major incidents from the UK, U.S., and Lebanon. Between them, they have responded to incidents ranging from boots on the ground at 9/11, to coordinating the pandemic response for an entire country, and everything in between … bus crashes, train derailments, gas explosions, bioterrorism, forest fires, floods, and hurricanes.
This is an event where theory, research and first-hand experiences come together. Our speakers will share not only what they’ve learned from their personal experiences, but what they wish they’d known beforehand and what crucial points they now find themselves passing to others.
This webinar is aimed at those who may have to plan for, and/or respond to, major incidents. As well as the obvious emergency service personnel, think also of hospital staff outside ED, council workers, undertakers, utility companies, coroners’ teams and many more. The event is also open to the general public, and promises to be a fascinating and absorbing morning.
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This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
Ambulances for Ukraine lead Chris Manson returns to provide an update on the program that is now not only sending ambulances, but also fire trucks and SUVs to Ukraine. To date. U.S. Ambulances for Ukraine has delivered 38 ambulances and 6 fire trucks to Ukraine. A further 12 ambulances, 2 fire engines and several SUVs are to be shipped in July.
Host Rob Lawrence and Chris recap the program so far and the tasks that the donated vehicles are be put to in country. Sadly, some of the ambulances donated earlier in the year have been destroyed due to hostile action. Chris issues a further call to action for donating ambulances, fire trucks and SUVs. Ukraine has now moved from defensive to offensive operations, and every vehicle is needed. As Chris describes, “If anyone gives me an ambulance, a fire engine or an SUV, I will get that vehicle into the fight.”
In the video edition of this episode of EMS One-Stop, Chris has provided photos of the vehicles on their way to Ukraine as well as images and video of the vehicles in action and the brave crews on the front lines that operate them.
TOP QUOTES FROM THIS EPISODE
“The reality is the Russians in this conflict are targeting first responders, and it is one of the things they like to do. They will shell an area, cause havoc in an area with some sort of military strike, and then they will wait until the first responders respond, and when they do, they will target them.”
“Like any firefighter in any city department, what’s the first thing you want to do when a kid wanders around the fire truck? You want to sit them in the seat or put the helmet on right? So we put the first kid in, got them out, put the second kid in, I turned around and 20 kids are lined up. I went through those 20 kids and the 20 turned into 100, it felt like the entire town came out.”
“I feel fairly confident now, that several of those vehicles have been destroyed.”
“If anyone gives me an ambulance, a fire engine or an SUV, I will get that vehicle into the fight.”
EPISODE CONTENTS
0:30 – Rob intro
01:17 – Introduction Chris Manson
01:38 – U.S. Ambulances for Ukraine backstory
04:53 – Why would we give serviceable ambulances to Ukraine if we still have a shortage in the U.S.?
06:38 – Current stats of vehicles donated
07:30 – The logistics of shipping a vehicle to Ukraine
10:34 – The road drive from Germany and through Poland
11:21 – Tracking ambulances – a big no-no!
12:40 – Distribution of vehicles in Ukraine
14:36 – The moment Chris arrives to hand over a vehicle down range
16:50 – Vehicles in military units liveried into camouflage paint
19:00 – The need for fire trucks and SUV/patrol vehicles
22:01 – Call to action – we need ambulances, fire trucks and SUVs – now!
24:00 – Where the fire trucks are deployed
25:15 – The Ukrainians can fix anything (so it doesn’t matter if the donated vehicle has a few faults)
27:55 – Final thoughts
ADDITIONAL RESOURCES ON THIS TOPIC
ABOUT OUR GUEST
Chris Manson is the vice president of government relations for OSF HealthCare, a 15-hospital health system operating out of Peoria, Ill. He is a former firefighter from California and he served in the U.S. Marine Corps Reserves.
CONNECT WITH OUR GUEST
U.S. Ambulances for Ukraine @ambulancesU
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Steve Grau, Anna Liotta and Steve Wirth join hosts Rob Lawrence and Chris Cebollero at the American Ambulance Association Annual Conference 2023
This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
In this EMS One-Stop/Inside EMS crossover podcast, Chris Cebollero teams up with Rob Lawrence to report on the 2023 American Ambulance Association Annual Conference from the MGM Grand, in Las Vegas. Rob and Chris discuss their own personal highlights and Rob’s leadership session, delivered with Acadian Ambulance President, Justin Back.
Rob and Chris are joined by Page, Wolfberg & Wirth Founding Partner, Steve Wirth, Esq., and discuss bias, the topic of Steve’s conference session. Rob then interviews AAA keynote speaker, Anna Liotta, together with Royal Ambulance President Steve Grau, as they discuss:
Generational codes in the workforceThe revolving door of employmentCreating the milestones of forward progressionUnderstanding that your people are you primary customerTOP QUOTES FROM THIS EPISODE
“In dealing with bias, self-awareness is absolutely critical – you have to do an inventory of your life and say ‘where are these things that I’ve experienced and how do they affect my decision making today and my interaction with other people,’ so self-awareness is really the first step.” — Steve Wirth
“When you go to a conference, go up to somebody. The reason that you have a nametag, with your first name in very large font is so that I can say, ‘Hello Chris, I’m Rob, pleased to meet you. What do you do?’ and that’s how a network occurs.” — Rob Lawrence
“Having this culture of a high-level of engagement is really focusing on our employees as our primary customer and making sure that we understand what their goals, ideals, passions are, and how to meet them.” — Steve Grau
“Just by the way they answered a simple question ‘so, what do you do?’ I could tell if they had been working there 2-3 weeks if they answer with a bright sparkle, ‘I work at Amazon.’ But if they had been there 2-3 months, they would pause, ‘well … I work at Amazon,’ And 6 months, they would drop a codeword, ‘I currently work at Amazon.’” — Anna Liotta
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Watch for more
https://www.ems1.com/leadership/articles/the-10-commandments-of-servant-leadership-OkBq610vz8C12Gb1/
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EPISODE CONTENTS
Part 1: Rob Lawrence and Chris Cebollero – Serving to lead
00:30 – Rob and Chris introduction
1:30 – Car seat safety (not rated for ambulances)
3:30 – Rob’s leadership session with Acadian President Justin Back on the principles of leadership, serving to lead
05:30 – Chris discusses leadership as a science
06:30 – What we want from our leaders
Part 2: Steve Wirth – Overcoming bias
07:30 – Welcome Steve Wirth
08:00 – Steve discusses his conference session, “We are all prejudiced” delivered in partnership with Macara Trusty (GMR)
11:30 – The importance of networking and meeting professional friends
14:56 – Chris talks about his leadership series on EMS1
Part 3: Anna Liotta and Steve Grau – Retaining your primary customer
16:00 – Introduction: Anna and Steve
17:00 – Generational difference - Have you seen a “Star Wars” movie?
17:30 – Anna: Common sense is not that common
18:30 – The Royal Ambulance (award winning) Career Bridge Program
20:00 – Generational codes in the workforce
22:50 – The revolving door of employment
24:00 – Creating the milestones of forward progression
25:00 – Anna’s Experience with Fortune 500 companies
25:30 – Understanding that your talent and people are your primary customer
26:00 – Creating an arc of experience
28:00 – Not allowing yourself to say “that’s how I did it”
29:00 – Fostering the whole human
30:00 – Pulling talent forward
31:00 – Rob and Chris close
ABOUT OUR GUESTS
Anna Liotta
Anna Liotta, creator of Generationally Savvy Communication Solutions, is an award-winning speaker, business consultant and author. She engages audiences with her practical strategies for attracting, growing and retaining top talent and loyal clients from every generation.
Anna integrates communications, sociology, business psychology and demography to unify workplaces and dramatically improve company performance. Her expertise and insight have helped such companies as Pike Place Market, Intel, Wells Fargo, Microsoft, Amazon, the PGA, NBA and United Way.
Steve Grau
Steve Grau and his family emigrated from Ukraine in 1989, arriving in San Francisco with $80 to their name. He became interested in healthcare 15 years later, when he took a hands-on role caring for his grandfather after a series of debilitating strokes. Witnessing how emotional support impacted physical healing, Steve was inspired to leave the tech industry to start an ambulance service that focused on patient experience.
Steve Wirth
Steve Wirth is a founding partner of Page, Wolfberg & Wirth. In a distinguished four-decade public safety career, Steve has worked in virtually every facet of EMS – as first responder, firefighter, EMT, paramedic, flight paramedic, EMS instructor, fire officer and EMS executive. He was one of central Pennsylvania’s first paramedics. Steve brings a pragmatic and business-oriented perspective to his diverse legal practice, having served for almost a decade as senior executive of a mid-sized air and ground ambulance service, helping to build the company from the ground up.
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This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
Our EMS One-Stop Host Rob Lawrence was recently invited attend the keynote session at the North Carolina EMS Expo, and to deliver an after-dinner speech at the banquet. The title of Rob’s session was “Elephants in the EMS room,” in which he addressed 10 things we must acknowledge and fix in order to improve the health of our profession.
As soon as he left the keynote stage, Rob joined Bradley Dean and David Blevans from the EMS Handoff Podcast to discuss the key issues raised in Rob’s presentation.
The biggest elephant in the room currently is recruiting and retention, and in addition to discussing inside industry suggestions, Rob looked to the outside world and got his inspiration from Glass Door, and identified what stands EMS apart from the nation's top 50 companies to work in.
The discussion also covers data and politics, cost collection and surprise billing, amongst the other elephants in the EMS room.
TOP QUOTES FROM THIS EPISODE
“I don’t talk about surprise billing, I talk about surprise payment, the surprise is what the insurance company actually gives you.” — Rob Lawrence
“A lot of local authorities will describe what they want to see in their EMS system when they bid them out and these are wholly unaffordable, in fact, they describe the cruise liner, when they can only afford a rowboat.” — Rob Lawrence
“We have to stop thinking that we are the UN and start to thinking like NATO, because NATO is an attack on one is an attack on all so, we have to start changing our mindset.” — Rob Lawrence
EPISODE CONTENTS
00:53 – Introduction
01:15 – Bradley Dean and David Blevins
2:10 – Elephants in the room
2:58 – Recruiting and retention
4:00 – Looking for clues via Glassdoor
5:05 – Is EMS in a pickle?
6:00 – Surprise billing
6:22 – EMS costs
7:00 – The cost of readiness
7:30 – Ground Ambulance and Patient Billing Committee
9:46 – Four little words – all those in favor!
10:20 – We are all politicians
11:30 – Degree or no degree – that is the question
15:40 – If you are going to get a degree anyway, why not a paramedicine degree!
17:00 – Data and making use of it
20:00 – Wall time
24:00 – The importance of advocacy
28:00 – National organizations working together
37:00 – The Peter Principle and training our people for the next position
39:00 – Close
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Dr. Lori Moore-Merrell announces plans to rename the USFA to the U.S. Fire and EMS Administration
This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
EMS One-Stop Host Rob Lawrence recently travelled to Florida to attend the Metropolitan Medical Directors Gathering of Eagles Conference. In this week’s episode, he shares video from key sessions and interviews with a number of leading EMS medical directors, including Dr. Jim Augustine, medical director of Lee County, Florida.
The Eagles also gave the floor to the U.S. Fire Administrator Dr. Lori Moore-Merrell, who identified how the Metropolitan Medical Directors will work closely in the future with the U.S. Metropolitan Fire Chiefs – and identified that a name change to USFA may soon follow.
TOP QUOTES FROM THIS EPISODE
“Seventy-five percent of what we do in the fire response space is in fact EMS, and something that I shared with these guys yesterday is an action, I won't say a movement yet, but an action under way, we may in fact in the near term actually rename the U.S. Fire Administration the U.S. Fire and EMS Administration.” — Dr. Lori Moore Merrell
“We have just stood up in January an EMS branch within our National Fire and EMS Programs Division. That is a huge move for USFA, so we are going to be moving toward even bigger announcements in the near future ... but we need to embrace what we do in the fire service, that is greater than 70%, most departments 75% and up of EMS.” — Dr. Lori Moore Merrell
EPISODE CONTENTS
01:00 - Takeaways from Brandon Morshedi, MD; Peter Antevy, MD; Joseph Zalkin; Petar and Amber Hossick
02:00 - Introducing the comments from Dr. Moore-Merrell
04:00 - Recorded comments from Dr. Moore Merrell
09:00 - Discussion with Dr. James Augustine
24:00 - Closing commentary
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Paramedic Amanda King shares her story of thru-hiking the Appalachian Trail and overcoming EMS burnout
This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
After realizing she was suffering from burnout, Paramedic Amanda King decided to leave her service and take on one of the most physically challenging trails in the United States. Amanda made a decision that changed how she saw people, how she viewed the world and how she understood herself.
Three months after resigning, selling her house and storing her furniture, Amanda was dropped off in Georgia, alone, with one goal: to hike the entire Appalachian Trail. With her hiker home packed into a rucksack on her back, she embarked on a seven-and-a-half month epic adventure which saw her hike nearly 2,200 miles. She endured harsh weather, a regional drought, rugged terrain and so much more on a journey that evolved her in ways she could not have ever imagined.
After deciding to return to EMS, Amanda chats with Rob Lawrence about her experience, the individuals she met along the way and how her experiences can be translated back into life as a medic. Amanda also reflects on her life before the trail and offers inspiration and takeaways for all.
TOP QUOTES FROM THIS EPISODE
“I think my biggest regret is, it's a very simple word. It's two letters long and it's the word ‘no!’ Don't be afraid to say no. Take time for yourself, because you are the most important person. You know, if you're not happy and if you're not safe, how can you expect to keep other people happy and safe? I think that's the biggest thing, don't work so much overtime, don't inconvenience yourself to do all of these things that's asked of you, in return you're not taking care of yourself. So, one thing that I decided if I got back into EMS, is I would use my vacation time. So I'll put it to you this way. When I was at the former employer, I took a vacation maybe twice in 6 years or something like that, like an actual vacation. I've already taken two vacations since I started here at Novant, since November – so that's a huge difference.”
“I don't want to say yes, a 7-month hike in the woods cured all my problems, because that's not at all the case. I think that it's an ongoing process that, once you reach that point of burnout, it's number one up to you. It's not up to anybody else to help you. It's up to you to help you. And you have to want that change. I think that it's an everyday thing. Every day I need to do things that keep me on that path of not going back down that road again.”
“I think that was a symptom of the burnout where I was at, I had no patience whatsoever and it showed. It showed to my partner, it showed to family members that I would encounter on a call. And I hate to admit all that; it's embarrassing, but that's where I was, that was the point where I was at. I think now, after all that time off, and all that time to self-reflect, I think I'm more patient because I believe that I'm more empathetic, which is also something that I can't say that I possessed before I left.”
EPISODE CONTENTS
02:29 – Introducing Amanda King
05:06 – Symptoms of burnout
07:16 – The moment you realize you are done
10:57 – Selling and putting everything in storage
13:23 – Hiking with friends
15:53 – Packing for a 2,000 mile walk
18:48 – Mental fortitude
22:47 – Trail angels
24:40 – Trail magic
26:32 – Becoming ‘moss’
29:49 – Hindsight is 20/20
31:16 – Keeping a journal
33:30 – Taking a zero: how to use down time
41:14 – 2,000 miles later …
48:05 – Developing patience
51:02 – Message to those heading into crisis or breakdown
54:13 – Contact details
ADDITIONAL RESOURCES ON THIS TOPIC
Reignite EMS passion by banishing burnout (eBook)On-demand webinar: Navigating a path to career satisfaction5 EMS tips for a work-life balanceEMS Burnout Repair Kit: Reigniting your EMS passionABOUT OUR GUEST
Amanda King is a paramedic from the coast of North Carolina. Prior to joining EMS, she obtained a Bachelor of Arts degree from the University of North Carolina at Wilmington. During her first 10 years in EMS, she was promoted to field training officer, became an EMS instructor, developed a field training and evaluation program for her former agency, taught EMS classes for the local community college and earned a real estate license. She left EMS and thought she’d never return. Now, after becoming one of just over 1,000 people to thru-hike the Appalachian Trail in 2022, she has returned to EMS and now works for Novant Health Mobile Integrated Health. She is currently in graduate school to obtain a master’s degree in public administration.
CONNECT WITH OUR GUEST
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Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.
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This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
Page, Wolfberg & Wirth was asked by the National EMS Information System (NEMSIS) Technical Assistance Center (TAC) to research frequently asked questions related to data in EMS patient care reports. PW&W analyzed these questions under applicable laws and guidance, and developed general answers and best practices contained in the new publication, “Patient Care Report Data QuickGuide - FAQs on owning, amending, retaining and sharing patient care report data.”
In this week’s EMS One-Stop, available in both video and audio versions, Host Rob Lawrence speaks with the PW&W authors of the project, Ryan Stark, managing partner, and Steve Johnson, director of reimbursement consulting. They discuss the guide, why it’s needed, and the major FAQs and misconceptions about PCRs.
The guide is broken down into four key areas of FAQs:
PCRs’ legal statusAmending PCRsPCR retentionTransferring PCR dataTop quotes from this episode
“I would much rather defend an organization who regularly goes through a quality assurance process, whereby they make the provider and hold them responsible for the accuracy and completeness of the record.” — Ryan Stark
“Others may say, we see a lot of amendments to your records. The answer is ‘yes, that’s because we care about getting it right’ – that’s the mantra of our organization.” — Ryan Stark
“One of the things behind the importance of documentation is that it doesn’t live in a vacuum. We are in a day and age where it’s going to follow the patient for their lifetime, so you may have a rehab facility that wants to consult the medical record to determine the mechanism of injury or how the injury occurred and the only person [that knows that] is the EMS practitioner.” — Ryan Stark
“Long gone are the days where we can give you a quick ticket, passing along the information to the receiving facility. Now we are marrying up records, electronic health exchanges and other mechanisms and the genesis of all this starts with the original call.” — Steve Johnson
“Everyone should sign the patient care report. Why? Because everyone was a function of providing that particular service and we get a lot of pushback and they say ‘well now I’m legally responsible for everything that happened,’ and that’s not what the law says. The law says, for what you did, you are responsible for what you did and what you didn’t do when you had a legal duty to do something or withhold doing something because it was contraindicated. All that indicates is that yes, I reviewed it and to the best of my knowledge it’s true and accurate.” — Ryan Stark
“The law will impose liability where it lands. Just because you’ve signed that particular patient care report, doesn’t mean you’re responsible for all the interventions and everything that I outlined in there, it would be whoever performed or withheld those interventions that would be responsible within the scope of practice.” — Ryan Stark
Episode contents
1:09 – Introductions
1:30 – PWW history
3:30 – Introducing the PCR Data QuickGuide
4:20 – The circle of life of a PCR
11:00 – NEMSIS data/research license and EMS by the numbers
13:20 – Who owns PCR data
15:50 – Signatures! And legal responsibility
17:40 – Accuracy of documentation to defend your actions
18:30 – Why does the driver have to sign?
20:00 – Amending PCRs: When and why
22:33 – Who do you tell if a record is amended?
24:30 – Can your state request you to amend your PCR?
27:30 – How long should we keep documents?
30:50 – When an agency closes down or merges
33:30 – Body-worn camera content
35:30 – Transferring paper records to digital
37:15 – Bi-directional data and HIE – responsibilities
40:00 – Final thoughts
Additional resources
The PCR Data QuickGuide is available now, and we encourage all EMS professionals to download their copies and gain a deeper understanding of PCR data best practices. To download the guide, please follow the link:About NEMSISAbout Page, Wolfberg & WirthAbout our guests
Ryan Stark
Ryan Stark is a managing partner with Page, Wolfberg & Wirth, and is the firm’s resident “HIPAA guru.” He counsels clients on labor relations, privacy, security, reimbursement and other compliance matters affecting the ambulance industry.
Ryan started in the healthcare field as a freshman in college, where he worked for a local hospital and a retail pharmacy. After college, he decided to become a lawyer, hoping to guide healthcare providers through the demanding legal issues they face. He has been with PW&W since 2007, fulfilling that ambition.
Ryan is passionate about educating EMS professionals and loves collaborating with providers and CEOs alike. He is a featured speaker in PW&W seminars and webinars, including the firm’s signature abc360 Conference, where he hosts the abc360 Game Show. Always enthusiastic, Ryan has been invited to speak at many state and regional EMS conferences, as well as national industry events. He is also an adjunct professor at Creighton University in the school’s Master of Science in Emergency Medical Services Program.
Ryan developed, and is the primary instructor for, the nation’s first and only HIPAA certification for the ambulance industry – the Certified Ambulance Privacy Officer. He also co-authored PWW’s widely used Ambulance Service Guide to HIPAA Compliance.
Ryan volunteers with local community nonprofit organizations. He was also a big brother with the Big Brothers Big Sisters program for over a decade and keeps in touch with his “little.” Ryan also enjoys hiking, running, kayaking and traveling, and spending time with son Oliver.
Steve Johnson
Steve began his career in the EMS industry in 1985, gaining valuable experience while serving as an EMT and later as director of a municipal ambulance service in Minnesota. As an ambulance service manager, Steve established his expertise in areas of operations, billing and administration.
Steve also has significant EMS educational experience. He established and served as training coordinator and lead instructor for a State Certified EMS Training Institution for EMTs and First Responders.
Steve served on both the Rules Work Group and the EMS Advisory Council to the Minnesota State Department of Health.
He joined the staff of a large, national billing and software company, where he was a frequent lecturer at national events and software user group programs. For over 7 years, Steve served as director of a national ambulance billing service and was responsible for all aspects of managing this company, including reimbursement, compliance and other activities for ambulance services throughout the nation.
Steve served as founding executive director of the National Academy of Ambulance Coding (NAAC), overseeing all activities of the Academy, including the Certified Ambulance Coder program, the nation’s only coding certification program specifically for ambulance billers and coders.
As the director of reimbursement consulting with Page, Wolfberg & Wirth, Steve is involved in all facets of the firm’s consulting practice. Steve works extensively on billing and reimbursement-related activities, performing billing audits and reviews, improving billing and collections processes, providing billing and coding training, conducting documentation training programs, and performing many other services for the firm’s clients across the United States.
Steve is also a licensed private pilot, and enjoys an active role in his church.
Rate and review the EMS One-Stop podcastEnjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.
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This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
This edition of the EMS One-Stop podcast spotlights the popular online education series Reel Emergency, which uses real bodycam footage to illustrate various types of medical emergencies. The footage is then discussed in a live broadcast by very well-known emergency medicine physicians, Drs. Peter Antevy, Mark Piehl and David Spiro.
Reel Emergency offers free continuing education credit on the day of the Prodigy EMS based broadcast (you must be in the live audience to receive CE) and is then made available via YouTube for all to view and use as part of their clinical education.
Reel Emergency has now produced 15 episodes and has been viewed tens of thousands of times as both individuals and departments benefit from the content, the expert analysis and commentary, as well as subject matter expert guests.
In this podcast, Rob Lawrence chats with Reel Emergency’s regular host Hilary Gates, director of educational strategy for Prodigy EMS; and Zach Dunlap, clinical education specialist from 410 Medical.
Zach also previously worked for an agency that pioneered the use of body-worn cameras in EMS and offers insight into their adoption and use.
TOP QUOTES FROM THIS EPISODE
“These real patient videos actually show what’s happening on a call. Where else do you get that? You can’t get that anywhere else and there’s something to be said for doing scenarios and having standardized patients or mannikins, but nothing beats watching the actual call itself because you also have all of the other elements of the call that are really hard to recreate in the classroom. You have all of the emotions all of the bystanders, all of the equipment, the communication aspects you have to worry about, and you have real human reactions” — Hilary Gates
“If you are an educator, and you are teaching a certain topic – anatomy, physiology, scene management, all operations, whatever it is – and there is a way to illustrate that, you should be required to illustrate it with a video – there’s just no better way to do it.” — Hilary Gates
“It should almost be a requirement at this point, the main reason people don’t want body cameras in EMS is because it’s grossly misunderstood.” — Zach Dunlap
EPISODE CONTENTS
1:00 – Introductions
01:35 – REEL Emergency
02:20 – Everyone knows Drs. Spiro, Antevy and Piehl
4:00 – Using video for education
6:10 – Gaining free CE and watching on-demand
07:20 – Using body-worn cameras on the street
08:23 – Using BWCs for performance improvement
11:25 – Suggesting that BWC eventually become the standard of care
12:50 – Where does Reel emergency get its videos from?
14:00 – Filming the Falmouth Road Race and heat emergencies
15:20 – How to view Reel Emergency?
ADDITIONAL RESOURCES ON THIS TOPIC
Current Reel Emergency topics include sessions on HP CPR, heat emergencies, peds emergencies, junctional hemorrhage, ped airways, anaphylaxis, intracranial emergencies, delirium, end of life care, GSWs and altered mental status.
Following are additional resources on incorporating body-worn cameras:
Promoting transparency and accountability with BWCsThree outdated paradigms holding EMS backLeadership’s role in keeping our workforce safeHow to buy body-worn cameras (eBook)ABOUT OUR GUESTS
Zach Dunlap began his EMS career as a paramedic in Amarillo, Texas. After working in Oklahoma City, he returned to the Texas panhandle, where he worked as a flight paramedic for several years. Zach now resides in Houston, and has served as a flight paramedic and clinical director for a progressive 911 system. Currently, he is a clinical education specialist for a national medical company educating and training clinicians across the country on volume resuscitation. Zach obtained his bachelor’s in emergency health sciences and has always focused on providing excellent patient care through innovative approaches. Zach enjoys sports and spending time with his two children, Brogan and Brynlee, and their Goldendoodle, Claire. Zach is also the assistant treasurer of the Board of Commissioners of Harris County ESD11 in northern Houston.
Hilary Gates, MAEd, NRP, is the director of educational strategy for Prodigy EMS and a volunteer paramedic in the Alexandria (Virginia) Fire Department. She is also a faculty member of the School of Education at American University in Washington, D.C., and teaches Introduction to Community Health in the EM Program at University of Pittsburgh. Beginning her career as a volunteer EMT with the Bethesda-Chevy Chase Rescue Squad in Montgomery County, Maryland, Hilary became a full-time paramedic, EMT instructor and FTO at AFD, and then served as senior editorial and program director for EMS World. She implemented AFD’s MIH/CP program in 2017 and has extensive experience as an EMS educator, symposium presenter and quality improvement trainer.
ABOUT THE REEL EMERGENCY PANEL
Dr. David Spiro is a pediatric emergency physician and professor at University of Arkansas Medical System, and he is chief medical officer of Reel Dx. Dr. Peter Antevy is a nationally recognized lecturer and expert in the field of prehospital pediatrics and cofounder of Handtevy Pediatric Emergency Standards. He currently serves as the EMS medical director for multiple fire and rescue departments in Florida. Dr. Mark Piehl is a board-certified pediatrician and pediatric intensivist at WakeMed Hospital in Raleigh, North Carolina, and co-founder of 410 Medical.
CONNECT WITH OUR GUESTS
Hilary Gates:
LinkedinTwitterZach Dunlap:
LinkedinTwitterRATE AND REVIEW THE EMS ONESTOP PODCAST
Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.
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This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
In this edition of the EMS One-Stop podcast, Host Rob Lawrence speaks with Dr. Maia Dorsett and Paramedic Nikki Little to discuss the NAEMSP Quality Improvement and Safety Course, an exciting year-long course that provides EMS physicians and quality improvement leaders with the knowledge and skills necessary to lead QI and patient safety initiatives in their region, system or agency. Participants will develop an in-depth understanding of how to apply QI tools and strategies to their local needs to affect the care of patients.
Dr. Dorsett and Little identify that the program will take participants on a journey to improve the quality of care and safety in their system through a multi-modal approach in sessions led by expert faculty, who will discuss key aspects of quality improvement.
TOP QUOTES FROM THIS EPISODE
“I think one of the things I love about this course is half the faculty are not physicians. There is a fair percentage of NAEMSP membership that are not physicians and the quality course especially is very deliberate. It has faculty from different backgrounds.” — Dr. Dorsett
“Your system is complex; all of the policies and procedures and processes that you have set up for the folks to work in them, they don’t always work as designed.” — Nikki Little
“Once a month, and even more often than that, because you meet with your mentees, you get to really collaborate idea-wise and work together with a group of people who are all there committed to making improvements in their system.” — Dr. Dorsett
“So many quality leaders are still stuck in this in this moment, where they’re looking at 50% in May and 52% in June, and we’re just comparing these two numbers and making massive strategic decisions about things that might be seasonal or have abnormal variation and we could be really making some really dumb mistakes if we’re not looking at our data over time.” — Nikki Little
EPISODE CONTENTS
02:00 – Introduction – Nikki Little
2:25 – Introduction – Dr. Maia Dorsett
02:40 – Description of the course
03:30 – Quality Course origin story
05:30 – Little’s experience as an inaugural participant
0745 – Month-by-month syllabus
10:00 – PDSAs and brevity in QI
13:00 – Capstone and results presentation
15:20 – Little’s course highlights
17:29 – Dorsett’s course highlights
21:25 – This course is not just for physicians
23:10 – Course overall timeline
24:30 – Cohort presentations at the annual meeting and poster presentations
26:20 – Class sign-up details
ADDITIONAL RESOURCES ON THIS TOPIC
NAEMSP Year-Long Quality Improvement and Safety Course
ABOUT OUR GUESTS
Maia Dorsett, MD, PhD, is an emergency medicine and EMS physician and educator. She completed her EMS fellowship at Washington University before moving to Rochester, New York, where she now serves as the medical director for EMS education at Monroe Community College and is the associate regional medical director for education and quality for the Monroe-Livingston Region. She is also the medical director for Gates Volunteer Ambulance as well as Prodigy EMS. Nationally, she serves on the board of the National Association of EMS Physicians and the National Registry of EMTs. She is involved in quality improvement implementation and education, serving as the co-course director for the NAEMSP Quality and Safety course.
Nikki Little, FAEMS, has fulfilled many roles as a paramedic, including advanced care paramedic, district chief of paramedic operations, 911 communication supervisor, and quality and patient safety officer in almost 30 years in EMS. She has a passion for patient-centered quality improvement of systems and has advocated for policy advances in the areas of patient safety, team communication and opioid overdose. She has dedicated countless hours to improve the quality and safety of patients with non-transport dispositions, (especially elderly and at-risk persons) and to improve the care for patients experiencing acute coronary syndromes (with particular focus on gender disparities in care). She has also contributed through committee work by way of the Paramedic Chiefs of Canada and the Manitoba Chapter of the Canadian Women’s Heart Health Alliance. In the area of quality improvement and paramedic education, she is in her sixth year as faculty of the National Association of EMS Physicians (NAEMSP) Quality and Safety Year-Long capstone course and preconference workshop. Her dedication to furthering the educational mission of the organization, and skill in teaching patient safety and improvement science to paramedic professionals and EMS physicians was duly recognized when she was named co-director.
CONNECT WITH OUR GUESTS
Maia DorsettNikki Little -
999, London Ambulance Service Deputy Director Simon Harding talks emergency planning for the royal gathering
This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
Recorded with less than 24 hours to go before the coronation of King Charles III, of England, host Rob Lawrence sits down with Simon Harding, deputy director of the London Ambulance Service to discuss planning for the coronation. Harding also serves as deputy director of the London's 999 control centers.
Harding begins by highlighting the construct of ambulance services in the United Kingdom, as well as the scope and operation of the London Ambulance Service, which serves 9 million citizens of the national capitol, plus visitors. LAS takes over 2 million 999 (the UK equivalent of 911) calls a year in addition to 2 million 111 calls (for non-emergency responses).
Harding and Rob discuss how incident management operates in the UK, using the GOLD, SILVER and BRONZE levels of command, and the roles and responsibilities at each level.
They talk about the plans for the coronation and how LAS – in partnership with public safety and military planners – are preparing to support the historic event.
Resources mentioned in this episode
London Ambulance Service John’s Ambulance ServiceAdditional resources for mass gathering planning
Boston EMS' Joe O'Hare: All hazards incident managementEMS coverage for mass gatherings and public eventsHow EMS can prepare for a mass gathering to become an MCI7 ways to be prepared before the mass gathering turns into an MCI -
This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
Ginny Renkiewicz, PhD, is an assistant professor of healthcare administration in the College of Health Sciences and Human Services at Methodist University, Fayetteville North Carolina. Dr. Renkiewicz has been involved in EMS for 21 years as a credentialed paramedic, administrator and leader. Her specific research interests include defining predictors and profiling traumatic stress syndromes in EMS personnel and she recently had two papers published in the U.K. and U.S. on subjects related to her research interests.
In this edition of EMS One-Stop, Rob Lawrence and Dr. Renkiewicz discuss her publications, “Secondary trauma response in emergency services systems (STRESS) project: quantifying and predicting vicarious trauma in emergency medical services personnel,” which discusses the emotional countertransference that occurs between the clinician and patient, and “Maladaptive Cognitions in EMS Professionals as a Function of the COVID-19 Pandemic,” which analyses how the coronavirus disease pandemic has profoundly affected EMS professionals.
TOP QUOTES FROM THIS EPISODE
“I don’t think we will ever go back to normal; this is kind of like 911. There was before 9/11, and there was after 9/11, and this is going to be before COVID, and after COVID.”
“Vicarious trauma is emotional counter, transference; essentially, you are feeling what the patient feels when they’re experiencing a traumatic event. Example being, if you had a call, for example, a stillbirth, you may for the following weeks or months have this weird aversion to children or things in which infants are involved and you may have a stress response to those situations in the same way that the patient would have.”
“Post traumatic stress injury is not the only stress disorder that exists out there. It is the one that I think most frequently cited by educators and administrators, because we don’t know all of the other more insidious stress disorders, of which vicarious trauma is one.”
“A predictor of having vicarious trauma as an EMS professional; my hypothesis is that if your parents or whomever your caregivers are do not teach you how to appropriately and emotionally cope with anything in any situation, it becomes very difficult for you to know how to do it properly in your adult life and so you overcompensate, and so vicarious trauma occurs in that population.”
EPISODE CONTENTS
1:12 – Introduction: Dr. Ginny Renkiewicz
1:55 – Ginny’s academic career
3:00 – The development of research on EMS
4:50 – Paper discussion – secondary trauma response
09:00 – Education on stress disorders
11:24 – Therapy dog program
12:30 – Next steps/further work on resilience training
1530 – Maladaptive cognitions
17:20 – Getting published in the SOM Journal
19:00 – Learning, conclusions and takeaways
23:00 – The new normal
24:18 – Call to action for leaders
26:13 – NHTSA Listening Group on wellness, resilience and peer support programs
27:30 – Getting involved in research
31:00 – NAEMT Lighthouse leadership program
ADDITIONAL RESOURCES ON THIS TOPIC
Secondary trauma response in emergency services systems (STRESS) project: quantifying and predicting vicarious trauma in emergency medical services personnel“Maladaptive Cognitions in EMS Professionals as a Function of the COVID-19 Pandemic”ABOUT OUR GUEST
Dr. Ginny Renkiewicz is an assistant professor of healthcare administration in the College of Health Sciences and Human Services Methodist University, Fayetteville, North Carolina. She has been involved in EMS for 21 years as a credentialed paramedic and Level II paramedic instructor. She has spent 17 years as a program director, division chair or department head and has been recognized for her contribution to the EMS profession as a Fellow of the Academy of Emergency Medical Services (FAEMS) through the National Association of EMS Physicians. She has won several national and international awards, including National EMS Educator of the Year and the global EMS10 Award for innovation in the field of EMS.
She holds an Associate of Applied Science in Sign Language Interpreting degree from Wilson Community College, a Bachelor of Science in Emergency Medical Care with a concentration in EMS management and a Master of Health Science in EMS education (both from Western Carolina University), and a Ph.D. in Health Science with a concentration in Respiratory Care from Rush University. Dr. Renkiewicz is a reviewer for several peer-reviewed journals; serves as executive director of the Foundation for Prehospital Medicine Research; and is enthusiastic about research, innovation and student mentoring. She is also the vice chair of the North Carolina Association of EMS Educators. Her specific research interests include defining predictors and profiling traumatic stress syndromes in EMS personnel.
CONNECT WITH OUR GUEST
Email: [email protected]
Twitter: @DrKrankyPants
LinkedIn: www.linkedin.com/in/ginnyrenkiewicz
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This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.
COVID-19 was declared a Public Health Emergency (PHE) on Jan. 31, 2020, and was extended a number of times, but it is now set to expire on May 11, 2023. In this episode of EMS One-Stop, Rob Lawrence is joined by Doug Wolfberg, Esq., of Page, Wolfberg & Wirth to discuss the immediate actions organizations should take (or should have already taken) to preserve documentation relating to the PHE, as well as adjust operational and documentation practices and procedures as we “return to normal.”
Rob and Doug discuss issues such as rule changes that have become normal operating procedures over the last 2 years and the need to build a time capsule to preserve evidence. They also cover patient signatures, telehealth changes, transport to alternate destinations, agency licensing and Physician Certification Statements.
Doug, a lifelong Beatles music fan, also shares that he has just published a book: “The Beatles: Fab but True: Remarkable Stories Revealed” and will be undertaking a book signing tour in the UK later in the year.
TOP QUOTES FROM THIS EPISODE
At the end of the PHE, “We revert back to the standard inflexible Medicare signature rules which means that the patient needs to be the signer, and the only time that you can get a signature from anyone else is if that patient is physically or mentally incapable of signing that statement.”
EPISODE CONTENTS
1:12 – End of the PHE announced
2:00 – Rule changes have become normal operating procedures
2:20 – The need to build a time capsule to preserve evidence
4:30 – Big change ticket item number one – patient signatures
6:40 – A reminder to establish the reason the patient is unable to sign a PCR
7:20 – Telehealth changes
10:00 – Transport to alternative destination coverage ends (but place your pandemic local clinical guidance in your time capsule now!)
13:07 – ET3 – not affected and is separate
15:24 – Doug and the Beatles
17:52 – Ambulance staffing waver also going away
18:55 – Agency licensing back into full force – no more grace periods
21:12 – Physician Certification Statements (PCS) – do not cut corners on your PCS signatures
22:15 – Leaders pay attention to this podcast
ADDITIONAL RESOURCES ON THIS TOPIC
CMS Waivers, Flexibilities, and the Transition Forward from the COVID-19 Public Health EmergencyDoug’s new book: “The Beatles: Fab but True: Remarkable Stories Revealed”ABOUT OUR GUEST
Doug Wolfberg is a founding partner of Page, Wolfberg & Wirth, and one of the best-known EMS attorneys and consultants in the United States. Widely regarded as the nation’s leading EMS law firm, PWW represents private, public and non-profit EMS organizations, as well as billing companies, software manufacturers and others that serve the nation’s ambulance industry. Doug answered his first ambulance call in 1978 and has been involved in EMS ever since. Doug became an EMT at age 16, and worked as an EMS provider in numerous volunteer and paid systems over the decades. Doug also served as an EMS educator and instructor for many years.
After earning his undergraduate degree in Health Planning and Administration from Pennsylvania State University in 1987, Doug went to work as a county EMS director. He then became the director of a three-county regional EMS agency based in Williamsport, Pennsylvania. He then moved on to work for several years on the staff of the state EMS council. In 1993, Doug went to the nation’s capital to work at the United States Department of Health and Human Services, where he worked on federal EMS and trauma care issues. Doug left HHS to attend law school, and in 1996 graduated magna cum laude from Widener University School of Law. After practicing for several years as a litigator and healthcare attorney in a large Philadelphia-based law firm, Doug co-founded PWW in 2000 along with Steve Wirth and the late James O. Page. As an attorney, Doug is a member of the Pennsylvania and New York Bar Associations, and is admitted to practice before the United States Supreme Court as well as numerous Federal and state courts. He also teaches EMS law at the University of Pittsburgh, and teaches health law at the Widener University School of Law, where he is also a member of the school’s Board of Overseers.
Doug is a known as an engaging and humorous public speaker at EMS conferences throughout the United States. He is also a prolific author, having written books, articles and columns in many of the industry’s leading publications, and has been interviewed by national media outlets including National Public Radio and the Wall Street Journal on EMS issues. Doug is a Certified Ambulance Coder (CAC) and a founder of the National Academy of Ambulance Coding (NAAC). Doug also served as a commissioner of the Commission on Accreditation of Ambulance Services (CAAS).
In his free time, Doug is an avid bicyclist and musician.
CONNECT WITH OUR GUEST
Website: www.pwwemslaw.com
Email: www.pwwemslaw.com/contact#
Linkedin: www.linkedin.com/in/douglas-wolfberg-099ab236
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Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.
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