CFCA

1
Fire Service EMS System Responsibilities Presente
d by Division Chief Bob OBrien Battalion Chief
Ron Mayfield
2
Behavioral Objectives

• The participant shall be able to describe the
  components of a Fire Department EMS management
  system
• EMS Oversight
• Medical Direction
• Education
• Quality Improvement (QI)

3
Introduction

• The target audience for this session
• EMS Managers, EMS Administrators, EMS
  Coordinators, Nurses, Educators and Medical
  Directors
• What this program is designed to
• Provide an overview of Fire-Based EMS management
• Identify things you wish you would have known
  when you took on your role in EMS oversight

4
Im NewWhere Do I Start?
Your Not Alone!
5
Im NewWhere Do I Start?
County EMS Officers Cal Chiefs EMS
Officers Networking Fire Departments Ambulance
Providers Receiving Hospitals Base Hospitals
6
Time Management

• Use Technology!
• E-mail
• Internet
• Paperless Office
• In-Basket Priorities
• Consider Your Credibility

7
Time Management

• In-BasketLots To Get Done!
• Reports
• Patient Care
• Daily
• Monthly
• Supply Orders
• Complaints
• Obligations
• Meetings
• Training

8
Time Management

• Review
• Statute
• Regulations
• Local State Protocols
• Internal/External Contracts
• Know
• When Where You Need To Be

9
Time Management

• DELEGATE
• PLAN
• (when if you can)

10
Job Description

• EMS Manager
• Medical Director
• EMS Coordinator
• Clinical Nurse/Educator
• QI Coordinator
• Liaison

11
Job Description

• Legal Review
• Counselor
• Planner
• Director

12
Job Description

• Depending on the size of your organization, you
  may be filling one or more of these functions.
  Does your boss realize the scope of your
  responsibilities?
• How many hats can you wear?

13
Things To Do

• Tasks
• Controlled Substances Monitoring
• Supplies/Equipment
• Regulations, Statutes, Policies, SOPs
  Performance Standards
• Field Responses Observation
• Field Care Audits
• Data Analysis
• Networking
• Liaison
• Meetings Internal/External

14
Things To Do

• Processes
• PCR Compliance Reports
• Data Systems Management
• Subpoenas
• HIPPA Compliance
• Billing Compliance Program For CMS
• Infection Control Plan
• QI Plan Feedback Loops
• Certification/License Tracking
• Training Records
• Budget

15
Reference Materials

• Journals
• Web Sites
• Newsletters
• List Servers
• Text Books
• National Fire Academy
• Hospital Library

16
Medical Direction

• EMS Agency Medical Director
• Base Station Medical Director
• Fire Department Medical Director
• Full Time vs. Contract
• Dispatch Center

17
Education
On The Job Training New Employee
Training Continuing Education (CE) Certifications
Licenses
18
EMS Programs

• Public Access Defibrillation
• Citizen CPR
• 12 Lead
• Grief Support
• CISD
• EMD
• Special Event Details
• Bike Medics
• Snow Mobile Medics
• Sporting Events

• EMT Program Manager
• ALS/BLS Engines, Trucks Squads
• Technical Rescue
• Metropolitan Medical Response System (MMRS)
• Urban Search Rescue
• NDMS DMAT
• Immunizations
• Public-Private Partnerships

19
Things That Can Get You Your Fire Department In
Hot Water

• Breach of Patient Confidentiality
• HIPPA Violations
• Federal Anti-Kick Back Violations
• Freebees
• Medicare Fraud
• Lack of a Compliance Program

20
Things That Can Get You Your Fire Department In
Hot Water

• No Medical Oversight or Quality Assurance
• Poor Patient Care
• Lack of Following Protocols
• EMSA/LEMSA
• Licensure Issues
• Accreditation Issues
• OSHA Violations
• Infection Control Program
• DEA
• Controlled Substances

21
Quality Improvement

• Formerly known as Quality Assurance
• Measuring
• Trending
• Data Driven
• Remedial Training
• Time Labor Intensive

22
Data Analysis
23
Data Analysis
24
Data Analysis
25
He/She Who Has Data Wins!

• Learn from the Cops
• EMS stats sell programs
• Provide a funding mechanism
• Its part of QI
• Youll probably be measuring your delivery system
  better than your counterparts in OPS!

26
Cutting Red Tape
Review

• Data Reports
• Response Times
• Analyze Information
• Provide Timely Feedback

27
Professionalism
Would you use your own service? Do you think
youd be surprised? How are your EMS
professionals viewed by the community? Are there
turf wars with transport personnel?
28
Professionalism
Build relationships with other EMS disciplines,
agencies, and departments.
29
Lack of Oversight

• Compromised patient care
• Time consuming investigations
• Personnel actions
• Credibility
• Turf wars
• Litigation
• Trust issues
• Community Confidence

30
Marketing
Does your fire apparatus market your service?
Professional lettering Adds pizzazz and clearly
identifies the level of service your providing.
Have you ever had someone sayHey, I just wanted
the paramedics not the Fire Department!
31
Using Appropriate Levels of Transport
QI activities should include ride-alongs and
field observations. Frequent PCR audits will
catch whether or not your personnel are using the
right transport resource. Assure proper
field protocols are used for complex scenes. Do
transport medics understand ICS?
32
Scene Safety and Patient Care
PCR audits will not always identify if EMS
personnel are providing appropriate care during
extrication activities. CE classes focusing on
these incidents must include patient care and
rescuer safety.
33
Diversity
Do your personnel understand respect in the
workplace and in the public arena?
34
Continuing Challenges
3 _at_ 50 We are loosing key members and
experience. Workforce Generation X dot.comers
48/96 Schedule Budgets! Continue to shrink and
change FD priorities. Is EMS a priority in your
organization?
35
Will Your Actions Pass The Headline Test?

• Is it the right thing for the customer?
• Is it the right thing for our Department?
• Is it legal, ethical, and nice?
• Is it safe?
• Is it on your organizational level?

• Is it something you are willing to be accountable
  for?
• Is it consistent with our Departments values and
  policies?
• if the answer is yes to ask if these questions,
  dont ask for permissionjust do it!

36
Will Your Actions Pass The Headline Test?
Can you stand in front of the City Council, Board
of Directors or Supervisors and defend all of
yours and other personnel actions?
37
Terrorism Threats
Changes of mindset Funding opportunities Trainin
g challenges
38

DISASTERS OCCUR ONCE IN A BLUE MOON
HOWEVER, WE MUST BE PREPARED!
39
Things To Help The Overwhelmed

• Share the workload
• FD staff (or partner FD)
• Optimize technology
• Make friends with the IT Department
• Network!
• CFCA, Fire Departments, Ambulance, Hospital
• History will repeat itself
• Establish Committees
• Quality Action Teams
• Prioritize
• Document what hits the cutting room floor

40
Things To Help The Overwhelmed

• When all else fails, delegate or plagiarize
• (with permission of course!)

41
(No Transcript)
42
Summary

• It takes time to learn your responsibilities
• Seek a mentor
• Use your time wisely
• Take advantage of technology
• Build partnerships
• Quality and training go hand-in-hand

43
Where to Get More Information

• California Fire Chiefs Association
  www.calchiefs.org
• EMS Authority
• http//www.emsa.cahwnet.gov
• Page, Wolfberg, Wirth www.pwwemslaw.com
• National Fire Academy www.usfa.fema.gov/dhtml/fir
  e-service/nfa.cfm
• And theres plenty more on the web!

44
Let Us Not Forget Our Roots
The CFCA EMS Management Academy has been
dedicated to Mr. Page. He spent most of his
career preaching the value of high quality
fire-service based EMS. He raised the bar many
years ago. Lets make sure the bar continues to
stay at a very high level.
James O. Page Father of EMS
45
(No Transcript)
46
(No Transcript)