News & Updates

EMS1.com, Fitch & Associates and the National EMS Management Association just published their EMS Trend Report.

Click below to view and download a copy.

2016_EMS_Trend_Report-1

If your organization would like to join AIMHI, the membership application is now available. You can access the application at the “Join Us” tab, or download it here. Please email the completed application to ariordan@ambulance.org.

Tue, May 17, 2016 | By Matt Zavadsky, MS-HSA, EMT

As part of the 2016 ZOLL Summit, industry leaders hosted pre-conference attendees for a deep dive into the transformation EMS should undertake to survive, and even thrive, in the new healthcare environment.

EMS 3.0 Explained

The workshop opened with an explanation of what the term EMS 3.0 means. The early days of EMS, just prior to the publication of the landmark document “Accidental Death and Disability, the Neglected Disease of Modern Society” in 1966, were when funeral homes ran 50% of the country’s ambulance services, ambulances were ill-equipped and personnel were inadequately trained. This was EMS 1.0. Starting in the 70s, more modern delivery systems developed and ambulance design changed substantially. Physicians took the clinical lead, training became more formalized and advanced life support became the norm in many communities. The economic model for EMS has been based on fee-for-transport and the main (really the only) performance measure has been response times. EMS 2.0. Today, with the healthcare system and its payers focusing on patient outcomes, the patient care experience and, most importantly, the cost of the healthcare system, we are introduced to EMS 3.0.

EMS needs to change its delivery model to one that can prove value. The days of payment for “you call, we haul” are waning as our healthcare system partners look to reward providers that can demonstrate value with new economic models that share the risk for improved patient outcomes and reduced costs.

New Economic Models & Value-Based Purchasing

Workshop participants worked through an exercise to identify the true cost of EMS delivery as a foundation to exploring economic models that are not reliant on the traditional fee-for-transport model. These new models included capitated, population-based payment models and models that pay for the response as opposed to the transport. Specific examples were used from MedStar Mobile Healthcare in Fort Worth, Texas, which is currently negotiating with several payers to establish capitated rates and rates based on responses vs. transports.

There were also presentations on what value-based purchasing may mean to EMS and the role of patient experience in the overall value proposition. Bobby Hopewell from EMS Survey Team demonstrated how using an external agency to survey patient experiences is part of the shift to EMS 3.0 and precisely how the rest of the healthcare system conducts patient experience surveys.

High-Performance EMS

Rob Lawrence from Richmond (Va.) Ambulance Authority and the Academy for International Mobile Healthcare Integration (AIMHI) walked the participants through the main tenants of what it takes to deliver high-performance EMS (HPEMS). He explained how the use of data, flexible deployment models, system status management and effective public policy development contribute to improved patient outcomes and reduced delivery system costs—the main components of EMS 3.0.
Lawrence also explained the role of advocacy and community relations to help get your message out about the value your EMS agency brings to the community.

MIH-CP

Christie Hempfling from the University of Pittsburgh Medical Center’s Center for Emergency Medicine, explained the role of MIH-CP in EMS 3.0 and provided an overview of the recently released MIH-CP Outcome Measures Strategy. The Outcome Measures document is a collaboratively developed method for uniformly reporting outcomes from MIH-CP programs related to program structure, patient safety and quality, utilization, and costs and balancing metrics. Hempfling also presented MIH-CP updates from around the country, showing what the profession has learned over the past five years and what we still don’t know, yet.

Building Community Trust

Finally, Josh Weiss from 10 to 1 Public Relations took all the information from the day and provided numerous examples of the ways EMS agencies can build public affairs strategies that work. Important points included how to effectively tell your story to demonstrate value, how to position your agency as a valued partner in the local community, and how to conduct effective media relations strategies. Weiss used several videos and a physical demonstration of how important it is to build strong positive branding to help counter a possible negative event.
In all, it was a jam-packed eight hours that left the participants with countless “to-dos” for when they get back and do the real work making a difference in their local community, and better prepared to survive the EMS 3.0 transformation.

Written by Matt Zavadsky, MS-HSA, EMT
Matt Zavadsky, MS-HSA, EMT, is the director of public affairs at MedStar Mobile Heatlhcare, the exclusive emergency and non-emergency ambulance provider for Fort Worth and 14 surrounding cities in North Texas. He holds a master’s degree in Health Service Administration and has 30 years of experience in EMS, including volunteer, fire department, public and private sector EMS agencies. Contact him at mzavadsky@medstar911.org.

Article from JEMS

Dan Fellows is the Fleet Manager for Richmond Ambulance Authority (RAA). We recently chatted with Dan about his time as a Fleet Manager, what makes RAA unique, and much more in our latest interview.

Dan, first off thank you for taking the time to speak with us. You are currently the Fleet Manager for the Richmond Ambulance Authority (RAA). Tell us how you came to work at RAA and what you did prior.

DAN FELLOWS: I had worked at heavy truck and light truck shops before attending Nashville Auto Diesel College. After graduating and working for Ford dealers for a few years on ambulances, I came to RAA in the mid 90’s when they were looking for an experienced ambulance technician.

RAA has a reputation for being a high performing EMS system with response times that remain some of the fastest in the nation. As the Fleet Manager, you are always looking for ways to improve efficiency. What are some of the most important things that the RAA does on a daily basis to remain a high performing EMS system?

DAN FELLOWS: At RAA, the availability and reliability of the vehicles is paramount. To achieve efficiency in the System Status Management System we consistently want to keep vehicle turnaround time as low as possible. Fleet service technicians are given 15 minutes to determine if a vehicle currently in service can be repaired within the time frame or if the vehicle needs to be changed out. All of the vehicles at RAA are fully stocked and ready for service and thus changing vehicles takes a matter of minutes. Vehicles in for repair not only have the service needed done, but are also checked over for other possible needs along with checks on high potential failure areas, which have been designated from data collected on repair and preventative maintenance.

You recently received the National EMS10 Award for your innovative approach to using solar energy to supplement the electrical needs of ambulances. Can you give us some background on how this concept came about and how it felt to win the award?

DAN FELLOWS: The concept came from the need to have a resource vehicle’s battery charged in a location without access to a shore line. The most effective possibility was solar. After installation and testing, it was found the solution worked exceptionally well, and a trial was implemented to test the effect on standard Type III ambulances. Data was collected and the findings were very encouraging so the decision was made to continue installing the solar to the remaining Type III fleet. Receiving the EMS 10 award was very humbling for me as the solution was created out of necessity and to be honored by my peers in EMS is very gratifying.

An article entitled “How to Develop a Fleet Replacement Strategy” by Rob Lawrence and yourself was recently published on EMS World. The article had stated that fleet selection should be based on environmental, as well as operational, conditions. What are your thoughts on Compressed Natural Gas (CNG) and its potential?

DAN FELLOWS: As with all vehicle technologies, as each reaches its effective state, CNG has great potential in the EMS industry. Not unlike solar, CNG does have the potential for increasing the effectiveness of fleets while reducing the cost of operation when infrastructure is developed and available for its use.

The RAA has been a loyal customer of Excellance for many years. What are the most important aspects that you look for in a manufacturer and how does Excellance provide that for RAA?

DAN FELLOWS: At RAA, I look for the quality of a vehicle, the ability to come up with innovative design, and the ability to remain cost effective with future changes through a rechassis process. Excellance provides an avenue to each of these goals.

What are some of the biggest challenges you have had as a Fleet Manager and what are you most proud of?

DAN FELLOWS: I have many of the same challenges as other fleet managers, maintaining budgets, maintaining efficiency, and keeping a consistent product on the road for the service of citizens. I am most proud of seeing the hard work my staff and I have done bearing fruit month after month, year after year in a fast paced, high volume system.

Do you have any advice for individuals looking to become a Fleet Manager?

DAN FELLOWS: Be not afraid of data or what it has to tell you. Do not be hesitant to call upon other fleet managers to aid in answering questions you may not currently have the answers to. Always keep the needs of the crews and citizens in mind when designing, maintaining, and replacing vehicles.

Article source: http://www.excellanceinc.com/2016/04/exclusive-interview-raa-fleet-manager-dan-fellows.html

 

RICHMOND, Va., April 13, 2016 – Richmond Ambulance Authority (RAA) paramedic Tiffany Samuels has received an American Ambulance Association’s (AAA) Star of Life award for her leadership in clinical excellence and exceptional training for new EMS field personnel.   The Stars of Life awards, presented at AAA’s Stars of Life Celebration April 11-13 in Washington, DC, honor remarkable ambulance service professionals from around the nation who truly stand out and represent excellence in their field.  All who receive this award are nominated by their peers.

Samuels has been with RAA since 2008 where she currently serves as a paramedic field training officer and chair of the RAA Clinical Services Committee.  After graduating high school, Samuels was briefly employed in the banking industry before beginning her EMS career with the Richmond Ambulance Authority.  In 2008, her EMS career started at an entry level position within the Logistics Department as a vehicle service technician.  She has worked very conscientiously, entering each new position with an undeniable passion.  Ms. Samuels’ dedication and focus ensured she was confident and proficient at current certification and skill level before progressing through the organization to her position as a paramedic – field training officer.  In this role she takes great effort and shows immense pride in teaching new employees how to provide world-class EMS.

“Tiffany is a delight to work with,” said Wayne Harbour, chief clinical officer for the Richmond Ambulance Authority. “She continues to be a valuable asset to RAA not only by the dedication with which she carries out normal day-to-day duties, but also by the many contributions she makes while serving on various committees. She helps shape the clinical direction of the agency by serving as chairperson of Clinical Services Committee”.

Last year, Samuels received the 2015 RAA Medical Director’s Award.  This prestigious award is presented annually by RAA’s internationally-renowned Medical Director, Dr. Joseph P. Ornato, to a paramedic who has demonstrated superior clinical abilities and has also dedicated personal time and effort to ensure RAA remains clinically on the cutting edge of mobile healthcare, not only in Richmond, but also nationally and internationally.

“She is an advocate for her fellow EMS providers while participating on the Wellness Committee, and she has presented many creative ideas to the Scheduling Committee promoting a positive work/life balance” said Chip Decker, CEO of the Richmond Ambulance Authority.  “She deserves to be recognized as a Star of Life, and we are proud of her many accomplishments.”

Samuels commented, “I am very honored to be selected by Richmond Ambulance Authority to represent them at the Stars of Life Assembly. To be considered with such high regard by my fellow coworkers and supervisors is truly humbling. I strive every day to live up to the reputation that this honor represents and will continue to do so with the pride and joy that comes along with truly loving my career.”

RICHMOND, Va., March 1, 2016 – Dan Fellows, fleet manager of the Richmond Ambulance Authority (RAA), has won the national EMS10 Award for his innovative approach to using solar energy to supplement the electrical needs of ambulances.  This award, presented at the 2016 EMS Today Conference by the Journal of Emergency Medical Services (JEMS), recognizes 10 individuals who have contributed to EMS in an exceptional and innovative way.

As fleet manager for RAA’s 40 ambulances, Fellows is responsible for the design and day-to-day operation of these vehicles, and he is constantly looking to for ways to improve efficiency.   When faced with the problem of finding a reliable energy source for a RAA resource vehicle that did not have access to a shoreline power plug at the back of headquarters, Fellows decided to explore the use of solar panels to charge the unit.

“The solar panels installed on this unit did an excellent job of charging the battery needed to start the vehicle each morning so we decided to try solar panels on a standard ambulance to see if we would have similarly positive results,” said Fellows.  “There were many factors to work through such as secure mounting and wiring the panels directly to the vehicle’s battery so the solar energy could power the ambulance’s entire electrical system.  Others in the industry had dabbled with solar to charge individual component batteries, not the entire vehicle, and we have come close.”

RAA’s solar panels don’t generate enough energy to completely power the largest ambulances but do generate enough electricity to offset the energy requirements of the many onboard electronics such as the mobile communications systems, air quality control, mobile gateways, and computer chargers, all of which draw power.  After offsetting the draw of the electronics on board, the solar energy provides about four additional amps of power to trickle charge the batteries.  As a result, ambulances no longer high idle when parked between calls.  While the solar panels don’t generate enough energy to allow the ambulances to be completely turned off between calls, the engine only needs to power the heating and A/C system; the solar panels power all the other electronics within the ambulance.

Before implementing solar-charging in all of RAA’s ambulances, Fellows tested an ambulance for almost a full year to collect data on its efficiency. The cost savings and positive environmental impact proved a winning combination.

“Dan is a creative manager who thinks outside the box and is constantly looking for solutions to improve efficiency,” said Chip Decker, CEO of the Richmond Ambulance Authority.  “The use of solar panels on our ambulances has led to noticeable cost reductions.  Battery life is extended, fuel is saved and the solar panels serve as a barrier so the vehicle absorbs less heat which reduces air conditioning demand in the summer.  There is also the added benefit of reduced environmental impact.  We are proud of Dan and happy to see his innovative approach to operational challenges recognized on a national level.”

“It is a tremendous honor to win an EMS10 Award,” said Fellows.  “I am blessed to work with supervisors and senior staff who encourage experimentation and are willing to explore new ideas and methods.  This culture of innovation at RAA – clinically and operationally – drives us all.”

This is the third EMS10 Award for the Richmond Ambulance Authority.  COO Rob Lawrence and Operational Medical Director, Dr. Joseph Ornato are also recipients of this prestigious national award.  Only two EMS organizations in the United States have three EMS 10 Awards – RAA and MedStar in Fort Worth, Texas.

About the Richmond Ambulance Authority
In 1991, the Richmond City Council and the city manager implemented an Emergency Medical Services (EMS) system that placed the patient first and guaranteed its performance to the City’s residents.  Today, the Richmond Ambulance Authority responds to approximately 200 calls per day and transports, on average, 140 patients per day.  RAA’s emergency response times are among the fastest in the nation with ambulances on the scene of life threatening emergencies in less than 8 minutes and 59 seconds in more than 90% of all responses.  RAA is one of only 24 EMS agencies in North America accredited by both the Commission on the Accreditation of Ambulance Services and the National Academies of Emergency Dispatch.  RAA is also a Commonwealth of Virginia Accredited Dispatch Center.  For more information, see www.raaems.org.

Fort Worth, TX — April 7, 2015 – At their meeting on February 19, 2015, the Coalition of Advanced Emergency Medical Systems (CAEMS) Board of Directors took a bold step in support of the industry movement toward being more than simply emergency medical services providers. CAEMS is now the Academy of International Mobile Healthcare Integration, helping the transformation of EMS to mobile integrated healthcare through the development of high performance systems, setting the standard for clinical excellence, accountability, public education, research and economic efficiency.

AIMHI’s vision is to improve patient health and experience of care by promoting excellence in mobile healthcare integration through evidence-based, out of hospital healthcare system effectiveness and efficiency.

A major focus for AIMHI will be to help publish peer-reviewed research projects that demonstrate the clinical, experiential and economic impact of sound MIH models. The Academy will also continue to promote the clinical, operational and fiscal benefits of High Performance EMS (HPEMS) models.

The Founding Members of AIMHI include:

• Emergency Medical Services Authority, Tulsa and Oklahoma City, OK
• Mecklenburg EMS Agency (MEDIC), Charlotte, NC
• Medic EMS, Davenport, IA
• MedStar Mobile Healthcare, Fort Worth, TX
• Metropolitan EMS Authority, Little Rock, AR
• Niagara EMS, Ontario, CA
• North Shore Univ./LIJ Health System, Syosset, NY
• Nova Scotia EHS, Nova Scotia, CA
• Regional EMS Authority, Reno, NV
• Richmond Ambulance Authority, Richmond, VA
• Pinellas County EMS Authority/Sunstar Paramedics, Largo, FL
• Three Rivers Ambulance Authority, Ft. Wayne, IN

 

Leading the transformation of EMS to mobile integrated healthcare through the development of high performance systems, setting the standard for clinical excellence, accountability, public education, research and economic efficiency.

Doug Hooten, the President of AIMHI and the Executive Director of MedStar Mobile Healthcare explains:

“The transformation of EMS into Mobile Integrated Healthcare (MIH) is a patient centered way to help the healthcare system achieve goals articulated in the Institute for Healthcare Improvement’s Triple Aim.

The members of AIMHI represent many of the thought leaders in MIH delivery and we are in the ideal position to not only promote the model, but conduct peer reviewed research demonstrating the impact of this service delivery model.

We invite all agencies interested in the effective delivery of MIH services, including the high performance EMS service line, to join us in promoting the evolution of our profession into this expanded service delivery model.”

To learn more about AIMHI’s members, its mission, vision and activities, and to join AIMHI as a member email info@aimhi.mobi.

Click here to view or download the official press release.