This paper will discuss the internal organizational conflict that occurred in the Wake County Department of Emergency Medical Services (EMS) after the formation of the Advanced Practice Paramedic Division (APP). Wake County EMS (WCEMS) is the sole entity with in the Wake county Government structure that is charged with providing prehospital emergency medical care to the visitors and citizens of Wake County. This paper is based on the opinion of the writer; it does not and is not reflective of the department’s opinion or the stance of the county.
Wake County EMS responds to almost 90,000 requests for service annually and serves almost 1 million people, which places the WCEMS system in the top fifty EMS systems in the country based on call volume and size of population served. ("Wake county department," 2012) In response to ever-increasing call volume, a decrease in primary care, and the universal changes in healthcare, which have resulted in more people using EMS and the local emergency room for primary care and non-life threatening events, the EMS Department elected to change their service structure. The department would move away from the traditional EMS mantra of “you call we haul” and having a system being designed around reactive responses to healthcare issues in the community to an evidenced based incident prevention structure. No longer, would it be considered prudent or correct to just continue to add transport resources to address the increasing call volume and continue to place the actual burden of care on the local hospitals, it would become the burden of the EMS system to provide alternatives to properly address the actual healthcare needs of those who called 911. Wake County EMS had already utilized evidenced based ...
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Ambulances, started to affect today’s modern health care after the Civil war. Ambulances are specially equipped motor vehicles. Ambulances carry sick, or injured people from the spot of their accident, to the closest hospital. Ambulances are part of the emergency medical services, EMS, which also includes helicopters, airplanes, and boats. Ambulances typically have room for one or more people. Ambulances can also hold many medical personnel and medical supplies.
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I found your post interesting, having worked in an emergency department during my paramedic years. In my career as a nurse working in a clinic on occasion we must send a patient to the emergency department. I always call to speak with the charge nurse to provide report prior to just sending the patient, often I am on hold for greater than 15 minutes. This often results in the patient arriving at the ER before I can give report. Adding to this the charge nurse on more than one occasion is calling me on another line to ask why the patient it there! However, from past experience I do know how busy the ER can be at any given time.
On account of theses limits other tools that are more efficient, objective and accurate are necessary to enhance acute hospital care. The National Institute for Health and Clinical Excellence (NICE 2007) have highlighted the importance of a systemic approach and advocated the use of EWS to efficiently identify and response to pa...
Trzeciak, S. & Rivers, E. (2003). Emergency department overcrowding in the United States: An emerging threat to patient safety and public health. Emergency Medicine Journal, 20, 402−405. doi: 10.1136/emj.20.5.402
The Urgent Matter Collaborative is a program funded by the Robert Wood Johnson Foundation (RWJF). The program was formed to identify, develop, and share innovative approaches, inventions, and models to improve Emergency Department (ED) flow and quality of care. Urgent Matters Collaborative has contributed to ED quality and patient flow improvement by working with hospitals throughout the United States.
The issue of off load delay is becoming ever more relevant as emergency departments (ED) are filling up and having longer wait times. This isn’t always an issue when there are free paramedic crews in the area but it often results in coverage lapses. The question becomes, should paramedics be leaving their less urgent patients in triage with walk-in patients so that they can get to other people in need? A balance needs to be found between leaving the CTAS 4 and 5 patients in the waiting room and leaving 911 callers at home to wait.
Emergency services face vast difficulties in the operations field when handling emergency situations, whether it comes from handling a minor accident to a catastrophic catastrophy. Many of the difficulties do not come from the actual incident, but instead they arise from forming a rescue team containing different agencies and people. For the benefit off all individuals participating, it is imperative that there be a unified command structure in place to effectively coordinate and oversee the tasks that need to be accomplished. The need of a unified command was seen from the hardships faced in incidents, bringing forth the development of the Incident Command System that was designed to be used in an array of conditions, to bring all individuals to a common ground. FEMA (n.d) stated “The Incident Command System (ICS) is a standardized, on-scene, all-hazards incident management approach…”
In 2005, Congress reauthorized the legislation for the NHTSA. Under the Safe, Accountable, Flexible, Efficient Transportation Equality Act: A Legacy for Users or SAFETEA-LU, Congress then created the Federal Interagency Committee on Emergency Medical Services. The EMS system today is still a serious career that is competitive to get into. Medical Assistance is integrated into Law Enforcement, Fire Fighters, and anyone in public safety because it’s an honorable career and works to improve the safety of the community in which we live in.
This paper’s brief intent is to identify the policies and procedures currently being developed at Midwest Hospital. It identifies how the company’s Management Committee was formed and how they problem solved and delegated responsibilities. This paper recognizes the hospital’s greatest attributes and their weakest link. Midwest Hospital hired Dr. Herb Davis to help facilitate the development and implementation of resolutions for each issue.
Just like communities, BCFS EMD has to remain prepared at all times. As a non-profit partner of federal, state and local government and private industries, our team of responders are always updating and refining their skills and knowledge just in case they have to spring into response. Our training and exercises provide tailored preparation to any state, jurisdiction or health care entity's needs. By implementing hands-on workshops and exercises, BCFS EMD helps strengthen the knowledge of communities and organizations seeking further response
Meredith, J.W (2008, May). The Lack Of Hospital Emergency Surge Capacity: Will The Administration's Medicaid Regulations Make It Worse? Presented at The House Committee On Oversight And Government Reform. Retrieved March 2014, from
McCormick, S. (2003). Article 12. Major incidents, leadership, and series summary and review. Emergency Medicine Journal, 20(1), 70–74. doi:10.1136/emj.20.1.70
Philosophically the term emergency medical service has developed to represent a transition from a simplistic system of vehicles delivering only transportation, to a system by which certified medical care is provided on scene and during transport. However in some less developed regions, emergency vehicles are still fundamentally a means of transportation to the medical facility that will provide care.