EMS One-Stop

Not just for physicians: Quality improvement and safety

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 Dorsett
Nikki Little

Preparing for the coronation

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 Service
Additional resources for mass gathering planning
Boston EMS' Joe O'Hare: All hazards incident management
EMS coverage for mass gatherings and public events
How EMS can prepare for a mass gathering to become an MCI
7 ways to be prepared before the mass gathering turns into an MCI

It’s not just PTSD: Stress disorders in EMS

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: drginnyrenkiewicz@outlook.com
Twitter: @DrKrankyPants
LinkedIn: www.linkedin.com/in/ginnyrenkiewicz
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Doug Wolfberg: What the end of the Public Health Emergency means for EMS

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 Emergency
Doug’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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Preserving history with the NEMSM

EMS One-Stop Show Notes - National EMS Museum
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 episode of EMS One-Stop, Host Rob Lawrence discusses the National EMS Museum (NEMSM) with President Dave Zaiman; Museum Director, Kristy Van Hoven; and Jon Krohmer, MD, immediate past-secretary and "We are EMS" coordinator. The National EMS Museum is a volunteer-led organization that collects, preserves and shares the history of emergency medical response in the United States in hopes of inspiring future professionals to take up the call.
The National EMS Museum organization operates a virtual museum and produces traveling exhibitions that tour the country every year. The Collections at the National EMS Museum house over 300 years of history that cover the development of prehospital care in the United States, North America and around the world.
TOP QUOTES FROM THIS EPISODE
“We are here to educate the future. We are here not only to document the legacy, but here to provide a foundation and an education that EMS as a profession, as we move forward is respected, is understood, and maybe in a small part this museum can play a part in improving EMS altogether.”
EPISODE CONTENTS
03:05 – Origins of the NEMSM
05:04 – The style and model of the NEMSM
07:00 – Changes underway – recruiting individuals with experience in museum activities
11:50 – President Dave Zaiman
13:20 – Getting EMS into the community
15:00 – Favorite artifacts
16:30 – From MAST pants to blood transfusion
17:20 – Fundraising effort in order to take the museum on the road
20:30 – Developing a traveling mobile “We are EMS” museum project
23:40 – How to book a traveling exhibit
ADDITIONAL RESOURCES ON THIS TOPIC
The National EMS Museum
California Ambulance Association Siren special edition: Fifty Years of Wedworth-Townsend
ABOUT OUR GUESTS
Dave Zaiman
Dave is currently Sales VP - Midwest at Pulsara.  For over 30 years, Dave has been working in healthcare – both as an EMS professional as well as holding several leadership roles in the healthcare technology industry. Based in Minnesota, Dave spent his first 15 years working in the field as an EMT and paramedic in the Twin Cities metro area for both Allina and Hennepin County Medical Center.
Kristy Van Hoven
Kristy is the museum director for the National EMS Museum and PhD candidate at the University of Leicester. Over the last 3 years, Kristy has worked with the National EMS Museum’s Board of Trustees to develop and implement engaging e-volunteer opportunities and community programs that reach their digital audience. In addition to her work with the EMS Museum, Kristy volunteers at several local museums in Toronto, Ontario.
Jon Krohmer, MD
Dr. Krohmer served as the director of the NHTSA Office of EMS before his retirement in November 2021.  During his tenure as director, Dr. Krohmer oversaw several milestones for the profession, including the creation of EMS Agenda 2050; major revisions to the National EMS Scope of Practice Model and the National EMS Education Standards; and improvements in the collection and use of EMS data through the expansion of the National EMS Information System. Soon after the onset of the COVID-19 pandemic, Dr. Krohmer was tapped to lead the prehospital/911 team as part of the Federal Healthcare Resilience Task Force.
Prior to joining NHTSA, Dr. Krohmer had decades of experience as a local EMS medical director, initially in his home state of Michigan. His EMS career began as an EMT with a volunteer rescue squad. Like many EMS professionals, he was inspired by the television show “Emergency!” and by the emergence of the relatively new field of emergency medicine. He entered medical school at the University of Michigan knowing he wanted to make EMS his career. After becoming involved in EMS at the state and national level, he also served as president of the National Association of EMS Physicians from 1998 to 2000. In 2006, he came to Washington to serve as the first deputy chief medical officer for the Department of Homeland Security Office of Health Affairs and served in several other DHS roles before joining NHTSA in 2016.
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Emerging pathogens, diseases, outbreaks and fevers

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 week, Host Rob Lawrence welcomes back, Alexander Isakov, MD, MPH, professor of emergency medicine at Emory University School of Medicine, executive director of the Emory Office of Critical Event Preparedness and Response (CEPAR), and EMS lead for the National Emerging Special Pathogens Training and Education Center (NETEC).
Returning guest, Dr. Isakov provides an update on the current emerging pathogens, diseases, outbreaks and fevers that have featured recently in the news. Candida auris, Marburg virus disease, avian influenza, Nipah virus are discussed as well as recaps on Ebola, COVID-19, polio and seasonal influenza.
TOP QUOTES FROM THIS EPISODE
“What’s concerning CDC officials and experts is there is a multi-drug resistant strain of Candida auris that is really picking up in their surveillance programs.”
“While no one wants to be exposed to a multi-drug-resistant Candida auris, it’s really the ominous compromised patient that’s going to be likely most affected by it, so that means elderly patients or patients that are getting chemotherapy and have some immunosuppression consequence of that or people that are taking immunosuppressant drugs, they are the ones really at greatest risk.”
“The likelihood that EMS personnel are going to encounter somebody with Marburg virus disease in the U.S. during routine operations is extremely low, but good to be vigilant about it and identifying that someone might have been exposed, and understanding their travel history, if someone is ill, has a fever or myalgia, GI complaints and has travelled within the last 21 days to equatorial Guinea or Tanzania, then it would raise suspicion.”
ADDITIONAL RESOURCES ON THIS TOPIC
CDC: Infection prevention and control for Candida auris
CDC: Information for infection preventionists
NETEC: Situation report: Marburg cases rise in equatorial Guinea and Tanzania
NETEC: EMS guidelines for Marburg virus disease
ABOUT OUR GUEST
Alexander Isakov, MD, MPH, is a professor of emergency medicine at Emory University School of Medicine. He is certified by the American Board of Emergency Medicine in both emergency medicine and emergency medical services (EMS).
Dr. Isakov is the director of the Section of Prehospital and Disaster Medicine whose faculty provides medical oversight for 911 communications centers, and ground and air EMS responders in metropolitan Atlanta. He is also the executive director of the Emory Office of Critical Event Preparedness and Response (CEPAR), which serves as the center for Emory enterprise-wide planning for and coordinated response to catastrophic events.
Dr. Isakov has provided leadership in emergency medical services and disaster preparedness locally and nationally. He serves as the medical director for the Sandy Springs Fire Department and Air Life Georgia. He is the founding medical director for the Emory-Grady EMS Biosafety Transport Program. He is the EMS lead for the National Emerging Special Pathogens Training and Education Center (NETEC) and is a designated Subject Matter Expert for the Assistant Secretary for Preparedness and Response, Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE). Dr. Isakov is also on the American College of Emergency Physicians Epidemic Expert Panel and is a member of the EMS sub-board for the American Board of Emergency Medicine. He previously served on the National Association of EMS Physicians board of directors and the Technical Expert Panel for NHTSA’s EMS Agenda 2050.
Dr. Isakov has an MD from the University of Pittsburgh and an MPH from Boston University. He completed his emergency medicine residency training at the University of Massachusetts Medical Center and his EMS fellowship with Boston EMS. Dr. Isakov has lived and worked in Atlanta for 20 years. He practices clinically in the emergency department of Emory University Hospital.
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Helping providers be seen, heard and cared for

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.
Russ Myers, Nikki Holm and Gwen Powell are chaplains at Allina Health Emergency Medical Services and in this episode, they join Rob Lawrence to discuss the role of chaplaincy in EMS. The guests discuss their role and responsibilities as well as the book, “Because We Care: A Handbook for Chaplaincy in Emergency Medical Services,” written by Russ Myers.
Over the past half century, the field of chaplaincy has come to a fork in the road. Many will recognize the well-traveled path of traditional chaplaincy. Others will follow the newer but clearly marked way to professional chaplaincy: a clinically trained, evidence-based discipline, reflecting and serving the diverse expressions of spirituality in modern society. Until now, chaplaincy in EMS has been the terra incognita, the unknown land on the map. Drawing on three decades of clinical chaplaincy practice, scholarship and original research, Russell Myers charts the map, making the case for ambulance service chaplaincy: how to think about it and how to do it.
TOP QUOTES FROM THIS EPISODE
“For me it’s all about love, how can I bring some light, some life, some love into the world, and I am able to do that in these situations by just showing up as we call in chaplaincy – the ministry of presence.” —Gwen Powell
“I do this work is to come alongside people and remind them of their humanity to help them break down their defenses and their shields to get back to the truth of who they are, to help them be seen and heard and taken care of.” —Nikki Holm
EPISODE CONTENTS
1:23 – Introduction Russ Myers
2:43 – Introduction Nikki Holm
4:00 – Introduction Gwen
7:35 – Book discussion: Because We Care – The Role of the Chaplaincy in Emergency Services
11:20 – Terra Incognita
12:30 – What motivates a chaplain?
15:30 – A chaplaincy intervention story
20:15 – A chaplain’s workload
23:00 – Being Proactive: Establishing a trusting relationship with the workforce
23:30 – Being Reactive: when an incident or issue occurs
30:15 – Education and being a presence during training
34:58 – If you are thinking about introducing g a chaplain
36:30 – Moral Injury and the social contract
40:40 – Overcoming the staff stigma about coming forward
42:00 – Close
ADDITIONAL RESOURCES ON THIS TOPIC
“Because We Care: A Handbook for Chaplaincy in Emergency Medical Services”
When EMS meets hospice. End-of-life care takes a heavy emotional toll: Seek support when needed
ABOUT OUR GUESTS
Russell Myers serves as a chaplain for Allina Health Emergency Medical Services, based in Minneapolis. He holds a BA from Ohio State University and a Doctor of Ministry degree from Luther Seminary, St. Paul, Minnesota. Russ is ordained by the Evangelical Lutheran Church in America and is board certified with the Association of Professional Chaplains. He lives in Saint Paul, Minnesota.
Gwen Powell is an ordained episcopal priest and board-certified professional chaplain who has been working with Allina EMS since 2020. Prior to working for Allina, she provided spiritual care to patients and staff on the adolescent behavioral health units at the M Health Fairview University of Minnesota Medical Center. Gwen graduated from Valparaiso University with a degree in psychology in 2008 and earned her Master of Science in Psychology from Kansas State University in 2010. She earned her Master of Divinity from Luther Seminary in St. Paul, MN in 2014 and has been passionate about mental health chaplaincy since beginning her ministry work in 2015. In her free time, she likes to beat her husband and kids at Mario Kart, exercise, walk/hike with her family, watch baseball, and sing with the Northern Lights Chorale.
Nikki Holm has been engaged in the meaningful work of EMS Chaplaincy through Allina Health since the Spring of 2020. Prior to making the transition to EMS, Nikki provided spiritual care and health education in an outpatient mental health setting for several years. Nikki was board certified with the Board of Chaplaincy Certification Inc. in 2017, graduated with a Master’s degree in Spirituality from St. John’s School of Theology in 2007 and with a Bachelor’s degree in Theology from The College of St. Benedict in 2005. Nikki lives in an earth home with her husband, their three beloved children, and three furry companions. Outside of soaking up life with her littles, Nikki enjoys rock climbing, writing, reading, yoga, gardening, and otherwise spending time with her tribe. Contact Nikki at Nicole.Holm@allina.com.
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‘Thrive despite whatever is thrown at you’

This special episode of EMS One-Stop is part of 2023 First Responder Wellness Week. Do you want to improve your physical fitness, increase your resiliency, eat better and sleep longer? Get started with videos, articles and other resources at www.firstresponderwellnessweek.com. You can also learn more about what Lexipol is doing to support health, wellness and safety among first responders.
In this special First Responder Wellness Week episode of  EMS One-Stop, Host Rob Lawrence welcomes Mike Taigman and Kevin Pannell to discuss the many facets of wellness, why wellness is essential for first responders, and easy tips for getting started to improve fitness, nutrition, stress management and more.
Memorable quotes
“The work we do involves your cognitive abilities to think well and sort out challenging situations for patients and calls and circumstances. You’ve got to lift people and move them and those kinds of things, so there’s a whole physical component, and the stress management is absolutely part of the wellness, and if you don’t kind of have a handle on that, there’s a lot of stresses this world presents to you – and poorly managed stress, we know, tears down your physical, psychological and emotional wellness.” —Mike Taigman
“If you’re in EMS or fire and you can’t carry the med box in one hand and the defibrillator in another up two flights of steps and you’re gassed and you can’t work when you get there, then you’re useless. And, for police, if you can’t wrestle with somebody because you’re exhausted in 30 seconds, it’s a problem.” —Kevin Pannell  
Together, they offer tips like:
Pay attention to your plant-to-processed food ratio
Start with pushups. You don’t need all the equipment they have at the CrossFit Games, Pannell notes. “You can get a smokin’ workout from just you and the ground.” Or take a walk.
Take a holistic approach to fitness (weightlifting, something that makes you breathe hard and stretching); it’s about balance
About our guests
Mike Taigman uses more than four decades of experience to help EMS leaders and field personnel improve the care/service they provide to patients and their communities. Mike is the Improvement Guide for FirstWatch, a company which provides near-real time monitoring and analysis of data along with performance improvement coaching for EMS agencies. 
He teaches Improvement Science in the Master’s in Healthcare Administration and Interprofessional Leadership at the University of California San Francisco and the Emergency Health Services Management Graduate Program at the University of Maryland Baltimore County.
Kevin Pannell works in program and project management in the healthcare IT space. He has previous experience as a public safety and military veteran, and produces wellness content.
Resources mentioned in this episode
Pannell5 Fitness Club
KEV Talks Podcast
Kevin Pannell on Twitter @pannellkg
“Undo It!: How Simple Lifestyle Changes Can Reverse Most Chronic Diseases” by Dean Ornish, MD; and Anne Ornish
“How Not to Die: Discover the Foods Scientifically Proven to Prevent and Reverse Disease” by Michael Greger, MD, FACLM; and Gene Stone

Funding models down under with Tony Walker

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, this month, Rob Lawrence talks with Professor Tony Walker, immediate past chief executive officer of Ambulance Victoria, a professor with the Faculty of Medicine, Nursing and Health Sciences and Bachelor Paramedic Studies at Monash University. While in charge of Ambulance Victoria, Tony led significant transformation to improve the health and well-being of their workforce and the response they provide to the community.
In this broad-reaching discussion, Tony explains the structure, organization and funding models of EMS down under and then Rob and Tony identify current challenges, issues and solutions common to both the U.S. and Australia, including the dreaded hospital handover challenges as well as reduction in lights and siren responses.
TOP QUOTES FROM THIS EPISODE
“We know at least one in five people who call triple zero, our 911 equivalent, don’t require an emergency ambulance and so new models of care are being developed.”
“When people call triple zero, they no longer expect that they will automatically get an ambulance, as often described to people, you don’t walk into a hospital triage and say I’d like you to admit me to the coronary care unit,, you get triaged, you work out what is wrong by a health professional and you get the care you need; that’s exactly the same being applied in the paradigm of ambulance service delivery here in Victoria and the rest of Australia.”
“In the next decade or so, I wouldn’t be surprised if we see predominantly women making up the majority of staff working on frontline ambulances.”
“New models of care have been developed. We have looked at the MPDS grid and where the disposition of those patients go to so we have reduced significantly the number of lights and sirens responses which has enabled us.”
“Issues of transfer of care in hospital are a real challenge for ambulance services in the time it takes to transfer patients and there is no easy fix for that.”
“If you are a paramedic who has gone to university, done your training, wants to deliver care and you are spending a significant proportion of your shift in an emergency department caring for your patient before he can offload it, that can be demoralizing and that probably goes against why you joined in the first place.”
EPISODE CONTENTS
1:16 Introducing Tony Walker
2:00 The scale and scope of Australian Services
05:45 Healthcare funding – how does the patient get their healthcare
7:45 EMS system organization and deployment
09:15 Degrees and paramedic education
11:50 Student debt … or not!
14:10 Is Australia over-producing graduate medics?
16:40 Alternative treatment models
19:00 Reducing lights and siren responses
21:08 Public expectation education
23:02 Looking after your people
25:50 Handover delay at the ED – a global issue
27:00 Gender and diversity
27:34 Scheduling and rostering – creating a flexible roster that meets the needs of the individual and service
28:40 Hospital capacity and flow issues
31:08 How can you work in Australia?
ADDITIONAL RESOURCES
Additional EMS One-Stop podcast solutions to EMS staffing woes from down under: Australia EMS medics join the podcast to discuss their efforts to fill U.S. positions with their paramedic surplus
On-Demand webinar: Ambulances held hostage: Strategies to unilaterally reduce ED wait times and get back into service
Ambulances held hostage: EMS strategies for reducing ambulance offload times
ABOUT OUR GUEST
Professor Tony Walker, ASM, is a registered paramedic with over 36 years’ experience working across senior clinical, operational and leadership roles within the ambulance sector. He was previously chief executive officer of Ambulance Victoria, where he led significant transformation to improve the health and well-being of their workforce and the response they provide to the community.
Tony is a Fellow of the Australasian College of Paramedicine and holds a Bachelor of Paramedic Studies, Graduate Certificate of Applied Management, Graduate Diploma of Emergency Health (MICA) and Master of Education.  He is a non-executive director of the Prostate Cancer Foundation of Australia, the Emergency Services Foundation and TLC for Kids, a Director of Fairhaven Consulting Pty. Ltd., and an executive member of the Global Resuscitation Alliance and an Associate Investigator with the Australian Resuscitation Outcomes Consortium.
He is a past non-executive director and chair of the Council of Ambulance Authorities (CAA), the peak body representing the eleven statutory ambulance services across Australia, New Zealand and Papua New Guinea, past chair of the Australian Resuscitation Council (Victorian branch) and past deputy convenor of the Australian Resuscitation Council ALS sub-committee.
Tony is published in an extensive range of literature relating to advancements in paramedic practice and prehospital systems of care, including prehospital thrombolysis, cardiac arrest, pain relief and prehospital rapid sequence intubation for traumatic brain injury.
Tony is a recipient of the Ambulance Service Medal (ASM) for his contribution to the development of ambulance services at a state and national level and awarded the National Heart Foundation President’s Award and Australian Resuscitation Council Medal (ARC) and included in the ARC Honor Roll, for his significant contributions to improving cardiovascular health and resuscitation practice and outcomes. He was a finalist for the Australian Mental Health Prize in 2019 in recognition of his work in improving paramedic mental health and wellbeing.
CONNECT WITH TONY WALKER
Linkedin
Twitter
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EMTs speak up: An EMS One-Stop Town Hall

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.
Like many other states across the U.S., California’s ambulance services are both understaffed and underfunded.  In what has turned into a vicious circle, poor reimbursement levels hamper the employer’s ability to increase pay and compete with other sectors that offer better hourly rates for less risky or skilled employment. In fact, California has not had an increase in its Medi-cal (Medicaid) rate in 20 years.
In this podcast, Host Rob Lawrence doesn’t talk about the EMTs on the truck – he talks to the EMTs on the truck.  He gets their views on what keeps them on the job and what is driving them away.  As Rob notes, “In talking to this amazing cohort of EMTs, it is clear that the passion to serve and care for those they treat is there, but the living wage they receive is not!”
Recurring themes emerge from the discussions (which are reflected in various EMS industry surveys):
Having a good and receptive boss/leader
Camaraderie – good coworkers make the day fly by
Training – keeping skills up to date.
The ability to do the job; respond; if necessary, transport; hand over and repeat! … not delay
About the guests
Alyssa Catalan – EMT with Shoreline Ambulance based in Orange County California
Doricela Mozo – EMT with. Medic 1 Ambulance based in Irwindale CA
Tyler Coombes – EMT with PRN Ambulance based on North Hills California
Ryan Walters – EMT with Falck Ambulance based in Orange County
Lasalle Jones – EMT with AmbuServe Ambulance based on Gardena California
Damian Henriquez - EMT with AmbuServe based in Gardena California
Top quotes from this episode
“We do have patients’ lives in our hands, and unfortunately, the pay does not reflect that whatsoever, so a lot of us are working two other jobs, like myself, I work here and I have another job and I have the most overtime than anyone else in the company and I still don’t have enough to pay my bills.” —  Damien Henriquez
“I have to work twice as much as a normal worker would have to to afford to live, and that’s one of the reasons why I’ve amassed about 40,000 work hours, I have a 20-year career but I’ve only been here 14 years.” — Ryan Walters
“One of the great things about EMS – coming to work and not knowing what type of call you are going to get, whether it’s interfacility transport, 911, just never knowing what kind of call am I going to get, sometimes you get really cool calls, sometimes you get calls that are very difficult, but after the call, just knowing that you accomplished it and what it took to accomplish is really rewarding.” — Lasalle Jones 
“Do you realize EMS as a whole is a bubble that’s about ready to pop? Do you want to be proactive or reactive? Do you want to get ahead of it before it bursts or do you want to figure it out after? Right here, right now, we are trying to be proactive so everyone can get a living wage.” — Damien Henriquez
Episode contents
01:25 – Meet the panel
02:56 – The view of the new EMTs
04:55 – Time served EMTs
07:17 – How can we help you make a living?
10:22 – What’s keeps you motivated and on the truck
13:56 – What is the FTO seeing as people come in?
21:40 – If you had a rider down the escalator with an elected official, what would you say to them?
25:54 – Get involved
26:24 – Final thoughts
Additional resources on this topic
California’s Fund First Responders Website
California Ambulance Association
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 editor@EMS1.com to share ideas, suggestions and feedback.