EMS One-Stop

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
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Leadership and labor: Saving California’s ambulance services

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 employers’ 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.
As part of the ongoing legislative campaign, California’s ambulance service owners and operators have created a coalition with all the labor unions that represent EMS in the state to campaign for increases.
In this episode of EMS One-Stop, both labor and leadership sit down with Rob Lawrence to discuss politics, funding and working as a team.
About our guests
Melissa Harris - president and CEO of Ambuserve Ambulance, Medic1 Ambulance and Shoreline Ambulance; and board member and treasurer of the California Ambulance Association
Shelly Huddleson - national labor representative for the International Association of EMTs and Paramedics
Chad Druten - COO Emergency Ambulance Service based in Brea, California; president of the Los Angeles County Ambulance Association, president of the Ambulance Association of Orange County
Ryan Walters - president of IAEP Local 370 representing EMTs and paramedics working at Falck in Orange County and Los Angeles
Jim Karras - vice president and chief operating officer of Ambuserve Ambulance, Medic1 Ambulance and Shoreline Ambulance; vice president, Los Angeles County Ambulance Association; and secretary of the Ambulance Association of Orange County
Top quotes from this episode
“EMTs are one missed shift away from poverty. This is the industry I love. I’ve seen people leave, people that I wish we could hold on to, but they have to provide for their families.” — Ryan Walters
“Unlike the In and Outs, the Jack in the Boxes, the Del Tacos who can raise their prices to meet the escalating minimum wage and escalating inflationary pressures that they are feeling, we don’t have the ability to do that. Our rates are set for us by the government and by government payers and they are capped and in some cases, they are fixed, so we are beholden to the State of California to help us and give us some relief.” — Jim Karras
“If we don’t do something soon with our Medi-Cal rates, then our EMS system is going to implode, it’s going to implode because our ambulance companies are either going to stop taking these Medi-Cal patients because they can’t afford them and so who is going to take care of them or they are going to start shutting their doors. When they shut their doors, our members lose jobs.” — Shelly Huddleson
“The patient is the one that’s most important here, the medical recipient, they are the ones that stand to lose the most and they are the only reason we exist, they are the only reason any of us have jobs and we can’t lose sight of that, so we are not just advocating for our industry, we are advocating for the citizens of California.” — Chad Druten
Episode contents
0:30 Rob sets the scene
1:00 Meet the guests
2:05 The campaign to increase reimbursement
3:08 EMTs are one missed shift away from poverty
3:45 Management and labor alliance
6:30 How labor and management can work together on political campaigns
9:00 We share a common humanity
11:00 We as an industry are not good at going hat in hand
13:00 The politicians are astonished at what we pay and that we are losing people to fast-food chains
14:00 Medi-Cal is for the patient to have equal access to healthcare
17:00 This is an economic nightmare
18:30 If you were in an elevator with a politician, what would your pitch be?
21:45 Find your champions – those elected officials that will fight for you
23:00 Acting as a coalition
24:40 Ambulance companies with staffing issues
26:10 Workers deserve a long and dignified career
28:30 The patient is at the center
30:00 A call to action
Additional resources on this topic
California’s Fund First Responders
California Ambulance Association
International Association of EMTs and Paramedics
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Norway EMS: Telehealth, educational requirements and future plans

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 the second EMS One-Stop international edition, Host Rob Lawrence welcomes Steinar Olsen, director for emergency medical services and national preparedness in the Norwegian Directorate of Health. Steiner describes the composition and deployment of EMS services across Norway – a country with the second largest coastline in the world and 1,100 miles from North to South (the distance from Seattle to San Diego or Chicago to Miami). Norway has one government/healthcare run system consisting of 400 stations, 520 ambulances, 4,500 EMTs and paramedics, aided by 14 helicopters and 12 fixed wing aircraft.
Educational requirements, current initiatives and future plans are discussed. Lawrence and Steiner also identify that EMS systems around the world encounter similar challenges, and international best practice exchange is always welcomed and encouraged. 
TOP QUOTES FROM THIS EPISODE
“Looking at just response times – you can waste a lot of money that could be used wisely in other parts of the service to create more health.”
“Between 25-30% of calls are handled with just a phone call or a combination of phone and video conference with the patient.”
“EMS in the next 20 years will develop from just lights and sirens to being an advanced platform for performing healthcare in the patients’ home instead of moving them to the hospital.”
EPISODE CONTENTS
1:13: Introduction – Steinar Olsen
2:08: Description of EMS in Norway
4:05: Ambulance stations, helicopters and fixed wing aircraft
6:07: Paramedic training and education
7:17: EMS as a gateway to healthcare
9:38: Norwegian support to international disasters and events (Turkey and Ukraine)
14:00: The next big things for EMS in Norway
16:00: Response times can waste a lot of money
17:35: Hear and treat – Nurse triage
20:00: The need for EMS nations to learn from each other
21:00: The challenge for treating patients in the future
23:34: The relationship between fire and EMS in Norway
24:50 : Vehicle extrication – Norwegian style!
26:15: Steiner Olsen’s final thoughts
27:10: Contact details
ABOUT OUR GUEST
Steinar Olsen is a RN and paramedic with 38 years of clinical and high-level management background from EMS and specialized healthcare services. He now serves as the director for emergency medical services and national preparedness in the Norwegian Directorate of Health. Steinar is also the regional chair of the European Regional Group for EMTs and national focal point to NATO joint Civil Military Health group. His previous experiences include serving in various positions in national healthcare, ranging from field disaster management to hospital management, project management through various national and international projects, including heading Norway’s contribution to Sierra Leone during the Ebola outbreak in 2014/15 and followed by various deployments to international humanitarian and consular crises.
ADDITIONAL RESOURCES ON THIS TOPIC
Patient Quick Release Extrication Paper
Norwegian Telemedicine and Nurse Triage Video (in Norwegian)
CONNECT WITH STEINAR OLSEN
Linkedin  
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Sirens, transformation and trends

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 welcomes Matt Zavadsky back to the podcast to catch up on three key ongoing issues and developments: MedStar’s EMS-on-demand model via their MedStarSaver+PLUS program, the recent article by Zavadsky and Dr. Doug Kupas on the reduction of red lights and sirens with the additional news that MedStar ceased all RLS use during the recent ice-related weather event.  Finally, Zavadsky discusses the recent National Association of Emergency Medical Technicians’ 2022 EMS Worker Engagement Survey and the top five takeaways.
Top quotes from this episode
“One of the mantras we have always said is if someone is going to get paid to reduce our call volume, it should be us.”
“We take an oath to do no further harm, if we know that we are doing something that causes further harm while we are getting to a call that probably doesn’t need an immediate response, then we are not fulfilling our oath.”
“Our medical director has implemented a directive in the same theme of bad weather, bad driving that no patient will be transported with CPR in progress, meaning that you are just not going to transport patients in cardiac arrest … there is no reason for us to relocate corpses from the field to the emergency room.”
“Community expectation ... is it really what the community expects or is it something we have taught them to expect because we are competing for contracts?”
Episode contents
1:52       MedStar Saver Plus Model
11:37    NAEMSP2023 discussion
13:15    Red lights and sirens reduction
15:11    MedStar suspends RLS
19:07    Political navigation to reduce use of RLS with local officials
23:06    We stink at communicating effectively with our workforce
23:45    We stink at providing feedback to our employees about their performance (and their patients)
24:59    We don’t pay our people enough
26:21    California’s Medi-Cal Campaign
29:10    Work-life balance is a real thing
32:13    This is a long-term challenge that needs long-term solutions
34:33    Zavadsky’s final thoughts
34:44    Drs. Larmon, Kazan and Mackey
Additional resources
EMS-on-demand the next big transformation for the profession?
Culture shift: Reducing lights and siren vehicle operation
The EMS workforce: Critical condition!
About our guest
Matt Zavadsky is the chief transformation officer for MedStar Mobile Healthcare, the Public Utility Model EMS system serving Fort Worth, and 14 other cities in Texas. He has 43 years of experience in EMS. He is an at-large director for NAEMT and chairs its EMS Economics Committee.
Connect with Matt Zavadsky
Online
Linkedin
Twitter: @MattZavadsky
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Dr. Dave Williams: 12 questions to learn about your system

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 a recent blog post, Dave Williams, PhD, noted that half to two-thirds of Dallas city general funds are dedicated to police, fire and EMS. With significant tax dollar investments, elected officials, community leaders, and the media want to be good stewards. Still, they are frequently not equipped with the knowledge or data to determine if their services are built to get results and where there are opportunities for improvement.
In this week’s podcast, host Rob Lawrence sat down with EMS thought leader, Dr. Dave Williams, to discuss and identify the 12 questions local leaders can use to learn about their communities. Each point discussed should generate ideas for more learning and improvement both inside an organization and for those citizens and elected officials that surround it.
Top quotes from this episode
“I have been to dozens of ambulance systems around the world and met with leaderships teams and I can count on one hand the number of times they started by talking to me about their clinical outcomes.”
“Almost all of your staff are not your generation … which means they have a totally different value system and a totally different prioritization of things.”
“One of your real powers is to be able to help your community and its leaders understand what’s happening in it. The data that you have is a huge enabler for others to be able to change policy.”
Additional resources on this topic
Williams’ Blog
To Err is Human: Building a Safer Health System
The EMS workforce: Critical condition! Why right-sizing EMS response is crucial to increasing pay and improving work-life balance
Crossing the Quality Chasm: A New Health System for the 21st Century
About our guest
Dave Williams, PHD, designs and improves ambulance systems. He is known for leading objective, ethical and collegial approaches focused on patient and community needs, and incorporating evidence-based and best practice methods. He is one of a few researchers to study EMS system design. His published doctoral research focused on patient-centric EMS system design.
Dr. Williams is a former paramedic, EMS commander and researcher. Previous leadership positions include the Institute for Healthcare Improvement, Fitch & Associates, and Austin-Travis County EMS.
Dr. Williams is faculty at the Institute for Healthcare Improvement and serves as a senior improvement advisor. He served as faculty in emergency health services at The George Washington University School of Medicine and public safety management at St. Edward’s University. He supported professional development programs, including the National Association of EMS Physicians Quality and Safety program, the American Ambulance Association Ambulance Service Manager Program, and the National Academies of Emergency Dispatch Communication Center Manager Program.
Dr. Williams served as the vice chairman of the Board of CommUnityCare, the Federally Qualified Health Center system serving the City of Austin, Texas, and was appointed by the Travis County Commissioners Court to serve as a member of the Advisory Board of Austin/Travis County EMS. He is an alumni of Leadership Austin (Essential 2013).
He has contributed to several EMS leadership and research textbooks and published dozens of peer-reviewed papers and industry articles. He is a frequent keynote speaker.
Dr. Williams earned a B.S. in EMS Management and an M.S. in Emergency Health Services Management. He also earned a Ph.D. in Organizational Systems, where his research focused on the obstacles to patient-centric EMS system design.
Connect with Dave Williams
Online
Twitter @davewilliamsATX
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.
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