Hire an EMS coordinator
An EMS coordinator can function as a liaison and problem solver, says Robert Suter, DO, MHA, FACEP, regional medical director for Questcare Emergency Services in Dallas, TX. "It's important that this person is a paramedic because that's the way you get the most effective communication," he recommends. "If the crew is having problems with a particular nurse and your EMS coordinator is also a nurse, the crew may be reluctant to tell that nurse they are having problems with another nurse."
Providence Hospital and Medical Centers in Novi, MI, created an EMS coordinator position two years ago. "We have seen about an 8% increase in our census by ambulance since the position has been in place," reports Linda Honeycutt, EMT-P, EMS programs coordinator for providence Hospital and Medical Centers in Novi, MI. "They really appreciate having someone to call and voice concerns with, and being treated like part of the team."
The coordinator does outreach to stations, coordinates educational programs, delivers supplies left in the ED, and attends all county medical control meetings (see job description, page 93). "Our hospital serves as a base system for fire departments, and we participate with two different medical control authorities, so we needed a dedicated person to support the hospital and go to committee meetings," says Honeycutt.
Building those relationships is helpful. "Because I work with the coordinators and medical directors from all the different EMS agencies, if we change a policy in-house, such as patient disposition follow-up, they are more supportive and we are able to make that transition much more smoothly," says Honeycutt.
The EMS coordinator also oversees the monthly continuing medical education program for paramedics. "One fire department is entering into an endotracheal intubation study, so we will provide them medical direction, closely oversee it, and if they need additional education, we will provide it," says Honeycutt.
When the county approved a new spinal immobilization protocol for prehospital agencies, Honeycutt provided inservicing to ED staff. "We made sure the ED staff was brought up to speed, so when a patient comes in who is not on a backboard, they will know that those criteria have been met," says Honeycutt.
EMS and ED staff can both voice concerns to the coordinator to clear up misunderstandings. "If a patient comes to the ED and either nurse or physician in-house thinks what was done in the field was inappropriate, I have the opportunity to discuss with medics in field and find out what they were thinking, or even set up a meeting with the staff, if there is a concern to enhance continuity of care," says Honeycutt.
Likewise, EMS can explain potential problems. "Sometimes, medics in field have said they feel accurately portrayed, hoping to get an order for medication but did not get the order, and want to know why," says Honeycutt. "Staff who are really tied up and don't have time to discuss may come to me. This way, I can tell the EMS that I spoke with the physician, and explain their additional concerns-that they wanted to do some additional workup before administering that medication."
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