Tom Quillin, chief of Leon County Emergency Medical Service in Tallahassee, Fla., is the winner of the 2011 EMS Executive of the Year Award. Sponsored by the National EMS Management Association and NASCO, the award was presented at the EMS World Expo, held Aug. 29 to Sept. 2 in Las Vegas.
When Quillin took over as chief of Leon County EMS (LCEMS) in 2005, the organization was facing numerous challenges. His predecessor and another top officer had been fired; turnover was high and morale was low. “EMTs and paramedics were uncertain about their future at LCEMS, and it was difficult to find enough medics to staff the trucks on duty,” his staff said in the nomination form. “It was a daily occurrence for office staff to have to stop work and get on an ambulance and take calls. The service was floundering and it was doubtful if this organization would continue to thrive.”
Quillin and his team knew they needed to make changes. Among the initiatives: replacing an aging fleet of ambulances with newer, safer models; instituting other safety measures such as power-lift gurneys; and encouraging continuing education, including a tuition reimbursement program to give employees a chance for personal growth while on the job.
The results were evident quickly: Back injuries fell, turnover decreased and morale has improved.
Public service is in Quillin’s blood. His father was fire chief in Union City, Tenn. Quillin followed in his footsteps, becoming a firefighter with the Lake Forest (Ill.) Fire Department and assistant chief six years later. Along the way, he became a certified EMT. He also earned an associate’s degree in fire protection technology and a bachelor’s degree in technical education from Oklahoma State; and an MBA from Lake Forest Graduate School of Management. Quillin later became fire chief in Rolling Meadows and Skokie, Ill. And in 1990, he was named chief of the Tallahassee Fire Department. During his 15-year tenure, the department began answering medical calls for the first time in its history. After retiring as Tallahassee’s chief, Quillin took the job with LCEMS.
Today, he oversees the $15 million budget of an agency that serves some 274,000 residents of Tallahassee and the surrounding county, covering a 702-square-mile region. LCEMS answers 31,000 calls a year and transports just over 22,000 patients.
The Executive of the Year Award was a career highlight, he says. “I was blown away when I was notified that I had been selected. I had no idea that I had been nominated,” Quillin says. “Naturally I am extremely honored and humbled.”
Quillin spoke with Best Practices about his work to reduce turnover and injuries and to improve coordination with hospitals in his region.
What were some of the first steps you took to turn things around when you became chief?
We were short staffed. It was difficult hiring people because the turnover was so high and administrative people were having to staff the trucks in the street. So we started adding people and increasing the number of trucks on the street and we finally got to the point where we had adequate units on duty.
How did you tackle the morale issue?
We started having regular command staff meetings. I also introduced myself to everybody—I know their name, and I know who they are. We developed a strategic plan for the agency that covers how we’re going to staff it, how we’re going to run the organization, and what our goals and objectives are for the future. We started giving clear direction to people.
We’re also upgrading our fleet from smaller units on Ford F350 or Chevy chassis to medium-duty ambulances with a larger box and a larger chassis.
Why did you make that switch?
We wanted to offer our providers a greater level of safety, so we chose medium duty ambulances by Horton, a manufacturer that crash-tests its trucks. We have included airbags for the paramedic in the back of the ambulance. We have also implemented automated CPR devices so we don’t have paramedics standing up in the back of moving ambulances.
In addition, we’ve placed power-assisted lift stretchers on all 23 of our EMS units to save the backs of our personnel and reduce injuries. We have also implemented a complete bariatric patient moving system.
Your colleagues credit you with better integrating EMS into the hospital and the community. Can you describe what you did?
One of the things I thought was important was having our agency involved in the hospitals and the community. We worked with Tallahassee Memorial Hospital and Capital Regional Medical Center on getting their chest pain accreditation with the Joint Commission on Accreditation of Healthcare Organizations. We follow every cardiac call from the time we pick them up to the time they’re discharged. Every other week, our quality manager sits with the hospital staff to review all cardiac cases and to see the end result of what we’re doing in the field and how the patient was treated through the entire continuum of care.
We do 12-lead EKG transmissions from the field to the hospital so the staff there can activate the cath lab and reduce our door-to-needle times for all STEMI patients. Time is muscle—the quicker you can get the patient into the cath lab, the better chance you have of improving their outcome. At the beginning of the program, less than 50 percent of patients with chest pain reached the cath lab before 90 minutes. Now 98 percent are in the cath lab before 90 minutes.
We’re making progress in resuscitation, too. Our return to spontaneous circulation rate is 21 percent; the national average is 3 to 7 percent. We’re also working with the hospitals on starting hypothermia therapy in the field. We anticipate that being put into place in the next few months.
We’re also working with Tallahassee Memorial Hospital for them to become a Level II trauma center, which we did not have in our region before.
Some of the others things we do are not only visible in the community but in the state. LCEMS is the lead agency in beginning regional prehospital and hospital cooperation by starting the North Florida/South Georgia Regional Medical Committee. These meetings have resulted in significant cooperation in the sharing of radio channels between agencies, sharing and coordinating protocols, and cooperative efforts with disaster planning.
Why was it a priority to assist with establishing a Level II trauma center?
We are geographically isolated. The closest trauma center was in Jacksonville [Shands Jacksonville Hospital is a Level I trauma center], which is 150 miles away. At the time we started about two or three years ago, there were no Level 1 or Level II trauma centers in the Panhandle, and the death by trauma rate was very high compared to other areas of the state served by trauma centers.
What are some other initiatives that have made an impact on your community?
We’ve been a big proponent of AEDs. We’ve gotten grants from the state department of health to offer public access defibrillators by offering them at a reduced price, and we’re up to more than 500 in the city and the county. We have the locations of AEDs listed in our CAD system so we can give bystanders pre-EMS arrival instructions about where the AED is in the building. We also got a grant to put AEDs in all sheriff’s deputies’ cars; that was 116 AEDs. We’re also working cooperatively with the city police department to get AEDs in all of their cars as well. Our AED program was recognized by the state surgeon general.
What makes a great EMS leader?
You have to take a genuine interest in your people. You have to be accessible to them, to help them with their problems when they have problems. You have to encourage people and give them opportunities for career enhancement and challenge them to do things outside their comfort zone, so that they grow in the agency and so that they can do more things in their job.
As an example, we have a new public education officer, Capt. Sally Davis, who wasn’t familiar with writing and managing grants, but she was interested in doing that and now she is. We try to get people to do interviews with the media so they become comfortable with that.
We also encourage higher education. We’ve had people go to the National Fire Academy for EMS training. One of our EMS deputy chiefs has just been accepted to the Naval Postgraduate School where he will be going through a master’s degree program. A large number of our staff who were hired as EMTs have gone to paramedic school and become paramedics.
We have a tuition reimbursement plan offered through the county. If it’s job-related, we encourage that.
We also recently formed a critical care transport team. About 20 people have completed the course and the testing and are certified. When we have a patient who’s classified as critical care, we now have people we can call on to staff a long-distance, interfacility transport.
LCEMS is a team effort. Last year, LCEMS was selected by the Florida Department of Health’s Bureau of EMS as EMS Provider of the Year. We also recently became accredited by the Commission on Accreditation of Ambulance Services. One of our paramedics, Steven Suarez, was recognized as the Florida Paramedic of the Year. Our medical director, Dr. Kim Landry, was named Florida’s Medical Director of the Year. And Deputy Chief of Operations Malcolm Kemp won a lifetime achievement award at the state EMS awards ceremony.
Do you believe EMS is about more than answering 911 calls?
Yes. We’re heavily involved in public education. We do CPR and AED training. We have a grant to do child safety seat inspections, and to give away car seats as needed. We have a remote-controlled, battery-operated ambulance that we use to teach kids about how to stay safe and when to call 911. We feel like we are the ones in the community that ought to be doing this. We want to be active in preventing injury and deaths.
