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EMS One-Stop: Creating a major IMPACT

An inside look at Guilford County’s award-winning program response to low-acuity and behavioral health calls

Editor’s note: 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

In this episode of the EMS One-Stop podcast, the host, Rob Lawrence, discusses Guilford County’s innovative community project called the Interagency Medical Provider Assessment and Care Team – project IMPACT. The project involves sending non-transport units, staffed by EMTs, to certain low-acuity 911 calls, allowing paramedics to focus on higher acuity cases. The program has received national recognition, in the shape of an award from the National Association of Counties.

Lawrence sits down with Hannah Muthersbaugh, PA-C, MMS, NRP, deputy medical director for Guilford County Emergency Services, in Greensboro, North Carolina, and Justin Harget, Guilford’s operations manager, who share insights into the program’s development, challenges faced, and the positive impact it has had on patient care and system efficiency.

Muthersbaugh and Harget also discuss future goals, such as expanding the program to operate 24/7. The episode emphasizes the importance of data-driven decision-making, stakeholder engagement, and addressing challenges in EMS innovation.

Related: Creating a new EMS value proposition with mobile integrated healthcare

Top quotes from this episode

  • “We surveyed our supervisors, our telecommunicators, and the feedback we got was brutally honest. It was hard to read, but it highlighted for us a set of system stressors that we were like tangentially aware of but weren’t sure about all of the details. And so, it really helped us think about how we could try to fix some of those things.” — Hannah Muthersbaugh
  • “We also partnered with our police department with a behavioral health response team where we put EMS personnel in a police squad that specializes in behavioral health, and they’re able to pull out calls that we were getting for police checkups, for mental health clearances. And so, just in their first year or so, they were able to pull out about 500 calls that we never sent an ambulance to.” — Justin Harget
  • “So for our people, it’s always been the closest unit instead of necessarily the right resource. And so we’re really trying to change that, that mindset. What resource does the patient need in the right timeframe?” — Hannah Muthersbaugh
  • “When somebody asks you how much money you need, and you say a lot … a lot is a word, not a number. You need to have the number ready to say.” — Rob Lawrence
  • “Our Guilford County EMS EMTs, they’re the rock stars in this, and I just really want to say thank you for all the work that they’ve done and continue to do. — Justin Harget

Related: Top 10 MIH or community paramedicine program funding sources

Episode contents

02:44 – Guest introductions

05:08 – About Guilford County EMS

06:38 – Project history

07:30 – Surveying the staff – and the feedback was brutally honest!

08:00 – NAEMSP year-long safety course

10:32 – Data analysis

12:17 – BLS/EMTs providing the service

17:16 – Stakeholder, community, FD and PD involvement

18:50 – 6,300 with no EMS response at all!

19:18 – PD Behavioral Health Response Team

21:51 – Staffing and equipment challenges

24:34 – Program funding

26:15 – The National Association of Counties award

27:41 – The EMTs in the system

28:22 – Future plans

About our guests

Hannah Muthersbaugh, PA-C, MMS, NRP

Hannah Muthersbaugh is a North Carolina-based physician assistant specializing in emergency medicine and EMS. She currently serves as the deputy medical director for Guilford County Emergency Services. Her journey in the healthcare industry began on the front lines, as she progressed through the ranks as a field provider. Starting her career with Guilford EMS as an EMT and later advancing to the role of paramedic, she gained invaluable hands-on experience and a deep understanding of the challenges of prehospital care.

Hannah’s pursuit of excellence led her to Wake Forest University, where she dedicated herself to further education and earned her Master of Medical Science degree. She has practiced with the Wake Forest Emergency Physicians Group since 2013, serving in various leadership roles throughout her tenure, including lead advanced practice provider and chair of the Cone Health Advanced Practice Provider Executive Committee.

Hannah’s career path exemplifies her passion for emergency medicine and her continuous dedication to improving healthcare systems. She will further that commitment in the spring of 2024 as she begins her Doctor of Medical Science PhD program at The Wake Forest University School of Medicine.

Justin Hargett

Justin Hargett is the operations manager for Guilford County Emergency Services. His educational background includes a bachelor’s degree in emergency medical care obtained from Western Carolina University. Complementing his undergraduate studies, he pursued a master’s in executive leadership from Liberty University, demonstrating his commitment to continuous learning and leadership development.

Over the course of 17 years in emergency services, he has served as a volunteer and career firefighter, paramedic and hazmat technician. This diverse range of roles has equipped him with a comprehensive understanding of emergency response across urban, suburban and rural environments.

He advanced his focus on organizational excellence in 2021 when he was promoted to the role of emergency services manager. Initially, he led the Quality Improvement and Assurance team before moving into his current role of operations manager.


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Rob Lawrence has been a leader in civilian and military EMS for over a quarter of a century. He is currently the director of strategic implementation for PRO EMS and its educational arm, Prodigy EMS, in Cambridge, Massachusetts, and part-time executive director of the California Ambulance Association.

He previously served as the chief operating officer of the Richmond Ambulance Authority (Virginia), which won both state and national EMS Agency of the Year awards during his 10-year tenure. Additionally, he served as COO for Paramedics Plus in Alameda County, California.

Prior to emigrating to the U.S. in 2008, Rob served as the COO for the East of England Ambulance Service in Suffolk County, England, and as the executive director of operations and service development for the East Anglian Ambulance NHS Trust. Rob is a former Army officer and graduate of the UK’s Royal Military Academy Sandhurst and served worldwide in a 20-year military career encompassing many prehospital and evacuation leadership roles.

Rob is a board member of the Academy of International Mobile Healthcare Integration (AIMHI) as well as chair of the American Ambulance Association’s State Association Forum. He writes and podcasts for EMS1 and is a member of the EMS1 Editorial Advisory Board. Connect with him on Twitter.