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EMS coordination: Healthcare coalitions provide organized cooperation

Healthcare coalitions offer EMS a “seat at the table” for regional emergency planning


The federal model of coalitions specifically lists EMS, hospitals, public health and emergency management as core partners and strongly encourages the participation of other organizations.

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Several years ago, the federal government began using the term “healthcare coalition” in the context of state and regional disaster plans, and the emergency response of the healthcare system.

What is a healthcare coalition? The U.S. Department of Health and Human Service’s Assistant Secretary for Preparedness and Response (ASPR) began to promote the idea that many different agencies and organizations should work together when a disaster or other healthcare crisis strikes an area or region. This idea was not completely new. Many of our states were already following ASPR’s “hospital preparedness program” guidelines to receive funding to build emergency response systems.

The new coalition approach, however, widened the scope and made it clear that many other organizations, including EMS, public health, clinics, emergency management, coroners and medical examiners, outpatient care providers and long-term care centers, needed to be involved in the planning, prevention, response and recovery.

The federal model of coalitions specifically lists EMS, hospitals, public health and emergency management as core partners and strongly encourages the participation of other organizations. Almost all states are now using some form of coalition model, although some use slightly different terms, such as emergency preparedness committee, healthcare emergency readiness coalition or regional planning group.

Why should EMS care about healthcare coalitions?

When the concept of healthcare coalitions first started rolling out, many in EMS said the same thing: “Oh great, another meeting to attend.” But, as the program has evolved, industry leaders have found that the idea is going to make our work more efficient and help improve preparedness in our regions.

Using tools provided by ASPR, regional healthcare coalitions are beginning to identify gaps in their local healthcare system’s capabilities and capacities. They are engaging the aforementioned partners to develop plans to mitigate and prepare for emergencies that are likely to impact their area (hazard vulnerability analysis). They are utilizing $225 million in ASPR grants to equip and train providers and build important infrastructure like redundant communication systems.

One of the first requirements ASPR has placed on coalitions is to build surge plans. It’s no secret that most healthcare organizations – public and private – now run on tight budgets. They plan carefully to provide just enough staff and resources to care for the number of patients they are likely to see that day. As EMS providers, we regularly see hospitals running at capacity and many of us spend our shifts transferring patients to the next town over because there are no beds open at our local hospital.

When a multi-patient or mass casualty event occurs, hospitals must scramble to find places to place and care for this “surge” of patients. By building and testing surge plans, coalitions engage all levels of partners:

  • Hospitals implement incident command.
  • Clinics and outpatient centers are tasked with opening their doors for green patients or other non-emergency cases.
  • Long-term care facilities accept urgent transfers from hospitals to help open their beds.
  • Public health offices open family assistance and reunification centers.
  • Emergency management offices coordinate resources.
  • EMS agencies initiate mutual aid and implement alternative transport plans.

These are just a few examples of actions that coalition partners are planning to take in a coordinated effort to respond to a healthcare emergency.

What is a coalition surge test?

As part of their federal grant funding requirements for the next few years, regions will be conducting coalition surge tests (CST) where they simulate evacuating large numbers of patients from damaged or disabled hospitals. The region must work together to find other beds to transfer the impacted patients. Not only do they have to identify transfer resources, but they also have to activate plans to provide medications, equipment, supplies, medical records and caregiving staff at the receiving facilities. It’s easy to see how these tests will help regions be better prepared for other kinds of healthcare emergencies.

EMS involvement in the coalition surge tests will be key. Aside from helping hospitals evacuate their patients, EMS should also view participating in these tests – and being part of the coalition – as “getting a seat at the table.” Use the coalition to get to know your hospital, public health, and emergency management peers. Take the opportunity to let these partners know about the important work that EMS does and the expertise we have to share. Develop relationships and be part of the decision-making process for your region.

How can we get involved?

Finding your local coalition should not be too difficult; an important part of their strategic plan right now is to build partnerships. Contact your state EMS office, a local public health department, your emergency management office or your local hospital emergency preparedness coordinator, and they can point you to a coalition contact. Most coalitions have at least one part- or full-time paid coordinator who will be happy to talk to you about their organization.

Start attending meetings to learn more about how EMS fits into the regional plan and the coalition’s current work plan. See how your disaster plans match theirs and provide input to help get all players onto the same page.

Learn more about healthcare coalitions at ASPR’s public health emergency website.

Michael Fraley has over 30 years of experience in EMS in a wide range of roles, including flight paramedic, EMS coordinator, service director and educator. Fraley began his career in EMS while earning a bachelor’s degree at Texas A&M University. He also earned a BA in business administration from Lakeland College. When not working as a paramedic or the coordinator of a regional trauma advisory council, Michael serves as a public safety diver and SCUBA instructor in northern Wisconsin.