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Sirens, transformation and trends

Matt Zavadsky shares how MedStar ceased red lights and sirens operations during recent weather event and discusses EMS on-demand


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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.


“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?”


  • 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


EMS-on-demand the next big transformation for the profession?

Culture shift: Reducing lights and siren vehicle operation

The EMS workforce: Critical condition!


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



Twitter: @MattZavadsky

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.