July 12, 2018 | View as webpage
This briefing brought to you by Pinnacle

Are you attending the Pinnacle EMS conference at the end of the month? I will be there to meet with EMS leaders, write articles about featured presentations and post highlights to @EMS1. Make sure to say hello during a break or meal and tell me about your department's recent successes as well as the most pressing problem you are working to solve.

The 2018 EMS Trend Report from Fitch & Associates and EMS1, in partnership with the National EMS Management Association, will debut on Monday, July 23. I will be discussing the top findings during a Friday, July 27 bonus session. Download the 2016 and 2017 EMS Trend Reports to read on your flight to Phoenix and come ready to ask me questions about the 2018 report.

Greg Friese, MS, NRP
Editor-in-Chief, EMS1

In this issue:

By Greg Friese

Two Australian paramedics are under investigation for misconduct for refusing to take a late call after completing a 12-hour overnight shift. The paramedics were reportedly concerned about their level of fatigue when they turned down the overtime work, which was a non-emergent patient transfer to home.

Though I take a minor amount of comfort in knowing that the morale-crushing late call is ubiquitous worldwide, I am extremely concerned that a misconduct investigation is the result for two paramedics reporting they were too exhausted to accept the assignment. EMS1 regularly reports ambulance crashes attributed to the driver falling asleep, and near-miss and adverse incident reports to the EMS Voluntary Event Notification Tool often cite fatigue as a primary or secondary cause.

Respondents to the 2018 EMS Trend Report ranked retention as the most critical issue facing EMS by a large margin. Any service that’s not proactively mitigating paramedic fatigue, regularly sending paramedics on late calls and uses misconduct investigations as a response to self-reporting of “too tired to work” is sure to have a retention problem. Here’s what should be happening instead.

1. Fatigue in EMS: Evidence-based guidelines were previewed at the 2017 Pinnacle EMS conference and published in January 2018. The guidelines conclude several years of NASEMSO-sponsored research and recommend guidelines for fatigue education, on-duty napping, use of caffeine as a countermeasure to fatigue, limiting shift length and fatigue monitoring.

2. Late call procedures need to have more steps than 1) Offer late call and 2) Report paramedics for discipline if they refuse the late call. Intermediate steps might include assessing the urgency of ambulance transport, assessing suitability of alternative transportation methods, holding the call for the next on-duty crew, asking a mutual aid partner to take the call, offering the call to other crews or on-call personnel.

3. Health and wellness is a culture change that happens when actions align with policy and procedures. A leader’s commitment to fatigue mitigation, paramedic retention and workplace safety rings hollow when they don’t walk the talk.

4. Use late call data to make staffing and resource allocation changes. Regular and frequent late calls need a different solution than simply holding over the last shift. When do late calls happen? How often do they happen? Where are late calls coming from? What type of incidents most often result in late calls? How much are late calls costing in overtime?

Don't limit data collection and analysis to ePCR and CAD data. Use a department survey to ask questions like: How do field paramedics feel about late calls? What’s the best way to be asked to take a late call? How many late calls in a month turn it from a chance to make some extra money to a lifeforce sapping burden?

Your sleepy caregivers need more rest

How reliable are your disaster communications systems and policies? In this guide, you will learn how to improve policies for large-scale mass casualty incidents, as well as improve training and preparation for response to natural disasters.

By Chief Marc Bashoor
Progress in our business is not merely a process of osmosis, but a deliberate development through education, examining scientific analysis and combing through our lessons learned. While you’ve likely heard the phrase, “don’t mess with something that works,” forward movement cannot continue through momentum alone. Momentum, without fuel, will eventually ebb.

Think about communication like gasoline – in its purest, refined sense, gasoline powers our engines, to keep our vehicles moving efficiently. If water invades the gasoline, separation occurs, air pockets develop and engines choke forward progress.

Effective communication in public safety

Communication is the fuel that keeps the momentum of action moving forward. Follow these four simple and proven steps for effective communication:

1. Listen. Don’t just hear, really listen. Be engaged and deliberate with discussion.

2. Acknowledge. Listening means listening, not fumbling with your phone or staring off in the abyss. Absorb the communication and process the cues. Your non-verbal responses are part of ensuring the communication process is effective.

3. Calm down. In the emergent sense, remember, this isn’t your emergency. In the non-emergent sense, a calm and measured response will breed confidence and more calm in response.

4. Know what you’re talking about. Be respectfully assertive when necessary. Learn your craft and be prepared to engage through knowledge.

Regardless of their hyperbole, nobody knows it all, and no one book is the panacea for all of our ills. Keep the safety of your communities and people always at the forefront.

Our mission is to bring calm to chaos. An effective communication strategy will help facilitate calm action and forward progress

Say what you mean, mean what you say

3 and out …
3. Lessons in Leadership is a 10-part PoliceOne article series covering the most important principles police officer Rich Emberlin learned during his nearly 30-year career with the Dallas Police Department. Emberlin’s SWAT stories are compelling and his leadership lessons are broadly applicable to any public safety leader.

2. Succession doing. Every organization needs to have a plan to develop and replace it’s leadership at every level. Here's a police department template for succession planning that has principles applicable to EMS and fire departments. Also, check out this career ladder for the paramedic profession

1. EMS fiction for the beach or mountains. Paramedic Graeme Pole takes readers on a tour of Banff National Park, the surrounding wilderness and the front country mountain towns in his novel "Siren Call"
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Got a leadership tip, management question, commercial use inquiry, or an article idea? Send me an email at greg.friese@praetoriandigital.com.

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