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June 10-14 2024 SAVE THE DATE!

June 12 – 16, Seminole Hard Rock Hotel and Casino, Hollywood, FL 33314

Today’s EMS System: Unique Challenges and Creative Solutions

For most patients Emergency Medical Services (EMS) represents the primary entry point into the emergency healthcare system. It is the tip of the spear not only for emergencies but often for definitive or community healthcare. EMS has become the essential link between the community and healthcare services at all levels.

The indispensable role EMS fulfills in our society places many challenges on the system never considered in its original design. Those challenges grow exponentially, year after year. This blog will attempt to outline some of the more prominent operational challenges facing EMS today and suggest some best practices to overcome them. While each of these topics could be a journal article unto itself, the best practices offered may serve as a springboard for other ideas or concepts that can be applied to individual agencies.

Staffing Shortages 

Since the Pandemic staffing shortages have plagued almost all service industries worldwide. EMS, healthcare, and even the fire service are not exempt. With a rising demand for services and a decreasing supply of qualified EMS professionals, agencies often find themselves under-staffed and over-stretched. Personnel in all level of healthcare are working extra or extended hours, and in some cases, performing multiple tasks usually assigned to several people.  All this can lead to stress, exhaustion and burnout.

No easy fix: There is no definitive pathway to resolving staffing issues. However, there owever are several options which have worked in the past. While not all work well for every system with some adjustments relief may be possible.

Effective recruitment and retention strategies can attract those who might not otherwise consider healthcare as a profession. EMS in particular, offers some attractive features which can draw the attention of those looking for unique and challenging opportunities. Flexible scheduling, incentive-based salaries, and benefits can serve as huge draws for potential employees. Some systems have even deployed part-time or per diem schedules where someone can work flexible or varied schedules but are not permanently locked to a single employer or contiguous schedule. Over-stretched or rural communities may also consider volunteers as a force multiplier or supplement to full-time staffing.

Limited Resources and Funding 

Most EMS systems face budget constraints which force employers to limit otherwise robust employment packages. This is especially true for rural and underserved areas, which can struggle to maintain fully equipped and adequately staffed EMS systems. Systems which depend upon third party or Medicare/Medicaid revenue as sources of funding find this especially challenging.

Creativity works: Ad Valorum taxes and fee-for-service funding creates given limitations to growth in many EMS system. Exploring alternative funding sources such as grants or donations, can help fill funding gaps or provide opportunities for growth and expansion.

High-Stress Environment 

The EMS environment is sometime referred to as “hours of shear boredom interrupted by moments of pure panic!” Those who work in urbanized EMS environments may disagree but one thing is common, EMS professionals often work long hours in high-stress situations which can lead to burnout, stress-related illnesses, and high turnover rates only deepening the staffing issues.

What’s in it for me? The noble generations of the past who sought these careers because it was a great service to the community are just that; a thing of the past. Today’s worker wants to know, “What’s in it for me?”

Wellness and personal development programs that promote both physical and mental health can help mitigate the impact of the afore mentioned stressors. Flexible scheduling, adequate time off, and access to mental health resources, including counselling and stress management programs, can be beneficial. Regular team-building activities, incentivized exercise and wellness programs, and open communication channels can also help foster a supportive and welcoming work environment. 

Rapid Technological Advancements 

As with any technological growth, the faster is goes, the faster it grows. The EMS technology of 30 years ago usually involved trying to calculate IV drips at 4 AM or connecting the Biophone to the Lifepack 5 to send an ECG to the ED Doc. Today’s medical technology landscape presents far greater challenges for EMS. Keeping up with these advancements, learning about new medications, and managing such high-speed, high-powered technology can be costly and often requires continual training and equipment updates. 

Keep arms and legs inside the car at all times: Introducing the latest technology into EMS practices can be exciting. It opens new vistas and in-depth learning opportunities never before possible. Collaborations with technology providers for inspirational, hands-on training can ensure a system and its personnel will embrace these advancements. Furthermore, applying for technology grants or seeking community donations can help manage costs associated with these advancements, build system-wide spirit and community support,

Timely and appropriate patient transportation 

With increasing demands for service, staffing shortages, and limited funding, EMS systems often find themselves stretched beyond acceptable limits.  Extended response times, overdue vehicle maintenance, and long turn-around times at emergency departments can cause a system to struggle in meeting community demands and expectations.

Okay, maybe it is rocket science: Utilizing technology such as Automatic Vehicle Location, GPS, system status management, scheduling software, and priority dispatching can help ensure the right levels of service get to the right patients at the right times.

Community Paramedic programs have been shown to reduce repeat patient occurrences which often over-tax systems and clog emergency departments.

Additionally, coordinating efforts with hospitals, clinics, and other healthcare facilities to ensure patients are transported to the most appropriate facilities can often shorten transport times and return units to service quicker. Implementing telemedicine capabilities can offer immediate access to specialists, thereby improving patient outcomes, especially in remote areas. Volunteer first responders, although limited in capability, often provide rapid BLS response in rural or underserved communities as well.

Many of these issues and solutions fit the theme of this year’s FTFC & GOE conference, “Doing more than ever before.” Learn about the challenges faced by so many systems and unique ways to address them Visit To learn more and register today.

While today’s EMS systems face a myriad of operational challenges, these hurdles are not insurmountable. By implementing strategic, proactive solutions and focusing on staffing, resource allocation, mental health, technological advancements, and care coordination, EMS systems can find creative and unique ways to address these challenges, build a better system and maybe set a new standard for what is possible in EMS.