21 Steps To The 21st Century: Preparing Fire Service EMS For The Future

The year 2000 is rapidly approaching and demands on fire service EMS personnel have never been greater. How will you, as an EMS professional, face tomorrow? Eric W. Heckerson outlines 21 critical steps each emergency medical services professional needs...


As the turn of the century draws ever closer, those in the fire service EMS continue to wonder what the future may hold for pre-hospital care. As an integral component of the nation's ever-changing health care system, EMS professionals will most certainly feel the effects of managed care and the...


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As the turn of the century draws ever closer, those in the fire service EMS continue to wonder what the future may hold for pre-hospital care. As an integral component of the nation's ever-changing health care system, EMS professionals will most certainly feel the effects of managed care and the many other factors causing major health care corporations to be turned upside down.

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Photo by Nicolas Girard
Whether paid or volunteer, rural or urban, every agency providing emergency medical services should embrace change and prepare for the future.

Whether an agency is paid or volunteer, rural or urban, each should begin to embrace change and prepare for the future. EMS and the fire service have been built into well-respected, team-oriented cornerstones of America and deserve to be protected. Members from every level of an organization must work together to maximize their strengths, minimize weaknesses and make the most of the opportunities that are presented. Here is a list of 21 steps that can better position agencies for the challenges of the 21st century.

A Place To Start

1. Obtain the document EMS Agenda for the Future.

You may have heard of it or read it by now, but this document published by the National Highway Traffic Safety Administration (NHTSA) is an invaluable tool. It contains a blueprint of ideas on how to prepare organizations for future challenges (see the EMS column on page 18). Many specific ideas are offered on how to best deliver emergency medical services in the next century. It can be downloaded at http://www.nhtsa.dot.gov.

2. Begin with the end in mind.

In The Seven Steps of Highly Effective People, Steven Covey suggests that managers have an idea of what they hope to achieve before trying to accomplish it. Leaders should have a concept of where, in the best-case scenario, an organization should be in five years, 10 years, 20 years. A lot can change in a short time, including goals, but once these preliminary ideas are in place, a plan can be developed on how best to proceed.

Formulate A Strategy

3. Develop local and regional strategic plans for EMS.

4. Link strategic plans (in some way) to the budgeting process.

In the business world, a strategic plan is used to identify where a company is headed and what strategy will be used to get there. The same concept can (and should) be applied to fire and EMS organizations. This plan should focus on identifying the strengths and weaknesses within the organization, opportunities available and impending threats. A strategy can be developed to take advantage of strengths and opportunities while minimizing weaknesses.

A strategic plan is based on the overall mission, or master plan, of an organization. From that starting point, a detailed plan can be established with three major components:

  • Long-term goals are needed to give an organization a general sense of direction. These are desired results sought to be achieved over a period of time, usually three to five years.
  • Annual objectives must be developed as a set of more specific and measurable goals. These statements should describe what is expected on an annual basis to accomplish the overall strategy of the agency.
  • Functional strategies identify activities that should be undertaken to meet the annual objectives. These are individual tasks describing exactly what needs to be accomplished to meet the annual objectives.

A strategic plan is a weak document unless its objectives are transformed into action items. The budget process should reflect the organization's strategy. The processes of developing the two may occur separately, but should eventually be linked as the blueprints of the agency's future.

Consider The Options

5. Consider public/private partnerships.

6. Do not reinvent the wheel.

While managed care makes its way across the country and into the different areas of health care, chiefs and administrators debate on how much to become involved with the managed care organizations (MCOs). One of the best ways to produce win-win situations is to enter into public-private partnerships. Combining thoughts and ideas with private agencies on transportation services or expanded scope of practice, for example, may be just the formula needed to ensure survival.

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