EMS One-Stop

“If you're the smartest one in the room, you're in the wrong room.”

Education is the word of the day on this episode of Inside EMS, as cohosts Chris Cebollero and Kelly Grayson dissect the impact of higher learning on providers’ career longevity and advancement. Plus we dig into all this:

Starter EMS agencies. “Some agencies might just have to be the minor leagues, the starter programs and the feeders to the real EMS agencies."

Prioritizing your professional growth. “We're in charge of the career ladder. I shouldn't have to worry about my organization putting something in place for me to grow. They don’t owe that to me. It's my job to market myself and create the opportunity."

Big picture impact of higher education. “When people say, ‘I don't need an education to be a paramedic,’ they don't know what they don't know. It's not until you get a little older and a little wiser that you realize the value of that education."

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

In this episode of the EMS One-Stop podcast, host Rob Lawrence sits down with Fayetteville, North Carolina’s Cumberland County EMS Chief David Grovdahl and Behavioral Health Community Paramedic Tara Tucker to discuss the Cape Fear Valley Mobile Integrated Health Behavioral Health Community Paramedicine programs.

The Cape Fear MIH Team is composed of four community paramedics, one social worker and a peer support specialist. The team focusses in particular on overdoses/request for substance use treatment, suicide related calls – ideation/attempts as well as youth calls related to mental health and substance use, and also EMS referrals and associated case management.

Fayetteville is home to Fort Liberty and Pope Army Air Base, and is the sixth most populous city in North Carolina with a high number of uninsured and underinsured patients. Fifteen percent of Cumberland County’s population is military-affiliated and it is the third busiest EMS system in North Carolina. Cumberland’s affiliated ED, CFVMC Emergency Department, had 90,595 visits in 2021 for adults, and 30% of those (27,300) were for behavioral-health related issues, creating the need for a Behavioral Health service line employing community paramedics.

In addition to discussing their mobile integrated healthcare system, Grovdahl also shares about the North Carlina whole blood programs and their progress.

“Even after all these years of being in EMS, I still want to learn.” Flying solo this week, Chris Cebollero takes a note from EMS1 columnist Tim Nowak, walking listeners through his “11 keys to success for the rookie EMT.” Though directed at new EMTs, Cebollero makes the point that Nowak’s list of advice is really poignant for anyone at any point in their EMS career.  

Listen to learn: 

• The role ego plays on scene … and how to move past it 

Top quotes 

• "When someone needs you and needs your ability and needs your knowledge and needs your skill, you don't need to be looking for the OB kit." 

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com. 

“When your communication is intuitive … that’s what makes EMS an art for me.” This week, our cohosts discuss what makes a good EMT partner and a supportive paramedic mentor. The discussion was inspired by EMT-B Clay Gilman’s recent EMS1 poem submission, “To my medic, from your EMT.”

The conversation also touches on:

The use of BLS intercepts in place of paramedic intercepts 

How empowering EMTs can provide staffing relief 

Why EMTs should be taught to think above all else 

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

In this special, on-site episode of EMS One-Stop, host Rob Lawrence takes us to the 2024 North Carolina EMS Expo in Greensboro, North Carolina, a well-attended conference with over 1,200 attendees.

Rob spent time with several conference faculty.

EMS lawyer Matt Streger joins Rob to discuss just culture, HR issue spotting, leadership communication and employee engagement.

Kevin Collopy joins Rob to discuss the outstanding prehospital training being delivered to medics in Ukraine and also discusses this years “Stand and Deliver” new speaker event (a now annual event held as EMS World Expo).

Rob discusses whole blood and its national rollout with Dr. Randall Schaeffer and David Grovdahl.

To close, Peter Dworsky of the National EMS Safety Conference provides an overview of the current top EMS industry safety themes.

Enjoying the show? Email [email protected] to send in guest suggestions, episode feedback or questions for our host. 

Editor’s note: This episode of EMS One-Stop With Rob Lawrence is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

In this episode of the EMS One-Stop podcast, host Rob Lawrence welcomes back Matt Zavadsky to discuss the latest development in the move to fund treatment in place and the recent disclosure from CMS about the potential savings to Medicare identified in the analysis of the limited ET3 program.

Matt discusses the potential legislative moves regarding EMS funding, highlighting bipartisan support and urging listeners to engage with elected officials to support bills benefiting EMS.

The conversation underscores the need for sustained advocacy efforts and highlights the level of interest shown by key policymakers.

Rob and Matt also discuss the recent developments in the City of Fort Worth and the decision to absorb MedStar into the Fort Worth Fire Department, emphasizing the need to ensure equitable treatment for EMS personnel transitioning to new roles.

“We can officially say that the net savings to Medicare after they pay EMS and after they pay the tertiary provider telemedicine, whatever it is, is still $550 to $570 per enrolled ET3 participant. And when you do the math, that's a billion dollars or more of savings to the Medicare program, which now CBO can use to evaluate the benefit, economically of doing a treat, no transport, treatment-in-place model. So it's big news.” — Matt Zavadsky

“Nobody benefits from a knock-down, drag-out fight. But as you indicated, there are now people in the community and people across the country that are saying why and what does this mean? We don't have all those answers, but again, it's the decision from the folks who are elected to represent the community and if that's what they want to do, that's great. Our role is to try and do as much as we can to maintain a transition into a new provider system that keeps those core tenants – the high performance, high value mobile, integrated healthcare, flexible deployment. All those things that have really made the system a world class EMS system, even though it might say something different on the side of the ambulance and the employees might be wearing a different uniform.” — Matt Zavadsky

“It's going to be a long transition – 12 to 18 months, and it's not just branding and rebranding, it's really infusing the culture of a group of people who are used to doing 7-10 calls in 12 hours and used to having things operate with a certain cadence that's going to be totally different when they start a different type of organization.” — Matt Zavadsky

00:00 – Introduction

02:15 – ET3/TIP: Challenging CMS outcome data

03:15 – Cost savings per intervention

04:00 – CMS data showing net savings to Medicare

04:30 – Congressional Budget Office score based on savings

06:00 – Net savings of a billion dollars or more

07:00 – Applying this new information for the good and benefit of the industry

09:00 – Congress is, is what Congress does

10:40 – Meeting with Congress to push TIP

14:30 – Fort Worth and the PWW Advisory Group

14:50 – Fort Worth economies and level of service

17:30 – Matt Zavadsky to join the PWW Advisory Group

19:15 – The staffing issues as Med star staff transit to the FD fire department

21:00 – Ensuring the staff is protected

25:00 – Call to action-how we communicate all value to elected officials

26:00 – Final Thoughts

About our guest

Matt Zavadsky is the former chief transformation Officer at MedStar Mobile Healthcare, formerly the exclusive emergency and non-emergency public utility model EMS system for Fort Worth and 14 other cities in North Texas.

Coming to MedStar in 2008 as the operations director, Matt made significant changes to the EMS delivery model, and in 2010, successfully eliminated the need for the tax subsidy that MedStar had been operating on since its inception in 1986. He has helped guide the development and implementation of numerous innovative programs with healthcare partners that have transformed MedStar fully as a Mobile Integrated Healthcare (MIH) provider, including high utilizer, CHF readmission reduction, observational admission reduction, hospice revocation avoidance, 911 nurse triage programs and partnerships with home health agencies. He is also the co-author of the book “Mobile Integrated Healthcare – Approach to Implementation,” published by Jones and Bartlett Publishing.

He has 42 years’ experience in EMS and holds a master’s degree in Health Service Administration with a graduate certificate in Healthcare Data Management. Matt is a frequent speaker at national conferences and has consulted on numerous EMS issues, specializing in high-performance EMS operations, finance, mobile integrated healthcare, public/media relations, public policy, transformative economic strategies and EMS research.

This week on Inside EMS, MedStar’s Matt Zavadsky joins the show for the 10th time as a guest host to discuss potential changes to how the organization operates in the City of Fort Worth … as well as a change to Zavadsky’s personal career path. The pair also discuss:

• The four options on the table for transforming MedStar

This episode of Inside EMS is brought to you by Lexipol, the experts in policy, training, wellness support and grants assistance for first responders and government leaders. To learn more, visit lexipol.com.

“We wanted to build something to solve the problem and help the paramedic, not hinder them.” Clive Savacool, CEO and founder of LogRx, joins the podcast this week to discuss preventing drug diversion/theft.

Host Christ Cebollero and Savacool discuss:

Who sets the tone for compliance accountability in an EMS organization

The practice of gatekeeping narcotics from “drug seekers”

Modernizing documentation practices to increase accuracy

The LogRx smartphone platform and solution for tracking narcotics and other drugs

This episode of the Inside EMS Podcast is sponsored by LogRx. Learn a better way to track your narcotics at LogRx.com.

Inside EMS cohosts Chris Cebollero and Kelly Grayson delve into a legal case out of New Jersey in this week’s episode, in which law enforcement officers and EMS providers were recently charged with the in-custody, in-ambulance death of a patient under the influence of bath salts.

The discussion also discusses a similar incident out of Colorado in which two paramedics and a police officer were convicted in the 2019 death of Elijah McClain after he was injected with ketamine.

Chris and Kelly share vulnerable moments from their careers when they regret not advocating for their patient in the face of law enforcement actions, plus we dig into all this:

The growing legal scrutiny of EMS practices

How to use de-escalation techniques to mitigate contentious situations with law enforcement partners

The ethical responsibilities of EMS providers

This episode of the Inside EMS Podcast is sponsored by LogRx. Learn a better way to track your narcotics at LogRx.com.

“Sometimes we made decisions and wound up getting corrective action where maybe a culture of coaching would have taught me to grow.”

Kelly Grayson puts the spotlight on fellow cohost Chris Cebollero this week as the pair discuss whether progressive discipline still has a place in EMS or if a move to a culture of coaching, as written about extensively by Chris, would have a more positive impact on retention rates, turnover, burnout and overall career satisfaction.

Top quotes

“Experience comes from mistakes and mistakes come from lack of experience.” – Chris Cebollero

"I've gotten enough progressive discipline, enough paper that I can wallpaper a small closet." – Chris Cebollero

“This isn’t about me wanting to fire you. This is about me wanting to make you the very best that you can be.” – Chris Cebollero

This episode of the Inside EMS Podcast is sponsored by LogRx. Learn a better way to track your narcotics at LogRx.com.