EMS One-Stop

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 Inside EMS, our cohosts and best-selling authors put our listeners on the path to becoming authors.

Top quotes from this episode

“Everybody has a book title in them and we’re going to put everybody on the path of becoming authors.”

“I have an idea of where I want the story to go, but how the characters interact, how they talk, the adventures and trials and tribulations they go through, develop as the story goes along.”

“When I'm at my best, the writing just flows, and I'm just typing away and I'm giggling or crying, as the case may be, and enjoying the hell out of it.”

“The days that it doesn't flow like a waterfall is where it takes some work ethic and some discipline, and you have to get the story on the page no matter how bad you think it is, and then find your muse and find the spark in it in the editing process.”

Together, Chris and Kelly discuss:

• How writing can be therapeutic

Additional resources

• How to submit an article to EMS1

Send your book titles to [email protected]

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.

Our EMS One-Stop Host Rob Lawrence was recently invited attend the keynote session at the North Carolina EMS Expo, and to deliver an after-dinner speech at the banquet. The title of Rob’s session was “Elephants in the EMS room,” in which he addressed 10 things we must acknowledge and fix in order to improve the health of our profession.

As soon as he left the keynote stage, Rob joined Bradley Dean and David Blevans from the EMS Handoff Podcast to discuss the key issues raised in Rob’s presentation.

The biggest elephant in the room currently is recruiting and retention, and in addition to discussing inside industry suggestions, Rob looked to the outside world and got his inspiration from Glass Door, and identified what stands EMS apart from the nation's top 50 companies to work in.

The discussion also covers data and politics, cost collection and surprise billing, amongst the other elephants in the EMS room.

TOP QUOTES FROM THIS EPISODE

“I don’t talk about surprise billing, I talk about surprise payment, the surprise is what the insurance company actually gives you.” — Rob Lawrence

“A lot of local authorities will describe what they want to see in their EMS system when they bid them out and these are wholly unaffordable, in fact, they describe the cruise liner, when they can only afford a rowboat.” — Rob Lawrence

“We have to stop thinking that we are the UN and start to thinking like NATO, because NATO is an attack on one is an attack on all so, we have to start changing our mindset.” — Rob Lawrence

EPISODE CONTENTS

00:53 – Introduction

01:15 – Bradley Dean and David Blevins

2:10 – Elephants in the room

2:58 – Recruiting and retention

4:00 – Looking for clues via Glassdoor

5:05 – Is EMS in a pickle?

6:00 – Surprise billing

6:22 – EMS costs

7:00 – The cost of readiness

7:30 – Ground Ambulance and Patient Billing Committee

9:46 – Four little words – all those in favor!

10:20 – We are all politicians

11:30 – Degree or no degree – that is the question

15:40 – If you are going to get a degree anyway, why not a paramedicine degree!

17:00 – Data and making use of it

20:00 – Wall time

24:00 – The importance of advocacy

28:00 – National organizations working together

37:00 – The Peter Principle and training our people for the next position

39:00 – Close

In this episode of Inside EMS, our Cohosts, Chris Cebollero and Kelly Grayson, break down the skills needed to be a servant leader.

Notable quotes from this episode

“My job as a leader is to get work done through other people.”

“The true measurement of leadership success is how engaged, satisfied and productive the workforce is.”

“What I believe as a leader is that my job as the chief of the department is not any more important than your job of working on the ambulance. It’s that we have different roles and responsibilities for reaching the vision.”

“The most important component of servant leadership is realizing that it’s an honor for you to be in the position that you’re in and you can get taken out of that position as fast as you were put into it.”

Together, they discuss:

• Chris’s recent article and video on servant leadership

Enjoying the show? Contact the Inside EMS team at [email protected] to share ideas, suggestions and feedback, or if you’d like to join us as a guest.

Dr. Lori Moore-Merrell announces plans to rename the USFA to the U.S. Fire and EMS Administration 

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.

EMS One-Stop Host Rob Lawrence recently travelled to Florida to attend the Metropolitan Medical Directors Gathering of Eagles Conference. In this week’s episode, he shares video from key sessions and interviews with a number of leading EMS medical directors, including Dr. Jim Augustine, medical director of Lee County, Florida.

The Eagles also gave the floor to the U.S. Fire Administrator Dr. Lori Moore-Merrell, who identified how the Metropolitan Medical Directors will work closely in the future with the U.S. Metropolitan Fire Chiefs – and identified that a name change to USFA may soon follow.

TOP QUOTES FROM THIS EPISODE

“Seventy-five percent of what we do in the fire response space is in fact EMS, and something that I shared with these guys yesterday is an action, I won't say a movement yet, but an action under way, we may in fact in the near term actually rename the U.S. Fire Administration the U.S. Fire and EMS Administration.” — Dr. Lori Moore Merrell

“We have just stood up in January an EMS branch within our National Fire and EMS Programs Division. That is a huge move for USFA, so we are going to be moving toward even bigger announcements in the near future ... but we need to embrace what we do in the fire service, that is greater than 70%, most departments 75% and up of EMS.”  — Dr. Lori Moore Merrell

EPISODE CONTENTS

01:00 - Takeaways from Brandon Morshedi, MD; Peter Antevy, MD; Joseph Zalkin; Petar and Amber Hossick

02:00 - Introducing the comments from Dr. Moore-Merrell

04:00 - Recorded comments from Dr. Moore Merrell

09:00 - Discussion with Dr. James Augustine

24:00 - Closing commentary

In this week's episode of Inside EMS, Cohosts Chris Cebollero and Kelly Grayson lean on their experience as field training officers and EMT instructors to discuss EMS skills mastery.

If our message to new EMT graduates is, “You don’t know everything there is to know about EMS,” then how do we teach them what they need to know in the field?

Top quotes from this episode

“It’s not laziness; it’s cognitive offloading.”

“If I’m not using it, why am I teaching it?”

“Is the way you intubate today the way you intubated when you started in EMS?”

“There is nothing that substitutes for constant repetition and practice.”

Contact the Inside EMS team at [email protected] to share ideas, suggestions and feedback, or if you’d like to join us as a guest.

In this week's episode of Inside EMS, Cohosts Chris Cebollero and Kelly Grayson share their messages on professionalism, career development and asking questions with the graduating classes of EMTs.

Memorable quotes from this episode

• “You don’t know everything there is to know about EMS – so you need to be able to ask the question why.”

Together, they discuss:

• Choosing your hard

Additional resources on career mastery and growth

• Achieving EMS mastery

Paramedic Amanda King shares her story of thru-hiking the Appalachian Trail and overcoming EMS burnout

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.

After realizing she was suffering from burnout, Paramedic Amanda King decided to leave her service and take on one of the most physically challenging trails in the United States. Amanda made a decision that changed how she saw people, how she viewed the world and how she understood herself.

Three months after resigning, selling her house and storing her furniture, Amanda was dropped off in Georgia, alone, with one goal: to hike the entire Appalachian Trail. With her hiker home packed into a rucksack on her back, she embarked on a seven-and-a-half month epic adventure which saw her hike nearly 2,200 miles. She endured harsh weather, a regional drought, rugged terrain and so much more on a journey that evolved her in ways she could not have ever imagined.

After deciding to return to EMS, Amanda chats with Rob Lawrence about her experience, the individuals she met along the way and how her experiences can be translated back into life as a medic. Amanda also reflects on her life before the trail and offers inspiration and takeaways for all.

TOP QUOTES FROM THIS EPISODE

“I think my biggest regret is, it's a very simple word. It's two letters long and it's the word ‘no!’ Don't be afraid to say no. Take time for yourself, because you are the most important person. You know, if you're not happy and if you're not safe, how can you expect to keep other people happy and safe? I think that's the biggest thing, don't work so much overtime, don't inconvenience yourself to do all of these things that's asked of you, in return you're not taking care of yourself. So, one thing that I decided if I got back into EMS, is I would use my vacation time. So I'll put it to you this way. When I was at the former employer, I took a vacation maybe twice in 6 years or something like that, like an actual vacation. I've already taken two vacations since I started here at Novant, since November – so that's a huge difference.”

“I don't want to say yes, a 7-month hike in the woods cured all my problems, because that's not at all the case. I think that it's an ongoing process that, once you reach that point of burnout, it's number one up to you. It's not up to anybody else to help you. It's up to you to help you. And you have to want that change. I think that it's an everyday thing. Every day I need to do things that keep me on that path of not going back down that road again.”

“I think that was a symptom of the burnout where I was at, I had no patience whatsoever and it showed. It showed to my partner, it showed to family members that I would encounter on a call. And I hate to admit all that; it's embarrassing, but that's where I was, that was the point where I was at. I think now, after all that time off, and all that time to self-reflect, I think I'm more patient because I believe that I'm more empathetic, which is also something that I can't say that I possessed before I left.”

EPISODE CONTENTS

02:29 – Introducing Amanda King

05:06 – Symptoms of burnout

07:16 – The moment you realize you are done

10:57 – Selling and putting everything in storage

13:23 – Hiking with friends

15:53 – Packing for a 2,000 mile walk

18:48 – Mental fortitude

22:47 – Trail angels

24:40 – Trail magic

26:32 – Becoming ‘moss’

29:49 – Hindsight is 20/20

31:16 – Keeping a journal

33:30 – Taking a zero: how to use down time

41:14 – 2,000 miles later …

48:05 – Developing patience

51:02 – Message to those heading into crisis or breakdown

54:13 – Contact details

ADDITIONAL RESOURCES ON THIS TOPIC

• Reignite EMS passion by banishing burnout (eBook)

ABOUT OUR GUEST

Amanda King is a paramedic from the coast of North Carolina. Prior to joining EMS, she obtained a Bachelor of Arts degree from the University of North Carolina at Wilmington. During her first 10 years in EMS, she was promoted to field training officer, became an EMS instructor, developed a field training and evaluation program for her former agency, taught EMS classes for the local community college and earned a real estate license. She left EMS and thought she’d never return. Now, after becoming one of just over 1,000 people to thru-hike the Appalachian Trail in 2022, she has returned to EMS and now works for Novant Health Mobile Integrated Health. She is currently in graduate school to obtain a master’s degree in public administration.

CONNECT WITH OUR GUEST

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RATE AND REVIEW THE EMS ONE-STOP PODCAST

Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.

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 EMS Week episode of Inside EMS, Cohosts Chris Cebollero and Kelly Grayson welcome Brian K. Hathaway, president/CEO of Spirit EMS, in Greenville, Ohio, who offers a free EMT training program. Hathaway shares his perspective on how EMS education has changed, and the creative ways Spirit is attracting, engaging and retaining recruits – from 2-year agreements, to giving away a car during training.

Together, they discuss:

• Why Hathaway is the Oprah Winfrey of EMT education

“As we educate in the classroom and make sure that people are comfortable and confident in their skills, and we’re making sure that we’re doing that good head-to-toe assessment on the patients – that that’s the ultimate important thing.”

“Memorizing 43 things on a skills sheet to make sure that we’ve touched everything is not necessarily applicable to every patient that we’re taking care of.”

“My concern is we’ve got to get people involved and we’ve got to continue to change with the times or it’s going to be a competition when I’m in the nursing home 25-30 years from now as to who’s going to get out of bed and respond to the call if we don’t do something now.”

What skills should we test?

Whatever will we do without the skill sheets?

Brian K. Hathaway is president/CEO of Spirit EMS, in Greenville, Ohio. Brian has been actively involved in Fire/EMS since 1996. Aside from his duties as an owner of Spirit, Brian is a 27-year veteran of the Union City Fire Department and continues to work part-time as a 911 dispatcher at the Darke County Sheriff's Office where he has worked since 1999. Brian is a certified Advanced EMT, EMS continuing education instructor, volunteer firefighter, Certified Ambulance Coder, Certified Ambulance Compliance Officer and Certified Emergency Medical Dispatcher. Brian serves as education chairman and is a board member of the Ohio Ambulance and Medical Transportation Association, a member of the Four County Career Center advisory board, a member of the Darke County Chamber of Commerce, and attends the EUM Church in Greenville. Brian enjoys spending time with his wife Audrey as well as their daughter Naomi.

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.

Page, Wolfberg & Wirth was asked by the National EMS Information System (NEMSIS) Technical Assistance Center (TAC) to research frequently asked questions related to data in EMS patient care reports. PW&W analyzed these questions under applicable laws and guidance, and developed general answers and best practices contained in the new publication, “Patient Care Report Data QuickGuide - FAQs on owning, amending, retaining and sharing patient care report data.”

In this week’s EMS One-Stop, available in both video and audio versions, Host Rob Lawrence speaks with the PW&W authors of the project, Ryan Stark, managing partner, and Steve Johnson, director of reimbursement consulting. They discuss the guide, why it’s needed, and the major FAQs and misconceptions about PCRs.

The guide is broken down into four key areas of FAQs:

1. PCRs’ legal status

Top quotes from this episode

“I would much rather defend an organization who regularly goes through a quality assurance process, whereby they make the provider and hold them responsible for the accuracy and completeness of the record.” — Ryan Stark

“Others may say, we see a lot of amendments to your records. The answer is ‘yes, that’s because we care about getting it right’ – that’s the mantra of our organization.” — Ryan Stark

“One of the things behind the importance of documentation is that it doesn’t live in a vacuum. We are in a day and age where it’s going to follow the patient for their lifetime, so you may have a rehab facility that wants to consult the medical record to determine the mechanism of injury or how the injury occurred and the only person [that knows that] is the EMS practitioner.” — Ryan Stark

“Long gone are the days where we can give you a quick ticket, passing along the information to the receiving facility. Now we are marrying up records, electronic health exchanges and other mechanisms and the genesis of all this starts with the original call.” — Steve Johnson

“Everyone should sign the patient care report. Why? Because everyone was a function of providing that particular service and we get a lot of pushback and they say ‘well now I’m legally responsible for everything that happened,’ and that’s not what the law says. The law says, for what you did, you are responsible for what you did and what you didn’t do when you had a legal duty to do something or withhold doing something because it was contraindicated. All that indicates is that yes, I reviewed it and to the best of my knowledge it’s true and accurate.” — Ryan Stark

“The law will impose liability where it lands. Just because you’ve signed that particular patient care report, doesn’t mean you’re responsible for all the interventions and everything that I outlined in there, it would be whoever performed or withheld those interventions that would be responsible within the scope of practice.” — Ryan Stark

Episode contents

1:09 – Introductions

1:30 – PWW history

3:30 – Introducing the PCR Data QuickGuide

4:20 – The circle of life of a PCR 

11:00 – NEMSIS data/research license and EMS by the numbers

13:20 – Who owns PCR data

15:50 – Signatures! And legal responsibility

17:40 – Accuracy of documentation to defend your actions

18:30 – Why does the driver have to sign?

20:00 – Amending PCRs: When and why

22:33 – Who do you tell if a record is amended?

24:30 – Can your state request you to amend your PCR?

27:30 – How long should we keep documents?

30:50 – When an agency closes down or merges

33:30 – Body-worn camera content

35:30 – Transferring paper records to digital

37:15 – Bi-directional data and HIE – responsibilities

40:00 – Final thoughts

Additional resources

• The PCR Data QuickGuide is available now, and we encourage all EMS professionals to download their copies and gain a deeper understanding of PCR data best practices. To download the guide, please follow the link:

About our guests

Ryan Stark

Ryan Stark is a managing partner with Page, Wolfberg & Wirth, and is the firm’s resident “HIPAA guru.”  He counsels clients on labor relations, privacy, security, reimbursement and other compliance matters affecting the ambulance industry. 

Ryan started in the healthcare field as a freshman in college, where he worked for a local hospital and a retail pharmacy.  After college, he decided to become a lawyer, hoping to guide healthcare providers through the demanding legal issues they face.  He has been with PW&W since 2007, fulfilling that ambition.  

Ryan is passionate about educating EMS professionals and loves collaborating with providers and CEOs alike. He is a featured speaker in PW&W seminars and webinars, including the firm’s signature abc360 Conference, where he hosts the abc360 Game Show. Always enthusiastic, Ryan has been invited to speak at many state and regional EMS conferences, as well as national industry events. He is also an adjunct professor at Creighton University in the school’s Master of Science in Emergency Medical Services Program. 

Ryan developed, and is the primary instructor for, the nation’s first and only HIPAA certification for the ambulance industry – the Certified Ambulance Privacy Officer.  He also co-authored PWW’s widely used Ambulance Service Guide to HIPAA Compliance.  

Ryan volunteers with local community nonprofit organizations. He was also a big brother with the Big Brothers Big Sisters program for over a decade and keeps in touch with his “little.” Ryan also enjoys hiking, running, kayaking and traveling, and spending time with son Oliver.   

Steve Johnson

Steve began his career in the EMS industry in 1985, gaining valuable experience while serving as an EMT and later as director of a municipal ambulance service in Minnesota. As an ambulance service manager, Steve established his expertise in areas of operations, billing and administration.  

Steve also has significant EMS educational experience. He established and served as training coordinator and lead instructor for a State Certified EMS Training Institution for EMTs and First Responders.  

Steve served on both the Rules Work Group and the EMS Advisory Council to the Minnesota State Department of Health.

He joined the staff of a large, national billing and software company, where he was a frequent lecturer at national events and software user group programs. For over 7 years, Steve served as director of a national ambulance billing service and was responsible for all aspects of managing this company, including reimbursement, compliance and other activities for ambulance services throughout the nation.

Steve served as founding executive director of the National Academy of Ambulance Coding (NAAC), overseeing all activities of the Academy, including the Certified Ambulance Coder program, the nation’s only coding certification program specifically for ambulance billers and coders.  

As the director of reimbursement consulting with Page, Wolfberg & Wirth, Steve is involved in all facets of the firm’s consulting practice. Steve works extensively on billing and reimbursement-related activities, performing billing audits and reviews, improving billing and collections processes, providing billing and coding training, conducting documentation training programs, and performing many other services for the firm’s clients across the United States.  

Steve is also a licensed private pilot, and enjoys an active role in his church.

Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the EMS One-Stop team at [email protected] to share ideas, suggestions and feedback.

Educating the public about when it is appropriate to call EMS – and how quickly we should get there

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 EMS Week episode of Inside EMS, Cohosts Chris Cebollero and Kelly Grayson dive into where emergency care begins, and how community paramedicine launched a paradigm shift years in the making. They discuss how EMS did a fine job of educating the community about the obstacles and dangers of the job during COVID-19, but need to capitalize on and maintain that momentum moving forward.

Memorable quotes from this episode:

• “Community paramedicine has everything to do with EMS week.”

Chris and Kelly discuss:

• How emergency care begins at dispatch and nurse triage of 911

Enjoying the show? Please take a moment to rate and review us on Apple Podcasts. Contact the Inside EMS team at [email protected] to share ideas, suggestions and feedback, or if you’d like to join us as a guest.