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Driving the Bus or Riding on It

All aboard; the EMS "bus" is leaving, and it's headed toward your future the future of your profession and the future of your organization.

You either need to get on, or be left behind.

Now that you've decided to board this bus, the question is where do you want to be sitting? Do you want a window seat to just sit and enjoy the ride, or would you prefer to be the one driving this bus?

In case you didn't know, this bus started its journey a number of years ago, and it's headed toward new destinations, changes. Now it is time for you to take an active role in determining where this bus is going and how it's going to get there. There are a number of people and groups already on this bus, and many of those people are working to be the ones who drive this bus.

Last year, a document called the "National Scope of Practice" was finalized." The EMS community developed this document through the help of a number of individuals and agencies, and it created four levels of EMS providers. In two of the four levels, the name stayed the same. In the other two levels, a new name was created.

As each state begins to look at these providers levels, it's time for every manager and even providers to get involved in the process their state agency is taking to develop state standards or statutes and rules to govern EMS providers. You shouldn't sit back and allow the new rules to be developed without your input by a few members of your EMS community.

If you're not sure what this is all about or you need a mini-reminder, you need to read or re-read a few documents. If you don't already have them in your agency library or literary collection, you should obtain copies.

To briefly bring you up to speed, you need to first read the "Agenda for the Future." This document laid out a roadmap for the EMS community to improve service delivery. It called for several improvements to be made to this (EMS) bus in order to keep it running and being more efficient.

Next, you should read the "EMS Education Agenda for the Future." This document proposed the development of new EMS core competencies, the development of a National Scope of Practice and the development of new educational standards to accompany the Scope of Practice. The Education Agenda also called for the development of a national EMS certification and national EMS education program accreditation. The core competencies and Scope of Practice have been completed and the educational standards are being worked on now. You should review those documents and have a copy.

The Scope of Practice developed the four levels and set floor level minimum skills needed for each reciprocity throughout the states. There were no skills exclusions listed for each level. The intent was to have the local, regional or state organizations set those ceiling levels, rather than be set at the national level. One can only hope they would be based on either some evidence or be determined by local needs, rather than an attempt to limit care.

This should be where you can have the most input. Before any standards or statues are developed or implemented, get with your state officials or organizations in your state that are looking to develop standards on each provider level and give them your ideas and suggestions on how to best implement these levels.

My recommendation is for you to get involved in your state's development of standards or statutes as it relates to the provider levels and how those levels standard of care affects your agency operations. Attend meetings and learn what the issues are as it affects providers and organizations in your state. Depending on the process, you may have a limited amount of input or a great deal of input. Either way, you need to make the effort to impact those levels and its effect on your agency operations.

You are at the bus station and everyone is figuring out which highway and direction to go. You need to help guide the direction by demonstrating the best options for EMS in your state on which highway and in which direction to go.

When the Educational Standards process begins the process of public comments in 2007, review the material presented and offer your suggestions for improvement. If you belong to a state or national EMS agency, work with them to contribute comments. Get actively involved in the process of making the EMS profession better, by providing your input and your actions.

Don't wait too long. If you are the last one on the (EMS) bus, you will be left standing in the isle, wondering where you're going only to be surprised when you get there.

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