Washington,„D.C., is working to implement the recommendations recently released by the city_s Task Force on Emergency Medical Services for reforming the DC Fire & EMS Department (DCFEMS). One of the first recommendations due for implementation is crosstraining of the department_s single-role„EMS providers in fire suppression.
The 13-member panel was formed as part of an agreement to settle a lawsuit brought by the family of retired New York Times journalist David Rosenbaum, who died after being mugged on a„D.C. street Jan. 6, 2006. Among other things, the lawsuit claimed DCFEMS EMTs missed Rosenbaum_s head injury (assuming his symptoms were the result of being drunk) and bypassed the closest appropriate hospital to take him to a more convenient facility.
The EMS Task Force included Rosenbaum_s son-in-law, the family_s attorney, seven city officials, a physician from outside the D.C. region, a fire chief from„Georgia and an„EMS chief from Boston EMS, a single-role agency that has produced some of the nation_s best patient outcomes.
Although Mayor Adrian M. Fenty campaigned in 2006 on a promise to address problems within DCFEMS by separating„EMS from the fire department, the task force didn_t include that as one of its suggestions. Instead, the panel offered two major proposals to address DCFEMS structure, culture and capabilities: to strengthen EMS leadership within the department and to crosstrain fire and„EMS personnel to create ˙a fully integrated, all-hazards agency.Ó
˙It_s fair to say that many of the recommendations have already been implemented,Ó says DCFEMS spokesman Alan Etter. One example is the creation of the new position of assistant fire chief/medical director. It was filled by Michael D. Williams, MD, a trauma surgeon and critical care physician at„Washington„Hospital„Center, who was sworn in June 8, along with new DCFEMS Chief Dennis Rubin.
˙I was the only person [on the panel] who did not support all the recommendations,Ó Richard Serino, chief of Boston EMS, says. He declined to specify his areas of disagreement. ˙Some good work was done, but it could have been better. This provided a golden opportunity for D.C. to have one of the best„EMS systems in the country, but the recommendations didn_t go far enough.Ó
Williams counters, ˙We view the recommendations as an opportunity to redefine ourselves and create the nation_s best„EMS service.Ó
Based on the panel_s recommendations, DCFEMS will create another new position for an assistant chief for„EMS and conduct a nationwide search to fill that role.„
Williams notes that about 1,400 DCFEMS firefighters are trained as EMTs. He says the department is now working with the International Association of Fire Fighters (IAFF) Local 36 (which represents the firefighters) and American Federation of Government Employees Local 3721 (which represents single-role EMTs and paramedics) to create a training program to ensure all are trained in EMS and fire suppression.
Along with the crosstraining, the EMS Task Force also recommended ˙basic pay and benefits parity between current single-role medical providers and dual-role providers.Ó
That issue must be ˙worked out with the unions during negotiations,Ó Williams says, adding that the recommendation for pay parity ˙was not based on the premise that people would stay in their current jobs and not engage in additional training.Ó
Rubin created the EMS Path Forward Working Group before the EMS Task Force released its recommendations. ˙We are cooperating and collaborating with the other stakeholders and other agencies and entities beyond„EMS that also have tasks and responsibilities with this,Ó Williams says.After the recommendations were made public, DCFEMS invited city administrators and officials from both unions to join the working group. ˙Local 3721…is less than enthused and is not participating in the Path Forward Working Group, although I_m hopeful that might change,Ó Williams says.