EMS Insider, Mobile Integrated Healthcare

Community Paramedicine Implementation Guide Being Developed for Fire-Based EMS

Throughout 2017, the National Fire Protection Association (NFPA) Technical Committee for EMS is developing NFPA 451: Guide for Fire Based Community Healthcare Providers. The scope of this guide will be to provide direction to agencies supporting the EMS mission for planning, preparing, implementing and evaluating community healthcare programs in an effort to meet the changing needs of the communities they serve.

The guide is being developed with fire-based EMS services in mind, but is written in a way that any EMS agency can use it as a comprehensive, easy-to-follow guide and roadmap to developing and implementing a community paramedicine or mobile integrated healthcare program.

Development Process

Although the NFPA is known for creating consensus standards, this document is being developed as a guide because of the fluid and dynamic nature of the subject matter. The committee felt as though there’s so much variation of rules and needs at a state-to-state and system-to-system level that it would be impossible to standardize this practice at this time.

The EMS Technical Committee, chaired by retired fire chief Kyle Gorman, a past vice chairman of the National EMS Advisory Council, sought out experts throughout the EMS community to develop the guide and its content, which includes chapters on regulation and policy, medical oversight, continuous quality improvement and delivery models to name just a few. (See Table 1 for a full list of chapters and chapter leads.)

The guide will also contain links and references to work already completed by partner organizations such as the National Association of EMTs (NAEMT), Academy of International Mobile Healthcare Integration (AIMHI), International Association of Fire Fighters (IAFF) and National Association of State EMS Officials (NASEMSO).

The committee has set a goal of complete a draft of this guide in 2017. Once complete the draft document will go to the NFPA Standards Council for review and approval. The standards council will then assign the document a revision cycle (usually 3 or 5 years).

Once the draft is approved, the document will be open for input from the public for at least 6 months. The EMS committee will then reconvene and review the inputs and make appropriate revisions, which will be open again for public review and comments for another 3-6 months. The committee will then review all comments, make their final edits, and justify their reasons for accepting or rejecting any public comments. Once this process is complete, the NFPA will officially publish the guide.

NFPA’s practice of open, consensus-based processes has allowed it to produce American National Standards Institute (ANSI) accredited standards. The open process and revision cycle also allows for the document to be updated with the best possible information in the ever-changing world of EMS and republished on a regular basis.

Future Standards

The Technical Committee for EMS has also done extensive recruiting to expand the committee, seeking representation from healthcare organizations, insurance companies, EMS legal experts, EMS technology partners, psychiatrists, and EMS leadership organizations.

The committee is tasked with the primary responsibility for documents relating to EMS, except those documents covered by other existing NFPA committees. It currently has one standard published, NFPA 450: Guide for Emergency Medical Services and Systems, a consensus standard for all EMS organizations.

The committee has also completed research projects on fire-based community paramedicine programs and an analysis on ambulance crash data. The committee is currently soliciting ideas for future standards and research studies related to EMS. Ideas may be sent via email to [email protected]

All NFPA committee meetings are open to the public. Committee meetings are usually held at hotels or conference centers and are spread throughout the country. The EMS committee last met in November in Albuquerque, N.M, and is next scheduled to meet on June 13 at the NFPA headquarters in Quincy, Mass. Those interested in attending the meeting can RSVP at www.nfpa.org/451next.