EMS System Regionalization

Excerpt

The Emergency Medical Services (EMS) system is a network of healthcare resources that delivers acute unscheduled care to patients outside of a hospital. The system closely interfaces with the rest of the healthcare infrastructure (in-hospital components, outpatient clinics, public health). EMS services vary in capabilities, with some providers able to provide basic life support and others able to provide advanced life support (ALS) or air medical services. Patients sometimes require definitive care unavailable at the closest hospital, so EMS systems need to be regionalized. This means that patients are transported to hospitals best equipped to care for their specific needs, even if it is not the local hospital in the ambulance's jurisdiction. Regionalization can help to improve patient outcomes, avoid delays in care, and help reduce overall resource utilization by avoiding secondary transports.

Regionalization of emergency medical care has become the standard of care in recent years. Studies have shown improved patient outcomes and reduced costs due to this policy. However, the success of a regionalized system requires constant quality assurance from all stakeholders and the EMS medical director. The system must focus on every aspect of the patient's journey through the acute unscheduled care system, constantly identify any barriers that need to be improved, and update processes as new outcome data becomes available. EMS medical directors play a crucial role by ensuring that the system meets the needs of the patients in their region while educating other healthcare stakeholders on the importance of regionalization, which healthcare organizations or individual providers may not fully understand. For example, local hospital administrators often have financial pressure to keep patients in the local community within their hospitals. EMS operations may want all units to go to the closest hospital to decrease turnaround times. Therefore, the EMS medical director must help different providers interface effectively and ensure the medical needs of the patient arriving by ambulance are the primary focus.