This paper will discuss the internal organizational conflict that occurred in the Wake County Department of Emergency Medical Services (EMS) after the formation of the Advanced Practice Paramedic Division (APP). Wake County EMS (WCEMS) is the sole entity with in the Wake county Government structure that is charged with providing prehospital emergency medical care to the visitors and citizens of Wake County. This paper is based on the opinion of the writer; it does not and is not reflective of the department’s opinion or the stance of the county.
Wake County EMS responds to almost 90,000 requests for service annually and serves almost 1 million people, which places the WCEMS system in the top fifty EMS systems in the country based on call volume and size of population served. ("Wake county department," 2012) In response to ever-increasing call volume, a decrease in primary care, and the universal changes in healthcare, which have resulted in more people using EMS and the local emergency room for primary care and non-life threatening events, the EMS Department elected to change their service structure. The department would move away from the traditional EMS mantra of “you call we haul” and having a system being designed around reactive responses to healthcare issues in the community to an evidenced based incident prevention structure. No longer, would it be considered prudent or correct to just continue to add transport resources to address the increasing call volume and continue to place the actual burden of care on the local hospitals, it would become the burden of the EMS system to provide alternatives to properly address the actual healthcare needs of those who called 911. Wake County EMS had already utilized evidenced based ...
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Bacal, R. (2012). Manager's guide to performance management. McGraw-Hill. (Bacal, 2012)
Myers, J. (2008). Evidence-based performance measures for emergency medical services systems: A model for expanded ems benchmarking a statement developed by the 2007 consortium u.s. metropolitan municipalities' ems medical directors (appendix) read more. Retrieved from http://informahealthcare.com/doi/abs/10.1080/10903120801903793
Resolving conflict situations. (2013). Retrieved from http://hrweb.berkeley.edu/guides/managing-hr/interaction/conflict/resolving
Sayre, M. (2006). Cardiac arrest survival rates depend on paramedic experience. Retrieved from http://www.researchgate.net/publication/246149504_Cardiac_Arrest_Survival_Rates_Depend_on_Paramedic_Experience
Wake county department of ems about us. (2012). Retrieved from http://www.wakegov.com/ems/about/Pages/default.aspx
The organizing function of the manager consists of developing organizational charts, job descriptions, and statement of work flows ( Liebler and McConnell, 2008, p.53). A healthcare department manager must have knowledge of the job functions, job descriptions, and how those relationships impacts, authority, chain-of-command and communication. As a Wayne County Sheriff Sergeant, the organizational jail chart reveals the decision making process in terms of, (a) major functions,(b) relationship of functions, (c) channels of supervision, and (d) lines of authority and communication and positions( by job titles) within the [jail] units (Liebler & McConnell,2008, p.194).
Nerenz, D. R. & Neil, N. (2001). Performance measures for health care systems. Commissioned paper for the center for Health management research. [PDF document]. Retrieved from Systemswww.hret.org/chmr/resources/cp19b.pdf
Waugh, William L, and Gregory Streib. "Collaboration and Leadership for Effective Emergency Management." Public Administration Review, 66.6 (2006): 131-140.
I found your post interesting, having worked in an emergency department during my paramedic years. In my career as a nurse working in a clinic on occasion we must send a patient to the emergency department. I always call to speak with the charge nurse to provide report prior to just sending the patient, often I am on hold for greater than 15 minutes. This often results in the patient arriving at the ER before I can give report. Adding to this the charge nurse on more than one occasion is calling me on another line to ask why the patient it there! However, from past experience I do know how busy the ER can be at any given time.
This paper’s brief intent is to identify the policies and procedures currently being developed at Midwest Hospital. It identifies how the company’s Management Committee was formed and how they problem solved and delegated responsibilities. This paper recognizes the hospital’s greatest attributes and their weakest link. Midwest Hospital hired Dr. Herb Davis to help facilitate the development and implementation of resolutions for each issue.
After analyzing the Coastal Medical Center, it is apparent that the employees and staff have no conception of the mission, vision, and values of this health care facility. In addition to this lack of structure, CMC has many projects in the midst of production that lack support of a common goal, employees are unsatisfied with their jobs, the two boards lack ability to agree on strategic decisions for the organization,, and the medical center has a dismal reputation when it comes to quality care.
On account of theses limits other tools that are more efficient, objective and accurate are necessary to enhance acute hospital care. The National Institute for Health and Clinical Excellence (NICE 2007) have highlighted the importance of a systemic approach and advocated the use of EWS to efficiently identify and response to pa...
Ambulances, started to affect today’s modern health care after the Civil war. Ambulances are specially equipped motor vehicles. Ambulances carry sick, or injured people from the spot of their accident, to the closest hospital. Ambulances are part of the emergency medical services, EMS, which also includes helicopters, airplanes, and boats. Ambulances typically have room for one or more people. Ambulances can also hold many medical personnel and medical supplies.
Trzeciak, S. & Rivers, E. (2003). Emergency department overcrowding in the United States: An emerging threat to patient safety and public health. Emergency Medicine Journal, 20, 402−405. doi: 10.1136/emj.20.5.402
In 2005, Congress reauthorized the legislation for the NHTSA. Under the Safe, Accountable, Flexible, Efficient Transportation Equality Act: A Legacy for Users or SAFETEA-LU, Congress then created the Federal Interagency Committee on Emergency Medical Services. The EMS system today is still a serious career that is competitive to get into. Medical Assistance is integrated into Law Enforcement, Fire Fighters, and anyone in public safety because it’s an honorable career and works to improve the safety of the community in which we live in.
Emergency services face vast difficulties in the operations field when handling emergency situations, whether it comes from handling a minor accident to a catastrophic catastrophy. Many of the difficulties do not come from the actual incident, but instead they arise from forming a rescue team containing different agencies and people. For the benefit off all individuals participating, it is imperative that there be a unified command structure in place to effectively coordinate and oversee the tasks that need to be accomplished. The need of a unified command was seen from the hardships faced in incidents, bringing forth the development of the Incident Command System that was designed to be used in an array of conditions, to bring all individuals to a common ground. FEMA (n.d) stated “The Incident Command System (ICS) is a standardized, on-scene, all-hazards incident management approach…”
Meredith, J.W (2008, May). The Lack Of Hospital Emergency Surge Capacity: Will The Administration's Medicaid Regulations Make It Worse? Presented at The House Committee On Oversight And Government Reform. Retrieved March 2014, from
At its most fundamental core, quality improvement of healthcare services and resources requires disciplined attention to the measurement, monitoring, and reporting of system performance (Drake, Harris, Watson, & Pohlner, 2011; Jones, 2010; Kennedy, Caselli, & Berry, 2011). Research points to performance measurement as a significant factor in enabling strategic planning processes and achievement of performance goals (Tapinos, Dyson & Meadows, 2005). Thus, without a system of measurement that accounts for the performance behaviors of healthcare professionals, managers and administrative employees, quality improvement remains a visionary abstraction (de Waal, 2004).
Philosophically the term emergency medical service has developed to represent a transition from a simplistic system of vehicles delivering only transportation, to a system by which certified medical care is provided on scene and during transport. However in some less developed regions, emergency vehicles are still fundamentally a means of transportation to the medical facility that will provide care.
Just like communities, BCFS EMD has to remain prepared at all times. As a non-profit partner of federal, state and local government and private industries, our team of responders are always updating and refining their skills and knowledge just in case they have to spring into response. Our training and exercises provide tailored preparation to any state, jurisdiction or health care entity's needs. By implementing hands-on workshops and exercises, BCFS EMD helps strengthen the knowledge of communities and organizations seeking further response