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Emergency Medical Service Management and the Fire Department

Upcoming Courses

Textbook

EMS Textbook Order Form - PDF [127 KB]

Course Description

Prerequisite: None
Nearly two decades ago the fire service started upgrading its traditional rescue service activity to include Emergency Medical Technicians and Paramedic services. Emergency Medical Services (EMS) is the term used for the system of pre hospital care for victims of sudden illness or trauma. Providers respond to an incident with immediate treatment for absence of breathing or heartbeat and stabilization of patients for transport to an appropriate facility.

EMS has developed in varied and different directions throughout the world. Regions have developed from simple transport to the nearest medical facility to sophisticated systems with multiple levels of medical care. Advancements in medical procedures and technology, financial support from governmental agencies, favourable public sentiment, and changing community demands have promulgated a rapid pace of growth in the provision of EMS. This has been an exciting stage of growth and advancement in many parts of the world.

The field of EMS is now faced with a new stage of development. EMS has grown through the infant and teen years and is entering adulthood. Much of the glamour and glitter of the early years has begun to tarnish. It is a time for thoughtful decisions regarding level of service, to weigh the benefits of technology, and to face the facts of fiscal independence. Advanced paramedic procedures have raised questions regarding their appropriateness in the pre-hospital setting. Explosive growth in medical technology has left all but the most imaginative minds wondering. Government funding has been drastically reduced. Local governments are fiscally constrained by the citizens whom they serve.

These events demand a new level of professionalism in EMS management. Typical EMS directors have had little or no training in management principles. They have come up from the street. They know technique through training and experience, but in this increasingly complex world they need help. They need training designed for management of EMS systems: they must move “Beyond the Street”.

This course does not present all of the necessary technical knowledge for the development or provision of Emergency Medical Services. For example, the training curriculum for Emergency Medical Technicians or Paramedics is not included in this text, nor is standards for rescue vehicles and equipment. This technical knowledge, if not already known, must be sought out or developed by the fire service manager. Rather, this course concerns itself with the planning and management of EMS within the fire service.

The development of EMS systems has been primarily reactive in nature. Fire departments, ambulance services, or other community leaders have identified needs and then reacted in ways to meet those needs. However, as the dust of these past two decades of development begins to settle, the managers of EMS services must move beyond the mode of crisis management. Established management functions of planning, organizing, staffing, directing, coordinating, and budgeting must become familiar friends to the future development of Emergency Medical Services.

Some of you may wonder: “Why learn how to manage EMS if EMS is not provided by my department?” This view is short sighted for the reasons as described below:

  1. EMS delivery by the Fire Service has arisen from community pressure. Thus it is better to be able to respond with a careful plan of action developed by the fire department, than to be forced by someone else’s plan.
  2. The processes which are presented in this course and in Fire Service Strategic Planning I will help you to diversify your department in a direction you want (e.g., hazardous materials first response, residential inspections, disaster planning and so on). That diversification will be inevitable as structural fires decline and municipal budgets shrink.

Unit One: Learning Objectives

By a combination of reading, studying and assignment preparation, you will gain an understanding of:

  • the different components which constitute a prehospital EMS system;
  • the resources required for each component of the EMS system;
  • the role of the fire service within the EMS system and each of the components;
  • the global and Canadian history of EMS.

Unit Two: Learning Objectives

By a combination of reading, studying and assignment preparation, you will gain an understanding of:

  • the wide variety of fire service involvement within EMS systems together with main features of each system
  • prevalent Canadian systems and how they interface with other EMS components
  • advantages and disadvantages of each system from a variety of customer, fire service and other perspectives

Unit Three: Learning Objectives

By a combination of reading, studying and assignment preparation, you will gain an understanding of:

  • The universality of common principles of management
  • Management methodologies that are being used within fire/EMS organizations together with their application and results
  • The importance of the fire service culture when attempting to change organization roles and direction

Unit Four: Learning Objectives

By a combination of reading, studying and assignment preparation, you will gain an understanding of:

  • the need for fire/EMS service involvement to be carried out in a professionally competent manner
  • the importance of medical direction in providing fire/EMS services at all levels
    common levels of EMS caregiver competency
  • medical direction methods within fire/EMS services

Unit Five: Learning Objectives

By a combination of reading, studying and assignment preparation, you will gain an understanding of:

  • the budget structure within fire departments;
  • the cost implications of various fire department EMS models;
  • factors to consider when constructing a fire ambulance transport competitive bid;
  • a variety of fire/EMS costing models.  

Unit Six: Learning Objectives

By a combination of reading, studying and assignment preparation, you will gain an understanding of:

  • the budget structure within fire departments;
  • the cost implications of various fire department EMS models;
  • factors to consider when constructing a fire ambulance transport competitive bid;
  • a variety of fire/EMS costing models.

Course Author and Instructor

Glen Maddess
Glen is the retired Director of the Fire Safety Division, Justice Institute of British Columbia. He is also the retired fire chief from the Vancouver Fire and Rescue Services. When he was chief, he established a high performance emergency medical system, that included continuous quality improvement, and computer aided dispatch. Glen holds a Masters in Science (EHS) degree from the University of Maryland and a Bachelor of Science degree from Western Oregon University.  He has worked as a consultant to the Province of BC, Ministry of Health Planning in establishing scopes of practice, governance and educational requirements for First Responders and Para Medics and currently as a consultant to the Fire & Emergency Services Training Institute (FESTI) for their Middle East programs in Toronto. In addition to being an instructor for Dalhousie University Fire Management Certificate Programs Glen is an adjunct faculty member of Western Oregon University, and the US Fire Administration, National Fire Academy. In 2008 Glen completed a rewrite of Emergency Medical Services Management and the Fire Department.