Paramedicine and Paramedic Education

10/23/2024

Looking forward to a great workshop tonight and tomorrow:

Sponsored by the National Academies of Science, Engineering and Medicine.

10/10/2024

LinkedIn just reminded me: I have completed six years now on faculty at Eastern Kentucky University (EKU Paramedic Degree Program) in their EMC program.

At first I thought LinkedIn got that wrong, but my (old) brain finally kicked in and I realized that my first year there I was writing my dissertation as I remembered the pay-bump once that degree was conferred 🤣

That was a fast 6-years...

10/03/2024

October 3rd - and the entire re-certification / licensure process is now complete.

07/02/2024

OK - I have gone on a FB rant in a while - but I'm triggered here.

I have FULL respect for this agency, and I feel in many ways they are a model for others to follow.

THIS IS NOT THAT CASE!!!

Balance billing patients for non-transport will discourage appropriate and inappropriate use of the system, will negatively affect access to care, and will not generate enough revenue to make an impactful difference on any agencies funding.

Even if you assume that they will bill and receive payment for every non-transport listed in this letter, that will generate ~$250,000 per year, but that is totally unrealistic. They maybe will get 30% of that back, or~75k per year, or roughly the cost of 1 paramedic's salary. Let's also not forget all the calls that the "patient" didn't request nor want 911, but a family member or bystander called, and the patient allowed you to take their vitals before refusal.... ARE YOU GOING TO BILL THEM TOO? I would love to see the litigation about informed consent and billing practices (which always happens post care if it happens at all) and how that holds up.

IS IT WORTH THE ISSUES THIS WILL CAUSE TO GENERATE THAT LITTLE BIT OF REVENUE?????

I'm honestly 100% balance billing patients for this - it will stop even more people from calling 911 because of fear of "costs" involved. I could see having a policy for those who abuse the system, and a system to track that, but to bill a person directly because 911 was activated isn't something we should be encouraging.

YES - state and local officials SHOULD change their policies / laws / reimbursement for EMS.

YES - Medicaid SHOULD pay for this (that is a state level decision)

YES - CMS should reimburse for Medicare patients as well

AND AND AND

YES - Cities and Towns need to FUND their EMS so this isn't an issue anyway. Its beyond time municipalities stop seeing EMS as either free or cheap OR worse yet as a revenue stream for the general fund!!!! Raise and appropriate the needed tax revenue to fund your system of care, so that decision like this (which again I feel are horrible for patient care and access to same) are not needed!!!!

STOP THIS NONSENSE! Fund your EMS agencies appropriately, stop this low cost / no cost or revenue stream models that are in place. And please, for the love of all that is holy in this wonderful world - do NOT come at me with "but but but, the town can't afford it!" Do they afford cops? Trash collection? Public Schools? Road maintenance? A fire department? And recreation services? A tax collector? IF YES to any of the above, it's not that they cannot "afford it" - it's they make the choice not to fund it.

Now back to your regular programming.

06/27/2024

Was just invited to be a Module Section Leader and Doctoral Advisor for the College of Remote and Offshore Medicine's (CoROM) Doctor of Health Sciences program.

Specifically, I will be re-writing the second module, Transforming Services & Delivering Quality, leading the instruction of that module as well as functioning as a dissertation advisor for students with similar research interests.

Service transformation and change is a passion of mine (as many of you know), and driving quality care is sort of my day job already 😁. The fit between my interests and this program is actually spectacular.

Maybe I'll get a trip to Malta out of it 🤣 (some day)...

05/22/2024

Mass General Brigham Ambulance Services is seeking committed, compassionate paramedics to join our Mobile Integrated Health program - serving the largest home hospital program in the United States. Our skilled providers set the standard for inpatient and urgent care delivered in the home setting, standing at the forefront of paramedic-driven care in the home and delivering care for some of the best hospitals in the world!

Our paramedics operate out of a fleet of brand-new Class V ambulances (pictured below) and work under an expanded scope of practice, including point-of-care ultrasound studies and POCUS-guided IV placement, point-of-care laboratory testing, and an expanded medication formulary. We provide care as part of a collaborative care team of paramedics, nurses, physicians, advanced practice providers, and many others. Driven by Mass General Brigham's investment in Healthcare at Home, our MIH program has grown from one patient visit in its first month to nearly 1000 visits last month!

We offer excellent compensation and benefits, opportunities for professional development and advancement as granted by Mass General Brigham's world-class resources, and above all, a team-based, patient-focused, and paramedic-led culture of excellence.

Please feel free to reach out to me with any questions!

To Apply:

Full-Time Mobile Healthcare Paramedic Roles: https://partners.taleo.net/careersection/ex/jobdetail.ftl?job=3279323

Per Diem Mobile Healthcare Paramedic Roles: https://partners.taleo.net/careersection/ex/jobdetail.ftl?job=3291156

If either of these links are not functioning appropriately, please search "Mobile Healthcare Paramedic" at the following link: https://partners.taleo.net/careersection/ex/jobsearch.ftl?lang=en

For more:

On Mass General Brigham Home Hospital:
Providing Hospital Care at Home Saves Money: https://www.bostonglobe.com/2023/07/26/opinion/home-hospital-healthcare-medicaid-medicare/ (Subscription may be required)
Hospital-level Care at Home is the Future: https://www.bizjournals.com/boston/news/2023/06/30/mass-general-brigham-s-home-hospital-program.html (Subscription may be required)

On Mass General Brigham Home Hospital Emergency Care:
Emergency care without the ED: https://www.massgeneralbrigham.org/en/about/newsroom/patient-stories/opals-story-emergency-care-without-ed
Bringing Emergency Care Home: https://www.massgeneralbrigham.org/en/about/newsroom/patient-stories/arnitas-story-emergency-care-at-home

Photo Credit: Charlene Van Cott, Mobile Integrated Health Paramedic.
Pictured: MGB MIH unit MH-6.

05/22/2024

Just got home after a 3+ hour EMS week cook-out for our crews.

And the crews weren't there in "drive by style" grabbing a cold burger and a bottle of water and back out turning calls. Not a left over pizza and 6 hours old "box of joe" in the day room and a "thank you" company branded blanket or koozie event. Not a "See how much we like you, now back to work"...

For the most part - the crews got to stay the entire time. People even came in from home for it, people stayed after their shifts for it (and they were on the clock because asking someone to stay but 'punch out first' isn't really gratitude after a 12 hour shift). It was a celebration of the crews, from Chair Car, to EMT, Paramedic and MIH.

We had executive level leadership from the Enterprise and multiple Docs come by and participate as well.

Grilled Salmon and asparagus
Grilled Steak tips
Grilled Chicken Breast with roasted pineapple
Smash Burgers with bacon and onions on the Blackstone
Watermelon Salad
And a bunch of sides

EMS Week daily raffle prizes given out
(SUNDAY - SATURDAY Daily Drawings)

Red Sox Tickets
Littmann Classic III Stethoscope
Giftcards $25-$50 to various places
Jackets and vests
Underarmor gym bags
and more.

We've had decades long employees all the way down to one person's very FIRST DAY with out win the drawings so far, and we are only 3 days in.

AND the head boss sat in a dunk-tank and encouraged all his providers to throw balls at him for a hour. (I got him with 1 throw :) )

This is how EMS week should be.

Happy EMS week to all those who put on the polyester pants and serve our patients and communities.

05/17/2024

This device, based on the preliminary study talked about in this article, could be a game changer for stroke care.

Working on a study protocol for IRB approval now to run a multi-center, nationwide, randomized cluster trial to see what impact it could have on prehospital care and point-of-entry.

Can’t wait to help operationalize this and get it in the field!

Stroke is the leading cause of disability worldwide and the second leading cause of death, but the right early intervention can prevent severe consequences. A new study led by investigators from Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, and....

05/16/2024

A little "flash-back" Wednesday.

After a very productive meeting today, looking at an exploration of higher-education based, credit granting, baccalaureate completion and affordable EMS education in Boston, a moment of nostalgia from my last commencement as an Academic Dean in 2022.

Being inside the walls of a graduate degree granting institution today (specifically in Health Professions) reminded me why I enjoyed teaching college students and leading an academic division.

(Academic Deans of NECC at the 2022 Commencement Ceremony)

04/23/2024

Feel free to join in tomorrow (WED 4/24 at 3:30pm) when my colleagues and I present on our research at Seton Hall University'S 28th Annual Petersheim Academic Exposition (ONLINE).

Title: Self-care agency (SCA) among U.S. emergency medical service (EMS) practitioners during the COVID-19 pandemic: Foundational research for creating a functional definition of self-care literacy

Michelle Lee D’Abundo, PhD, MSH, CHES; Laura Marinaro, PhD, RD, ATC; Vanessa Rodriguez EdD, MS, PA-C; Scott Lancaster, PhD, MHA, NRP

Abstract: Self-care agency (SCA) is part of the emerging concept of self-care literacy. SCA is the ability to meet and recognize care needs, assess available resources, and act to achieve goals. Self-care literacy is defined as knowledge, motivation, and competencies to promote health, prevent disease, and maintain health with or without the support of a healthcare provider. In the U.S., over 269,000 EMS practitioners assess injuries and illnesses provide emergency medical care. During the COVID-19 pandemic, SCA was assessed using the Self-Care Agency Scale-Revised among 91 EMTs. Findings will be presented and implications for defining self-care literacy will be explored.

04/19/2024

That’s a wrap for the 2024 National Association of EMS Educators mid year Board of Directors meeting in Orlando, Florida.

A big thank you to my fellow Board members who elected me into a leadership position of secretary for the next two years.

See you all in Pittsburgh for Symposium on August!