Service Integration and Workforce Trends in Emergency Medical Services

Abstract

o commemorate the report credited with the development of modern emergency medical services (EMS), the Institute of Medicine of the National Academies (IOM) examined the current status and future of emergency care in America. Emergency Medical Services at the Crossroads reports the IOM’s findings and provides an informative view of our nation’s EMS or prehospital emergency care system. 1 The report is part of a trend in exploring and dissecting the American system of emergency care, identifying problem areas, and making recommendations for improvement. The IOM highlights many system-wide deficiencies that inhibit EMS from accomplishing its primary mission of responding to emergencies whenever and wherever. Based on these findings, the IOM labeled the US “ill-prepared” and referred to the current EMS situation as nothing less than a “crisis.” 1 For some time, efforts have been underway to resolve many of the EMS challenges identified in the IOM’s analysis. These include promoting integration of EMS with other health care services and addressing challenges associated with maintaining a skilled and experienced workforce. More recently, health care pioneers have invested time and energy into expanding the health care role and responsibilities of EMS personnel to include more preventive and primary care tasks. 2-6 As potential momentum for the formation of future policy and research in North Carolina, these trends deserve some attention. Integration of the EMS System