EMS System Review - State of New Jersey

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State of New Jersey, DHSS, OEMSConsulting Services: EMS System Review• If I’m dying, save me quickly!• If not, can you make sure everything is OK or take care of it here?• If not, can you take me to the right place?• Please don’t financially devastate me! 33The New Jersey EMS system appears to do well with the first need and is somewhateffective with the third need. It does not address the other needs. This is where New Jersey mustseriously consider identifying strategic initiatives and seeing them through.Recommendation 1: NJOEMS and the NJ EMS Council should study and identifyalternative access and treatment pathways for EMS providers to follow. This includes, but isnot limited to, treat and release and transportation to alternative treatment facilities.EMS Research – This was one of two areas that the focus groups rated unsatisfactory.The focus groups discussed 21 possible recommendations with the top five being:1. OEMS Research Center – OEMS should serve as a clearinghouse for EMS research2. State standard EMS data collection system – see information systems3. Identify funding resources – this includes public, university, and private sources4. Evidence-based practice and protocol – ALS and BLS protocols should be researchbased.5. Regulations should facilitate EMS Research – Laws and regulations should promoteinstead of restrict EMS research. NJOEMS, the EMS Council, and the legislatureshould view this as a high priorityResearch is a major challenge for New Jersey EMS, perhaps even more than other EMSsystems. There are legal and regulatory restrictions on EMS research that make prospective,controlled studies nearly impossible. One EMS Medical Director identified an example of thesefrustrations. To perform a retrospective research study, approval is required from threeinstitutional review boards: the EMS project hospital board, NJOEMS, and the New JerseyDepartment of Health. Prospective research is nearly impossible as a representative of theAttorney General’s office has ruled that under the current laws, informed consent in prehospitalcare is impossible.33 Ryan, J. (2006). Personal Communications.TriData, a Division of 50September 2007System Planning Corporation
State of New Jersey, DHSS, OEMSConsulting Services: EMS System ReviewRecommendation 2: The NJOEMS should become a clearinghouse for EMS Research.They should work in conjunction with state medical schools emergency medicine residencyprograms and EMS management educational programs to facilitate prehospital research.Recommendation 3: The NJOEMS and the MICU Advisory Committee should workwith the NJ Attorney General’s office to make legal and administrative changes that willfacilitate EMS research.Legislation and Regulation – This component produced some of the liveliestdiscussions of the focus groups. While passions ran high, there was a great deal of consensus.Twenty-two specific ideas were identified by the groups. The top five ideas included:1. Require local government to provide EMS – This topic appears in multiplecomponents and is one of the most seriously discussed by the focus groups. Localmunicipalities have no legal obligation to provide EMS as they do law enforcementand fire suppression. While it would be a political disaster for a municipality tototally ignore its moral obligation to provide EMS, not having a legal obligationinvites benign neglect. Until the need to act becomes a duty to act, the subjectbecomes a lower priority. Fortunately, there are several possible alternatives toproviding EMS including, career municipal (fire, police, or separate service),volunteer first aid squads, commercial services, hospital-based, or a combination ofchoices.Recommendation 4: Legislation should be passed that requires local municipalities toprovide EMS (or cause to be provided). This obligation should be similar to the obligation toprovide law enforcement and fire services.2. Pass enabling legislation – That allows the executive branch more discretion toadminister and oversee the EMS system.3. Level playing field with one standard – EMS services should have one standardregardless of whether they are volunteer, career municipal, hospital-based, orcommercial.4. Take medical protocols out of regulations – Protocols should be in a separatedocument produced by NOEMS. They should be taken out of current regulations.5. All EMS providers should be regulated – All providers, regardless of operatingplatform, should be regulated by OEMS. This topic was agreed upon by all groupsexcept for the NJSFAC. They continue to oppose any regulation that involves crewsizeminimums or response times. They do believe that the non-affiliated squadsshould have a choice of being regulated or members of the NJSFAC.TriData, a Division of 51September 2007System Planning Corporation
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EMS System Review - State of New Jersey

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