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We Must Have
         a Patient Focus

Alfred Lincks
By Chief Alfred Lincks
Chief, Vineland EMS Services

9-1-1 Emergency Medical Service operates in the background of our lives every day. Then, one day we need to make that call. We expect an answer to the phone call and an ambulance to appear before the situation gets worse. Already this may be the worst day of our lives. It’s not the time to be let down. If the ball gets dropped here, there is no forgetting about it. The stakes are too high. This happens hundreds or thousands of times every year in every town in New Jersey.

A minimum standard does not exist for every EMS system in our state. Would the tax payers of your town accept a 30 minute response time? Does that happen today where you live? The proposed regulation establishes a minimum standard. This is a starting point. This is the beginning to assure the populace, they won’t get let down.

By having a standard, there is a bar to identify and improve upon problems or potential problems. The NJ EMS Council Ad Hoc Committee has developed a document that starts the standards and allows for growth and development into the future.

The formula to provide the best EMS system varies from locality to locality. In many areas municipal jurisdictions share volunteer, paid or contracted services. Some have plans that differ according to needs by fractions of a week. The proposed regulations allow for this flexibility in local system development and no one model is demanded. Community leaders can look within to find the most responsible way to provide the service. Possibilities include a separate part of municipal government that does EMS, a 501c3 corporation like many volunteer services, a hospital based system, a fire based system, a group of local jurisdictions or a police based model.

EMT staff loading a patient into an ambulance

A good municipal based EMS system is already handling the demands of the proposed regulation. Many are recovering revenue to offset the local tax burden while doing so. Certainly as New Jersey improves upon its system, the workload for these providers will increase. Data collection demands, quality improvement initiatives, and continuing medical advances will increase the burdens on these organizations. When the system is patient centric, the drive is already in this direction. State oversight and sharing of resources including guidance by physician representatives, will pave the way for advances to help each system’s patients. You are not likely to hear a good EMS system cry the bar is too high.

Look around New Jersey and it’s apparent that municipalities’ fund, to some degree, support, or contract a service to provide EMS. Municipalities have individually and in groups assumed the responsibility to provide EMS. While the mandate is a necessity to assure accountability, most municipalities have already accepted this responsibility.

One common test all EMS systems face is response time. The EMS leader in your community should have an understanding of the industry standards using fractile response times. That is, get an ambulance where it needs to be as quick as it needs to get there more than 90 percent of the time. Data reports that leave out calls unanswered by the system or simply average response times that produce a number are deceiving.
On the local level we should already be providing most of the demands of the draft legislation. The product that left the NJ EMS Council Ad Hoc Committee was a template for a state guided step toward a minimum standard and continued minimum standard development.

We need to keep the patient first in our EMS models. Fiscal prudency is inherent in every government decision today. We need to remember that we are making decisions that can affect the life of any or all the individuals for whom we work. The proposed legislation means more work for existing EMS systems; but it is making the road easier to follow by placing the tools ahead of us to advance in the quality of emergency medical service.


Alfred Lincks is Chief of Vineland EMS Services since 1992 and also served as a member of the NJ EMS Council Ad Hoc Committee. He has taught EMS students since 1983 and is Treasurer of the Medical Transportation Association of New Jersey.


This article was originally published in New Jersey Municipalities magazine. Vol. 86, No. 5, May 2009


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