Guideline 1-450 - EMS Leadership

CMH EMS & MIH Protocols

Scope:

Guideline:

CMH PHS leaders shall be utilized to improve safety, quality of care, and efficiency while deploying ambulances and managing emergency medical resources.

Purpose:

The purpose of this guideline is to provide support to leaders and staff to formally communicate resources and processes for EMS leadership.

Procedure:

1. CMH EMS Chain of Command:
1. Medical Director
2. Pre-Hospital Director
3. Clinical Chief
4. Managers
5. Supervisors
6. Crew Leaders
7. Community Paramedics (ALS FTOs have seniority)
8. Paramedics (ALS FTOs have seniority)
9. Registered Nurses (ALS FTOs have seniority)
10. Advanced EMTs (FTOs have seniority)
11. EMTs (FTOs have seniority)
12. Drivers
13. New hires
14. Students and all other riders
2. Crew Leader recommended duties:
1. The Crew Leader position is intended to serve as field supervisor to coordinate ambulance operations and support emergency and non-emergency responses in all four counties.
2. Be involved and dedicated to improving the service you work for and your profession.
3. Have an in-depth knowledge of all EMS policies, guidelines, and protocols.
4. Maintain situational awareness via all communication tools available (radio, Slack, vehicle tracking, etc.). Refer to Links Page for a list of online resources.
5. Make decisions at the lowest possible level. Be Empowered and "Just-Fix-It."
6. Demonstrate good clinical and professional behaviors. Enforce those behaviors when deviations witnessed. Escalate as needed to include appropriate management staff.
7. Complete Just Culture training and utilize Just Culture decision-making.
8. Ensure ESO documentation reviews are caught up. Refer to Guideline 1-450-33 - Documentation Reviewer Reference Sheet.
9. Touch base with EMS leadership, if available and appropriate at the beginning of shift.
10. Contact the appropriate dispatch centers when available.
11. Be the point of contact for dispatch to coordinate transfers and make transfer decisions.
12. Crew Leaders are expected to float between all counties, as appropriate, and are not in any dispatch call rotation.
13. It is up to Crew Leaders to pick up calls when status zero or other issues when an additional response is needed. Refer to Guideline 1-200 - Ambulance Dispatch for a list of call types where an EMS Supervisor and/or an additional ALS ambulance might be needed.
14. Support staff, as available, with Echo-level, multiple patients, RSI situations, and other situations you feel you are needed.
15. Facilitate implementation of hold-over guideline for all crews, including yourself, as needed.
16. Daily activities:
1. Walk station and grounds. Fix or report any issues.
2. Follow up on daily cleaning chores to make sure being done.
3. Conduct staff huddles and report any issues or concerns to supervisor or manager.
4. Check and correct mileage on Orbcomm when ambulance comes back from Fleet.
5. Monitor ESO for ensure trip tickes are being completed timely.
6. Monitor ambulance locations.
7. Monitor radio traffic and Slack for ambulance status levels in all counties.
17. Weekly activities:
1. Complete ambulance mileage report on F: drive.
2. Check oxygen quantities on hand.
3. Obtain and forward missed call report from dispatch center.
4. Check biohazard box and call for pickup when needed.
5. Monitor restock supplies.
6. Collect and forward receipts and invoices to manager.
7. Check narcotic boxes and log sheets.
8. Check RSI kits.
9. Ensure daily run logs are completed.
3. Supervisor recommended duties (in addition to Crew Leader above):
1. Ensure ESO clinical reviews are caught up. Refer to Guideline 1-800-33 - Clinical Reviewer Reference Sheet. Refer to Guideline 1-800 - Quality Improvement to determine which charts need reviewed.

CMH Pre-Hospital Services Mission: "Provide safe, exceptional, and compassionate care to our communities with an emphasis on highly trained and empowered staff."

CMH Mobile Integrated Healthcare Mission: "Provide exceptional, compassionate, and patient-centered care by a mobile collaborative team to improve patient experience, improve quality outcomes, and reduce healthcare costs."

Polk, Hickory, Cedar, & St Clair County EMS Protocols is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.