Breakdown in EMS Procedures

Emergency Medical Services System The components of an EMS system that are necessary to provide high levels of efficiency on metrics such as clinical excellence, response time reliability, economic efficiency and customer satisfaction can be thought of in terms of resources. However, there are a variety of different forms of resources that must work in unison for excellence, reliability, and efficiency to be achieved.

For example, even with state of the art facilities and equipment on the forefront of technological development, these resources are virtually worthless without a human resource component that talented, well-trained, and sufficiently experienced to operate the physical resources contained within the system. Too build loyal community relationships an organization must look beyond a "short-term" perspective (Chapter 5, p. 75).

Communities must make long-term investments in their public health needs; especially since EMS management strategies, such as the Public Utility Model, can be difficult to successfully orchestrate and corrective actions can be both expensive and time-consuming (Stout, 1980, p. 22). The case of David Rosenbaum's strategic death that was blamed on the DC emergency medical system serves as an ideal example of just how difficult it can be to align various forms of resources in order to meet the expectations of the community in which it serves.

Many employees in this system have stated that they feel they are underpaid, that the system is underfunded, and that there is resentment present between various departments and agencies (Pekkanen, 2009, p. 60). In a more comprehensive report prepared by the Office of the Inspector General (OIG), the report indicates that the firefighters and EMTs did not follow many of the rules, policies, protocols, and procedures that were applicable to their positions and their individual sets of responsibilities in regard to their job duties (Fenty, 2007, p. 7).

Despite the claims that the system was underfunded in general, the resources that were available were not properly utilized in this event. The disintegration of the continuum of care seems to be the primary cause of the inefficiencies in this event and furthermore the disintegration is systemic and prevalent throughout the entire system. Another report cites multiple individual failures during the Rosenbaum emergency suggest alarming levels of complacency and indifference which works to undermine the effective, efficient, and high quality delivery of emergency services in the area (Willoughby, 2006).

Other antidotal evidence obtained from interviewing team members confirms these findings. "The incident with Mr. Rosenbaum came as no surprise to many of us" says paramedic Kenneth Lyons, a 23-year veteran. "We've seen incidents like this all the time, and we continue to see them because we are a dysfunctional agency" (Pekkanen, 2009, p. 60). Many of the systemic failures attributed in the Rosenbaum circumstances in the D.C. system have been overcome by better managed systems.

For example, the emergency medical services (EMS) team in King County serves nearly two million people in the local area and states that they provide lifesaving services on average of every three minutes (Public Health - Seattle & King County, 2015). This system is perceived as efficient and effective by the residents of King County and serves as a model system for other EMS systems nationwide. In fact, the system has meet all.