EMTcity EMS

[Dustdevil]

third service (obviously) but with good links to 'health'

no for good financial reasons

build a sustainable business

But wait... is this going to be a third service or a business?

Can't really have it both ways.

[zippyRN]

But wait... is this going to be a third service or a business?

Can't really have it both ways.

999/911 is direct tax/ subscription funded so 'third' service ...

the rest of it is a business with the contracts negotiated with 'health'

you njeed to build a sustainable business around the emergency service

[Dustdevil]

you njeed to build a sustainable business around the emergency service

Why? The fire department doesn't. The police department doesn't. The library doesn't. The parks department doesn't. The streets and traffic department doesn't. How many city or county departments depend upon turning a profit to operate?

In the U.S., every single "Public Utility Model" EMS system that set up to monopolise transfers in order to offset EMS expenses has FAILED. It's time we let this silly notion go.

[zippyRN]

Why? The fire department doesn't. The police department doesn't. The library doesn't. The parks department doesn't. The streets and traffic department doesn't. How many city or county departments depend upon turning a profit to operate?

all need to balance their books ...

here in right pondia the police authority and fire authority will be expected to balance their books ... other local authorirty services are expected to generate a 'profit' whether that is a 'surplus added to reserves' or via the famous 'efficiency savings' ruse ...

many of the attempts to decouple none emergnecy and emergency ambulance services i nthe Uk have failed dismally as the private none emergency provider cannot provide the required service in a cost effective manner under competitive tendering... normally becasue they can't provide the emergency / critical care transfers required by the hospitals /PCTs at a viable cost when decoupled from the 999 work ...

In the U.S., every single "Public Utility Model" EMS system that set up to monopolise transfers in order to offset EMS expenses has FAILED. It's time we let this silly notion go.

[Dustdevil]

many of the attempts to decouple none emergnecy and emergency ambulance services i nthe Uk have failed dismally as the private none emergency provider cannot provide the required service in a cost effective manner under competitive tendering...

Ah.. I see where you're coming from now. This is not a problem in the U.S. though, where the government is not the single payer source for healthcare funding, and the going rate is paid here by the insurance companies, as well as the government funded Medicare. Trust me, the transfer system will not collapse in the U.S. for a lack of cost efficiency. The ability to man transfer trucks with minimum wage EMTs will assure that non-emergency transport is always cost efficient.

Many of them also provide very good critical care transport too, but this could well be handled by our 911 system too, not as a moneymaking tool, but simply as a means to assure quality service to critical patients.

[GBFDEMS174]

I think it should be made up of 3 divisions one that is just ALS and one that is just BLS and one that is just there for inter-facility

The more divisions we have the more money we can possibly make and the better off we can be financially

NO VOLUNTEER DIVISIONS

[stcommodore]

The possiblity exsists that in a large urban/county wide system that a "fluid deployment" using system status managment and "hybrid" use of 911 and transport services may be the ideal system.

[Just Plain Ruff]

I think this would have ben a good contest idea.

yes it would have been a god contest, but someone might have said it was too much like work

[brentoli]

If everyone is a paramedic or paramedic to be, why run BLS response with paramedic intercept? I am not very familiar with different ways of doing response, but seems like a waste to me. IF you have all these paramedics and paramedic students, why not team them up in the unit? Less units running around Anytown!

So would this idea work in an all ALS system with out BLS response? EMTcity Ambulance starts a new paramedic class January every year limited to the amount of turnover expected with in the service over the next two years?

You take our class, pay us to get you your license by our standards, maybe team up with a technical college to provide an AAS. But we won't promise you a job?

How about having PRN EMT-B's that are available for last minute fill in assignments and or special event coverage (concerts. fairs, festivals, things suited to the EMT-B scope of knowledge)?

[AZCEP]

The possiblity exsists that in a large urban/county wide system that a "fluid deployment" using system status managment and "hybrid" use of 911 and transport services may be the ideal system.

SSM does not work. It never has, and likely never will. There is no proven way to predict which areas are going to need emergency service with any accuracy. Yet another myth to do away with.