Feedback Form for the Draft National Framework Document

The project team thanks those that have provided input through the public survey and the meetings in California, New York, and Washington, D.C. We also appreciate your continued participation and input on the recommendations for National Framework Document for Promoting Innovation in EMS. Please scroll down as you fill out the form and when you are finished, please click on the blue "DONE" button at the bottom.

* 1. Please enter your information

* 2.
EMS education programs should strive to support EMS instructor development through rigorous hiring, quality improvement, supporting credentialing, formal education, experience, and mentorship.
 
Rationale:
Traditionally EMS Educational Institutions ( defined as any EMS training program, and could include school, countywide ems system, or company ) and organizations develop their own educators from within. In most cases EMS educators have no formal education in adult education.  There are a few educational workshops that train EMS Providers some basic principles over a few days and allow them to be EMS educators. Currently there are few to no, formal internships or fellowships in EMS Education. Agencies and educational institutions should also require degrees for instructors and there should be a targeted effort to increase the pool of instructors that have advanced education degrees. 
The goal is to advance the quality and level of EMS educators and leadership which will provide the foundation to be able to innovate. The terms ‘advanced’ and 'degree' means that agencies would possibly require: Master’s, Bachelors, or Allied Health of any degree level. Instructor, Faculty and Program Director positions in EMS Educational Programs are extremely hard to fill and in addition to changing that, this recommendation would address pay inadequacies, and promote higher reimbursement for field providers. The development of a Professional EMS Educator is essential for the future of EMS Education.

  Strongly Disagree Disagree Neutral Agree Strongly Agree
Do you agree with this recommendation?

* 3.
EMS agencies, providers, and educational facilities should explore funding opportunities for research and program development to encourage EMS providers, specifically Paramedics, to obtain academic degrees.
 
Rationale:
Unlike other healthcare organizations, EMS agencies are often not positioned to offer independent incentive programs to encourage their employees to pursue higher education. To replicate the career ladders and practice opportunities available to other healthcare providers, more emphasis needs to be placed on making higher education more accessible for EMS providers. 2 States have already done this successfully.  It is crucial to learn critical thinking and communication skills, and no specific degree area should be required. Innovative incentives both within and outside of traditional EMS systems need to be explored and developed to encourage more providers to pursue a college degree. Such incentives may, or may not, be financial. This might lead to more independent practice for EMS providers, for example: Advanced Practice Paramedic. Development of ‘bridge programs’ are a good way for EMS providers to pursue education as well.

  Strongly Disagree Disagree Neutral Agree Strongly Agree
Do you agree with this recommendation?

* 4.
By the year 2025 EMS agencies, leadership, management and educators should support, incentivize, and establish the requirement of a degree for paramedics.
 
Rationale:
The minimum will be an Associate’s Degree for Paramedics, and higher for leadership, by 10 years. This recommendation is directed at EMPLOYERS, NOT government. Legitimate concerns exist that employers wouldn't pay providers more if they got higher degrees; however, EMS will not be recognized as healthcare professionals in future if we do not move towards higher requirements for education. As in #1, to encourage higher level for those in leadership roles. The US now has a plethora of paramedic programs either rooted in a college or university, or in programs articulated with a college or university. Current research (Phelps, 2015) reveals that some colleges are providing enough credits or hours to actually confer at least an associate’s degree, but the colleges aren’t providing the degree option to the student. A baseline of education for paramedics would open up new opportunities for research and academic careers following further postgraduate education. It would also provide for paramedics to lead the research affecting the paramedic profession and the patients that paramedics treat.

  Strongly Disagree  Disagree Neutral Agree Strongly Agree
Do you agree with this recommendation?

* 5.
EMS Education should use evidence-based practice to teach evidence-based medicine.
 
Rationale:
EMS Education traditionally has used anecdotal or best practice as a model to share educational theories, which should change. This applies from policy-making to classroom practice—where the methods used are based on significant and reliable evidence derived from experiments. This method shares with evidence-based medicine the aim to apply the best available evidence from the scientific method to educational decision making. This should be required by all publishers having EMS Educator text and a part of all EMS Educator Courses.  Additionally, rather than number of hours, education level should reflect competencies required for each service level and educators should use literature to find best way to teach Paramedics: problem based learning, virtual reality, etc

  Strongly Disagree Disagree Neutral Agree Strongly Agree
Do you agree with this recommendation?

* 6.
A federal funding stream should be made available to develop multiple (IT, data management, chronic disease, collaborative programs, etc.) national educational standards to better prepare and integrate EMS, pre-hospital, out-of-hospital, and paramedicine care into the rest of the healthcare system.

Rationale:
Our current curricula are too narrowly focused on life-threatening emergencies and do not match the distribution of medical complaints and other issues that we encounter where a lot of innovation could occur. EMS education and scope of practice is currently focused exclusively on emergency response and transport. This would not be replacement curricula; rather, they would build on what exists. Funding would develop a curriculum that includes IT-based and information management for EMS curriculum. The issue is that there needs to be a development of national curricula that better addresses EMS and it's integration in the healthcare system and the purpose of this recommendation is to address desire for team-based education which would facilitate this. The Health Resources and Services Administration should fund IT-based education programs, for example as in Duluth, and how it did for nursing (ie. Informatics in nursing)


  Strongly Disagree Disagree Neutral Agree Strongly Agree
Do you agree with this recommendation?

* 7.
Hospitals, primary care offices, and other healthcare facilities should collaborate with EMS and other community based health care providers to provide initial and ongoing education (CME) with a focus on community based population health.  Initial and ongoing training for prehospital providers should include opportunities for integrated, team-based experiences with other disciplines in the patient care continuum.
 
Rationale:
Continuity of patient care is enhanced by all providers at every level having a knowledge of what types and levels of care other providers bring to a patient at every step of the process. Integrated, team-based experiences make it possible for providers at all levels to interact, explain procedures, gain knowledge of how each other works, what each other’s capabilities are, and how providers at each step in the process can better prepare the patient for receiving the best possible outcome at the next care step. Additionally, team-based experiences with providers of higher-level care can help a provider seeking to find their most promising career path.

This education should focus on interdisciplinary team development including effective therapeutic communication, optimal utilization of community based resources and the development of clinical assessment skills through clinical observation experiences in the facilities and in the community. With a focus on community population health, the education will focus on developing a common language to enhance communication and promote data sharing.  Data sharing is a vital component of continuity of care and thus progressive EMS agencies must develop contracts or memorandum of understanding that delineate roles and authorize data exchange. These have been successful where they have been implemented. This contractual relationship removes barriers related to privacy and the share of patient care demographics and information.  Bidirectional exchange between EMS, hospital stakeholders, and beyond hospitals in clinics and more, encourages hospital participation in EMS primary training and education. Local or state governments should facilitate combination of incentives and requirements. Requiring vs. incentivizing in order to push stakeholders to share data.


  Strongly Disagree Disagree Neutral Agree Strongly Agree
Do you agree with this recommendation?

* 8.
American Board of Emergency Medicine (ABEM) should include exposure to, and training in, population health and non-emergent patient care initiatives in the core content and fellowship experience for EMS physicians.

Rationale:
If EMS medical directors are to help drive innovation involving EMS playing a role in population health, they need to receive the education required to fulfill that role.  Likewise, if they are to provide medical oversight for providers in that role, they will need certain additional knowledge and experience to do it well. Additionally, maintenance of certification should include exposure to and training in population health and non-emergent patient care initiatives. Questions regarding this should be included on board certification exams in the future. A physician going through education and training to be in EMS that has these skills as required will foster innovation.

  Strongly Disagree Disagree Neutral Agree Strongly Agree
Do you agree with this recommendation?

* 9.
Expand training to harness potential of EMS data and informatics.
 
Rationale:

-Goal is to address awareness of data quality

-From data and informatics barrier discussions

-Not very much exists on specialized education/how much is needed for particular types of innovation

  Strongly Disagree Disagree Neutral Agree Strongly Agree
Do you agree with this recommendation?

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