EMS Agenda for the Future

The EMS Agenda for the Future establishes a vision for the future of emergency medical services (EMS) in the United States. The document discusses 14 attributes, and notes that further work on their development is vital to the future of EMS. The Agenda proposes goals for the future, describing them as "where we want to be." It also provides 90 suggestions for "how to get there." The EMS Agenda for the Future further defines how to get where we want to be, by providing meaningful objectives, or steps, for reaching the desired goals. The Implementation Guide is intended to serve as a companion document to the EMS Agenda for the Future. The two are to be used in concert.

Each of the Implementation Guide's set of objectives contains several components that facilitate appropriate reference to the Agenda, convey a course of action, help define partnerships, and illustrate part of its meaning.

The components are:

  • EMS Agenda for the Future sections-The Agenda sections indicate for which of the 14 EMS attributes are relevant. In most cases, objectives serve the established goals for more than one attribute.

  • Activity focus---The activities required to meet each set of objectives are described as national, state or local action. In many cases the focus may be at two or even three levels. Although activity may be focused at a particular level, activity at another level(s) is certainly not precluded.

  • Summary statement-The overall intent of the objectives is described, and correlates with the "How to Get There" statements in the Agenda. However, the summaries differ from the Agenda because they often represent more than one goal, correspond to more than one EMS attribute, and reflect further refinement of important concepts.

  • Short-term objective---Short-term objectives describe activities to be completed within one to three years. The activity may already be ongoing or even completed in some locations, but still requires initiation in most others.

  • Intermediate-term objective---Activities to be completed in approximately two to five years are described as intermediate objectives.

  • Long-term objective---Activities believed to require more than three years to initiate and complete are described as long term objectives. The terms short, intermediate and long term are meant to provide guidance and a broad time frame to prompt action. They are not meant to be overly restrictive. For example, work toward an intermediate objective might commence prior to meeting the corresponding short-term objective. However, initiation of short-term activity will generally precede the intermediate activity, as is also the case for intermediate and long-term objectives. More constraining or exact time frames are avoided in recognition of the diversity of EMS systems and the communities they serve. The ability to muster resources and commence work toward meeting individual objectives will vary across the nation.

  • Potential lead participants---Agencies, organizations and groups of individuals are suggested for assuming lead roles in developing the partnerships and conducting the activities necessary to meet the stated objectives. The participants are listed alphabetically.

  • Potential contributing participants-Agencies, organizations and groups of individuals are suggested for joining the partnerships and activities necessary to meet the objectives. They are listed alphabetically. The lists of potential participants are not meant to be exclusive. For example, an organization that is indicated as a potential contributing participant might find itself with the interest and resources to take the lead on a particular issue. This is encouraged. Similarly, an agency may have an interest in an area for which it was not suggested as a participant. The variety of potential participants is extraordinary; it must be if EMS is to realize its potential. Undoubtedly, there are possibilities for partnerships that are not described here. However, that does not mean they should not be pursued with interest and vigor. The lists of potential participants are calls to action intended to promote thought, discussion, involvement and the exploration of possibilities.

  • Vignette-The vignettes that accompany most of the objectives are meant to be illustrative and thought provoking. By themselves, they are not intended to advocate particular action or terminology.

Implementation Guide objectives correspond to three broad themes: developing partnerships, creating tools and resources, and building infrastructure. Developing partnerships will result in new and enhanced relationships among organizations, agencies and individuals. Partnerships can create synergy to effect change, which is necessary to better integrate EMS with other health services, improve its ability to affect community health, and ensure that its critical role in the health care system is fulfilled.

Creation of tools and resources facilitates the initiation of additional action on a widespread basis. Resources can be used to improve information, financial, legislative, educational and other aspects of EMS.

EMS infrastructure includes many aspects of the system, such as the workforce, communication systems. It provides the capacity to produce desired community-wide outcomes. Therefore, building infrastructure is crucial to the future of EMS if it is to realize its potential in the care of America's communities.

"Priority objectives" include objectives from each of the three themes. They are objectives that deserve the earliest attention because they best fulfill the following criteria:

  • They will significantly improve local EMS systems' abilities to serve their communities.

  • They address an important and pressing problem or need for which early action is desirable.

  • They lead to direct and positive influences on patient outcomes or community health, thus enhancing the effects of EMS;

  • They affect the greatest number of people, including EMS personnel and community members.

  • They are achievable with the resources currently available.

The EMS Agenda for the Future: Implementation Guide is a tool for EMS providers, administrators and medical directors; health care providers, administrators and payers; public health and safety officials; local, state and federal governmental officials; organization and community leaders; and any other entity or person with a potential interest or influence on the structure or function of the nation's system for providing emergency medical care. Every one is urged to review the objectives proposed here, and identify those for which they might play a role. Organizations, agencies and individuals should study the "priority" objectives to determine how they can help to achieve them. The index of potential participants and their corresponding objectives (Appendix B) may be useful for identifying other objectives on which particular groups might focus. Organizations, agencies and interested individuals should determine those objectives for which they are suited and prepared to begin work. They should then initiate or join the partnerships that will lead to the exploration and achievement of a vision for the future of EMS in America.