It is easy to snark when talking about a place that appears to be a legacy of fire-mangled ems. No surprise at the blog reactions when Doctor Jim Augustine announced his resignation as the Medical Director and Assistant Fire Chief for the District of Columbia Fire and EMS Department (DCFEMS).
Ambulance Driver says "Don't get sick in the District of Columbia" (HERE)
To Old To Work, To Young To Retire speculates on the etiology of the illness that lead to Doctor Augustine resigning after 17 months as the departmental medical director. (HERE)
Part of my university tasks in 2009 was to assist DCFEMS develop and deliver an accredited paramedic program. There have been challenges and frustrations.
WELCOME TO THE FEDERAL PLANTATION
The District of Columbia government provides both state and city functions. Every regulation, ordinance and even the results of local elections require approval by the U. S. Congress before they become laws, ordinances or administrative regulation.
The House Committee on Oversight and Government Reform, through the Federal Workforce, Postal Service, and the District of Columbia subcommittee, is authorized to accept or reject city legislation.
The 600,000 city residents do not have a full voting member in Congress, but any action to be taken by DC is overseen by a congressional committee. This link takes you to 10 myths about Washington DC. Click on the DCVote logo to get more information.
THE ROSENBAUM INCIDENT
Retired NY Times writer David E. Rosenbaum was mugged, found on a sidewalk and died from a head injury. A March 09, 2007 Washington Post article by David Nakamura sums up the situation:
The family of a slain New York Times journalist yesterday agreed to forgo the potential of millions of dollars in damages in exchange for something that might be harder for the D.C. government to deliver: an overhaul of the emergency medical response system that bungled his care at nearly every step.
David E. Rosenbaum's family said it will give up a $20 million lawsuit against the city — but only if changes are made within one year. Under a novel legal settlement, the city agreed to set up a task force to improve the troubled emergency response system and look at issues such as training.
WUSA9 reporter Dave Statter has extensive information about the incident, investigation, EMS Task Force, changes in DCFEMS operations/training/personnel, etc. The latest item is HERE.
RECOMMENDATIONS IMPACTING EMS EDUCATION
The Task Force on Emergency Medical Services released its report and recommendations on September 27, 2007 (HERE). Our work was within Recommendations 3 and 6:
Recommendation 3
Improve the level of compassionate, professional, clinically competent patient care through enhanced training and education, performance evaluation, quality assurance, and employee qualifications and discipline.
Recommendation 6
Strengthen Department of Health (DOH) oversight of emergency medical services.
NEW EMS EDUCATOR CREDENTIALS
The DC Department of Health (DOH) adopted the National Registry of EMT certification testing process. EMS educators were required to reapply, meet the new regulations and be monitored by a DOH official.
There are ten entities credentialed to deliver ems certification training in the District and one huge customer, the DC Fire and Rescue Department.
The university runs an on-campus EMT-Basic course with 160 students a year.
In the first draft, only paramedics employed by DCFEMS could teach. The second draft was better, but required educators to be affiliated with a DC-based ems provider. Most of our clinical instructors work as Maryland or Virginia caregivers.
One work around was to have our instructors join the student-staffed on campus ambulance. Think Mother, Jugs and Speed. That may have scared them, as the third revision worked for all.
Administrative regulations can only go into effect after the congressional review period expires. For these standards it was the last week of June. We needed to have all instructors monitored before the start of the August EMT basic course.
July was hectic. The thinly staffed EMS section of DOH was also working the H1N1 response. They were staffing a 24 hour "pandemic" desk.
… and then the city laid off the state EMS training director and a dozen other DOH employees.
Mike "FossilMedic" Ward
Nation's Capital EMS provides one perspective of an ongoing effort by many to improve the delivery of EMS services in the Nation's Capital.
edited to add: "Singing Pigs" title based on blog item title in Kelly Grayson's Ambulance Driver "Don't get sick in the District of Columbia" (HERE)
Also on FireGeezer…
- Calling them FEMS will not improve out-of-hospital emergency medical care – March 31, 2011
- DCFD lives … maybe! Fire and Emergency Services Logo Clarification Act of 2011 – April 5, 2011
- Mendelson: I support the Chief in moving away from the “DCFD” designation. Dennis Rubin did damage to the efforts to assert the EMS mission and a small part of that was re-asserting the DCFD designation. – April 3, 2011
- The Circle of Certification – August 19, 2011
