I hold licensure in three states as well as my NREMT-P certification. This is partially because I work in both Illinois and Wisconsin but also because I used to work in Iowa and maintain my license as an Iowa EMT-Paramedic Specialist. I keep that license too.†Since Iowaís a National Registry state, itís a simple matter of forwarding them my National recert paperwork to keep it up. Also, because Iím umÖ ďRather OpinionatedĒ and one never knows when Iíll get ran out of a state with pitchforks and torches from the townsfolk, I need a backup plan.
Oh, and I like being called a ďSpecialistĒ in something. Cool, huh? Iím Special, it says so right here on this card I carry. ďEMT-PSĒ
Today, my friend Google landed me on the web link for the new revision of the Iowa State EMS protocols (Revision Aug 2009) and I had the chance to study up on them. Thereís some interesting things in there. You can find the link below.
While they arenít as advanced as the EMS protocols that I function within in Wisconsin, there is something I found in there that I really like and want to bring to the attention of the EMS 2.0 crowd.
APPENDIX D GUIDELINES FOR NEW PROTOCOL DEVELOPMENT A RATIONAL DECISION MAKING PROCESS*
(Also can be used to evaluate existing protocols) Making a decision to develop a new protocol or evaluate an existing one should be based on a rational process. Questions that should be asked and answered when considering a new drug therapy or procedure are as follows:
Key Questions for any New Protocol
1) Is the drug therapy or procedure medically indicated and safe?
2) Is it within the scope of practice for the provider?
3) How specifically will this protocol benefit patient care?
4) What specifically is needed to implement this protocol (education/training, medical director protocol development/authorization, equipment needs, etc.)?
5) How will this protocol impact operations?
6) What is the opinion of providers concerning this protocol?
7) Does the medical community support this protocol change?
8) What are all the costs versus benefits associated with implementation and maintenance?
9) What are the medical-legal implications?
10) What ongoing provider involvement such as skills maintenance and continuous quality improvement is necessary?
11) How will success be measured?
Rational Protocol Development Process to Make the Right Protocol Decision
1) Study the issue thoroughly
2) Identify key questions
3) Compare with goals
4) Assess fit with system
5) Cost benefit analysis
6) Identify measuring tools
Stakeholders in this process are recognized to include, but not be limited to:
2) Medical direction (on-line and off-line)
3) Educators/training programs
4) Regulators of policy and rules
5) Service directors
6) Service providers
8) Third party payers
*Developed based upon discussion at the October 1998 meeting of the Quality Assurance, Standards, and Protocols subcommittee of the Iowa EMS Advisory Council; and on concepts from the article ĄWhen to Implement Clinical Protocol Change?í From EMS Best Practices September 1998.
My understanding of the Iowa State EMS system is that they have mandatory state EMS protocols that all providers must adhere to. Each service may have a medical director, who may choose to use the state protocols†at their base level, or may choose to add additional protocols†for more advanced treatment.†
HuhÖ A state that says ďThis is the minimum standard weíll hold you to. Now go make them better and report†back to usĒ Then actually†gives each individual paramedic and EMT the†logical framework to evaluate ideas and make revisions and†improvement?†
Also, and this is just HUGE. A state that posts the name and phone number of the State Director of EMS on the protocolsÖ Know what? He actually answers his phone. I know, Iíve called him.
Bravo State of Iowa EMS. Bravo a lot.