EMS World Expo 2018

For 50 years “emergency” medical service agencies have primarily sought emergency medicine physicians for clinical oversight for the providers of “emergency” care. However, most data analysis reveal that very few of the patients we treat are suffering a true medical emergency.  And, as EMS evolves to providing expanded roles in the community geared toward prevention and patient navigation, is the exclusive use of emergency medicine physician oversight the correct model? Is there a more appropriate model? Should there be a balance between emergency medicine oversight and general practitioner oversight? This lively, and likely at times controversial presentation will attempt to address some of these concepts.

In North America, delegated practice “medical direction” models are often used as a proxy for clinical quality and safety in paramedic services. Other developed countries favor a combination of professional regulatory boards and clinical governance frameworks that feature paramedics taking lead clinician roles. The purpose of this lecture is to bring together the evidence for medical direction and clinical governance in paramedic services through the prism of paramedic self-regulation.

We will critically examine the long-established North American Emergency Medical Services medical direction model and makes some comparisons with the other clinical governance approaches that are used to monitor and manage the quality and safety in several other Anglo-American paramedic services.