Visioning & Planning

Resource: Rural Ambulance Service Assessment Project

Organization: Minnesota Emergency Medical Services Regulatory Board

Description: On-site assessment of ambulance operations by EMSRB staff, Regional Program Director, and subject matter experts. Areas of focus include management and operations, financial practices, recruitment and retention, medical direction, staff development and training, and community support. A final written report is presented to the ambulance service governing board along with community leaders to facilitate strategic planning.

Resource: Attributes of a Successful Rural Ambulance Service

Organization: Wisconsin Office of Rural Health

Description: In the summer of 2015, the Wisconsin Office of Rural Health convened a national group of EMS leaders to create a mechanism to assess the capacity of Ambulance Services.  The goal was to create an assessment instrument that could be used on multiple levels:

  • By individual ambulance services, to identify their strengths and areas for improvement, benchmarked against other services across the state and nation;
  • By state agencies and organizations, seeking more information about the status of the EMS system, and looking to target funding to specific issues and to cohorts of like-performing services;
  • By federal agencies, seeking to identify funding needs on a state-by-state basis and measure outcomes of that funding.

With that in mind, 18 “Attributes of a Successful Rural Ambulance Service” were identified and a questionnaire developed to measure services’ adoption of each attribute.  Distributed as an electronic survey, the self-assessment lists each attribute of success, and the participant places their service within a five-point range of adoption - building from, “Say what, again?” to “We’ve adopted this attribute to the Gold Standard.”  Examples for each point on that scale are provided so there is consistency; a "3" on the scale means the same for everyone.

Resource: Template for Emergency Medical Services Informed Community Self Determination (ICSD)

Organization: National Association of State EMS Officials

Description: The ICSD process is intended for EMS response areas that are rural, relatively isolated, and do not have multiple EMS resource options. In urban and suburban communities, there are generally a number of EMS provider options available from which to choose. While it is important that those making the selection of EMS provider be well-informed about EMS standards of care and operation, they can benefit from resources such as a dedicated “public utility model” (permanently employing a governmental agency for EMS selection and oversight) or an ad hoc consultant to help with an EMS agency request for proposal and contracting process. With these aids, the responsible governmental or other entity can then choose from fire-based, private, municipal third party and other options.

Informed self-determination provides a process in which:

  • An objective evaluation of the service is completed by an outside expert or entity using a standardized evaluation tool.
  • The evaluator reports on issues which jeopardize service performance and their impact on response and the and level of care provided.
  • Options are presented within accepted national practices and state EMS law and regulations, and their implementation and cost impacts explained.
  • The community holds a meeting(s) of taxpayers and/or their representative decisionmakers, selects a level and type of service it desires, and establishes a level of funding needed to implement and sustain it.

Resource: Volunteer Ambulance Service Sustainability: A Self-Assessment Tool

Organization: North Dakota Department of Health

Description: Volunteer ambulance services across America are experiencing increasing challenges in recruiting and retaining volunteers. Many are facing critical volunteer shortages. This tool is designed to help the volunteer ambulance service self-assess their strengths, weaknesses, and long-term viability. It is also designed as a learning tool for services to understand how to maximize their appeal to a shrinking pool of potential volunteers. This tool is based on the ongoing national study of both thriving and failing volunteer ambulance services and the essential elements necessary for sustainability by SafeTech Solutions. By asking the Key Assessment Questions, ambulance services and communities can begin to understand whether or not they possess the necessary elements to be sustainable. While services may survive without all elements, the absence of any of the key elements will increase the difficulty of recruiting and retaining volunteers.

Resource: Rural Community Ambulance Agency Transformation Toolkit

Organization: National Rural Health Resource Center

Description: The primary goal of the Rural Community Ambulance Agency Transformation Readiness Assessment and associated resources is to help ambulance agency leaders in rural America assess the state of their agency’s readiness in the core competency areas outlined below. This assessment follows the Critical Access Hospital (CAH) Blueprint for Performance Excellence, adapted specifically for rural ambulance agencies, from the Baldridge Excellence Framework for Health Care. It provides resources and tools to assist rural ambulance agency leaders to succeed with moving from volume to value in their agency’s culture and operations. Leaders are encouraged to complete the assessment periodically to monitor their progress and receive updated resources to guide their journey.

ResourceReport on the Rural Minnesota EMS Sustainability Summit Meeting

Organization: Minnesota Ambulance Association

Description: Seventy Minnesota EMS leaders and stakeholders met on April 8-9, 2015, in Onamia, Minnesota, to discuss rural EMS sustainability in the state.
The idea for the meeting emerged from the Minnesota Ambulance Association. The meeting was planned by the Minnesota Ambulance Association and Greater Northwest EMS Region and funded by a grant from the Minnesota Office of Rural Health & Primary Care.
Participants in the meeting included:
• Representatives from the eight Minnesota EMS Regions;
• Leaders from a variety of rural and urban EMS agencies from across Minnesota;
• Officers of the Minnesota Ambulance Association;
• Representatives of various healthcare organizations; and
• Representatives of the Minnesota Office of Rural Health & Primary Care.
The goal of the meeting was to engage a broad segment of EMS leaders and stakeholders from across Minnesota in a discussion about rural EMS sustainability. Strategic trends, issues, challenges and directions were identified which led to a commitment to work toward progress to address the following areas of concern:
• Local EMS Leadership
• Workforce Sustainability
• Community Awareness
• Education/Certification/Recertification
• Funding
• Medical Direction

Resource: 2019 Rural Emergency Care Integration Summit Report

Organization: National Rural Health Resource Center

Description: The 2019 Rural Emergency Care Summit convened by The National Rural Health Resource Center (The Center), with support from the Health Resources and Services Administration (HRSA), Federal Office of Rural Health Policy (FORHP), was held to assist state Medicare Rural Hospital Flexibility (Flex) Programs and State Offices of Rural Health (SORH) support emergency medical services (EMS) in their states in the transition to population health and value.
The purpose of the meeting was to address the need for rural EMS agencies and providers to move into new roles in an evolving health care system. This report is designed to help rural EMS leaders and other health care providers during the transition from volume to value, providing ideas for collaboration and potential strategies to better prepare and integrate into the new value-based environment.