Last week at the NYS Vital Signs Conference, I had the pleasure of speaking with Dr. Jason Gluck, of Simulated Interactive Advanced Medical Education Center (SIAMEC), who along with his partners have recently launched

a state-of-the-art mobile education center housing two fully stocked simulation labs and a central control center.  The simulation lab provides a controlled, safe and reproducible environment for scenario based, advanced education on adult and infant computerized patient simulators.

Mobile Lab:
Due to its mobile design, SIAMEC offers the opportunity to practice and learn in a university level lab at any location.


Debriefing Screen:

Control Monitor

This mobile lab that they will bring to your area will challenge your skills and foster teamwork among your providers.

Today I spoke with Saratoga County EMS Coordinator, Mike McEvoy, to get his insight into some common issues in the pre-hospital care field. McEvoy has been involved in EMS since his college days in New York City, with teaching experience since 1980 and was appointed as Saratoga County EMS Coordinator in 1991.

What was the biggest adjustment made over the last 15 years?
The biggest change was how the county has evolved from all volunteer providers to having paid providers at nearly all our volunteer agencies. It’s not always well known or appreciated. Other changes were in automating county systems – mutual aid that is done from dispatch, protocols for helicopters and other technology in the county systems.

What are still some of the obstacles in you face?
With respect to paid & volunteer agencies, weaknesses of volunteer administrations become apparent when full-time paid providers are introduced. The time necessary to effectively manage also applies to paid organizations too. Management and leadership training are important. Having the time and resources to bring these skills into organizations is a significant challenge. We are also challenged to pay competitive wages and benefits to our providers as well as to recruit both volunteers and paid staff.

Do you think there is a good “tolerance of failure” in trying new approaches in EMS?
EMS is constantly stretched to the max – it’s a challenge to stay on top of things day to day and try new things. The fire side has more time during the workday to develop solutions to problems. What has been remarkable about EMS services and providers in Saratoga County is their ability to innovate. We have always had a cadre of progressive educators and providers who collectively have kept the level of care in Saratoga County at the leading edge of EMS.

What has been the best thing that’s changed over the years?
In our county, the ability to work together has improved. It is very collegial and cooperative. It speaks highly of the providers and agencies in our county.
What can agencies (EMS & Fire) do to become more effective?
There is a lot of duplication. Consolidation of administrations between agencies. The next ten years I think you’ll see more of this. There needs to be ways agencies can share operational functions. Naturally, Chiefs have apprehensions about sharing their roles with others. Ultimately, greater effectiveness will likely be had from eliminating duplication, allowing EMS staff to focus more energy and time on improvements at the agency level such as quality initiatives and community programs.

Do you think that in ten years we will have more Regional, or at least county wide Emergency Services?
Yes, the State’s goal is to make things more Regional. I believe that it will be more cost effective. For some agencies in EMS it may be the only viable option. While I’m fairly certain that Saratoga County has no interest in operating a county EMS service, I do believe that we will soon see some local consolidation of services and eventually, those may expand.

What advice would you give to someone who is considering advancing to a senior officer (Chief, Asst Chief) or Board member in an agency?
Education. Fiscal & personnel management training. You need a solid background in people and business management.

Would you have different advice for a career versus volunteer officer/Board member?
No. The responsibilities of someone who is paid or volunteer are no different, in my mind. I hear arguments for these differences across the State between people who are paid versus volunteer. Volunteers must provide the same standard of care and meet the same educational & training requirements. It is a difficult situation that volunteer agencies face. We can’t operate EMS in Saratoga County without paid staff. Volunteers are equally critical for maintaining “surge capacity” incidents where large numbers of personnel and resources are required, such as large MVA/MVC, or mass casualty incident. Volunteer Boards are also an asset that bring in expertise from other fields such as legal & accounting to an organization. From my perspective, I don’t see a difference between the responsibilities of a volunteer versus a paid provider, officer, or board member.
What is the top Officers (Chief/Operations Manager/Director of Operations) primary role?
To meet the needs of the providers who work for them. Money, policies & procedures, or other – it’s their mission to provide whatever the person in the bus needs to do their job.

What do you think is the best way to turn around an agency?
Time. Nothing happens overnight. Change in culture (can take 4-5 years) needs to happen; people need to see benefits. Having a political structure to get buy-in is key as well.

What are your greatest concerns as a county coordinator?
What worries me the most are mistakes made in practicing EMS and “gaps in the system”. Examples are organizations that don’t have policies in place for events that rapidly scale, technical failures such as might occur in the 911 system or cellular technology, and of course, those “gaps” we’re not aware of. Any of these can cause something bad to occur and these are difficult when they becomes public.

What do you predict technology to do for EMS/Fire or Pre-Hospital care that we don’t anticipate now?
In the next decade there will be a huge change in technology – especially in communication. Things that we can’t conceive of now; I would expect video in ambulances and lots of other digital communication technology. Enhanced remote communications with Physicians and assessing patients with technology that can tell us more what is going or not happening medically.

Mike McEvoy, Ph.D., RN, CCRN, REMT-P, is the EMS coordinator for Saratoga County and the EMS Director on the Board of the New York State Association of Fire Chiefs. A former forensic psychologist, he now works in the Cardiac Surgical ICU at Albany Medical Center and teaches Critical Care Medicine at Albany Medical College in NY. He is a paramedic for Clifton Park-Halfmoon Ambulance Corps and Chief Medical advisor for West Crescent Fire Department. He presently serves as a member of the New York State EMS Council and the State Emergency Medical Advisory Council. Mike also is an avid hiker and winter mountain climber.

« go back