Q&A: Jay Fitch, PhD, on what lies ahead for EMS leaders

This year, the Pinnacle EMS Leadership Forum enters its second decade. Pinnacle, held this year from July 18-22 outside of San Antonio, brings together EMS leaders to learn from each other and share innovative ideas.

Not only does this year’s Pinnacle mark ten years since the first conference, it is also the 50th anniversary of the whitepaper, Accidental Death and Disability, that launched modern EMS; and the 20th anniversary of the landmark report, the EMS Agenda for the Future. These milestones, along with the announced revision of the Agenda, have renewed discussions about the future of the profession — discussions that will certainly be on everyone’s mind in San Antonio.

Pinnacle Program Chair Jay Fitch, founder and president of the emergency services consulting firm Fitch & Associates, spoke with EMS1 about Pinnacle 2016 and the issues facing EMS leaders today and in the future.

EMS1: If someone’s never been to Pinnacle before, what can they expect?

Jay Fitch: Pinnacle brings together leaders who understand that EMS provides health care and has a responsibility to our patients and communities. We sit at the crossroads between public safety and health care, and our systems are often organized around a paramilitary model. Having Lt. Gen. Mark Hertling, someone who understands the military, and also how to educate clinicians, is going to create a powerful keynote.

But Pinnacle is also about creating and renewing friendships. It’s a place where people who lead EMS programs come to get renewed, to renew their spirit as well as their knowledge base. For a first-time attendee, it’s like being challenged and encouraged and slapped in the face with the things that are coming. The ideas and innovation discussed at Pinnacle can be overwhelming, but mostly I think they inspire leaders to go home and find ways to be better at what we do.

EMS1: The first Pinnacle was held in 2006. Could you have predicted at all what we would be discussing at Pinnacle 2016?

JF: I think while there was some thought that health care reform and reimbursement reform might be coming down the road, but no one understood the depth of what the changes would look like. We’re still adjusting to the idea of reimbursement based on outcomes or perceived value. At the time we started Pinnacle that was not high on the radar screen — or even visible at all.

But in other ways, the first Pinnacle foreshadowed today’s conversations. This year, for example, we have several sessions related to technology and data. Back then, the dialogue centered on using technology and information to make educated decisions about deployment and operations. While that hasn’t changed, the sessions now focus more on how technology and data can impact patient care, and the importance of sharing and integrating data with partners in healthcare and public safety.

Using hospital data is one of the things I’m excited to hear more about this year. We’re on the verge of being able to do some fascinating things, and we’ll hear from a number of people who are out there on the cutting edge.

EMS1: You also have a session titled "What keeps you up at night?" Are the things keeping leaders up at night now the same as at the first Pinnacle, or when you started your career?

JF: When I look at what we’ll be discussing in that session, I see issues that we knew about in the past but didn’t worry about nearly as much. As a young EMS chief more than three decades ago, I was aware of media coverage, but the media landscape has changed so much, and now anything any of your employees says on Twitter can quickly spread on the Internet and become national news.

Certainly, the safety of our caregivers has been an issue that has always kept us up at night. The way that’s different today has to do with the incredible increase in awareness about caregiver suicides. While there were suicides in that time frame, I don’t think we recognized the connectivity to stress and the way our work impacts our mental health.

The stigma associated with mental health issues in the public safety community remains, but the veil is finally being lifted. This year at Pinnacle, we have several faculty members addressing this epidemic, including Monique Rose and Amy Young, co-founders of RevivingResponders.com; Jim Marshall from the 911 Wellness Foundation, who will address developing resilience in the workforce; and Dr. Marshal Isaacs, who will discuss drug and alcohol addiction in EMS.

EMS1: Several sessions address the relationship between public safety leaders and the city and county officials they report to. Why is this such a critical topic?

JF: It’s more important than ever for EMS and fire service leaders to have a good relationship with city and county officials, and to make sure those officials have a solid foundation on which to base decisions. We are thrilled to have Dr. Bruce Moeller, who been both a city manager as well as a fire chief, an EMS chief and a director of public safety, teamed with Andrew Rand, who is the CEO of a multi-state community based ambulance system, and also chairs his county commission. I think the insights they have in terms of how to work with local officials are going to be very instructive.

EMS1: Last year, you addressed the "elephants in the room" during your Pinnacle talk, including diversity in the workforce, patient safety and accountability. This year your talk is titled "Looking Beyond the Yellow Brick Road." What can we expect to hear?

JF: With a topic like "Beyond the Yellow Brick Road," you might assume that I’m going to talk about what we can learn from some of the characters in the "Wizard of Oz." I don’t want to give away the rest you’ll have to come to Pinnacle to find out.

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