EMS System
History of EMS in Montgomery County
Introduction
MCHD EMS provides emergency and non-emergency ambulance transport for the citizens and visitors of Montgomery County, Texas. Covering 1100 square miles and population of 360,000, the agency responds to approximately 30,000 calls for assistance annually.
The EMS Department is comprised of the following subunits.
- Communications
- EMS Field Operations
- Clinical Training
- Logistics
- EMS Billing Office
- Fleet Maintenance
- First Responder Program
Organizational Goals
In January 1998, the MCHD Board of Directors gave the leadership team three overriding goals. These goals remain in place today as a guide for administrative decision making:
1. High quality care for the citizens of Montgomery County:
The Board renewed their mandate that this care be delivered to the patient promptly and within mandated response time standards. Care should be evidenced based and the impact of such care should be measured and monitored as approprirate.
2. Equivalent Cost:
The Board mandated that emergency medical services be provided in a cost effective manner. Public control does not lessen the need to be efficient. In fact, the public provider may be more efficient because it is accountable to the taxpayer, not the shareholder.
3. Accountability:
It is our duty to provide the taxpayer and patient with an accountable and responsive EMS system. This applies to all aspects of the operation; clinical, operations, as well as financial
Organizational Philosophy
An organizational culture based on personal and professional growth has been instituted throughout the service. The culture empowers supervisors, field personnel, support staff, and dispatchers to make immediate decisions necessary to efficiently manage sudden developments in daily operations. This method has been highly successful and has promoted an atmosphere of ownership and dedication to the District’s mission.
A corollary to this philosophy is the system-wide Quality Improvement program that allows personnel to learn from their previous decisions. Our goal is to have every employee performing their job better tomorrow than they are able today.
Equipment
In April of 1998, the system completed a near total retooling process. In addition to replacing the antiquated equipment, MCHD added new equipment such as highly adaptable Pnuepac ventilators and Baxter infusion pumps.
MCHD utilizes the Zoll RescueNet suite of products, including EMS Pro, Dispatch, Billing, and Mobile Data. Each of these programs is integrated into a seemless data network that has allowed MCHD to streamline processes, improve clinical practice monitoring, cut expenses, and increase revenue.
In the communications center, new ADA compliant consoles produced by Xybix were installed and the center moved to the new Montgomery County Emergency Communications District Building.
MCHD reformatted the pre-existing RSI protocol to provide a more humane, safe method of controlling the difficult airway. MCHD led the way with the prehospital introduction of Cordarone. An expanded pain management protocol includes a variety of agents so that paramedics can best meet the patient’s specific pain control needs. MCHD was the first service in the metro Houston area to implement C-spine clearance, Pericardiocentesis, and a trauma code termination protocol.
In July 2000, MCHD implemented the field administration of Retavase to heart attack patients. In conjunction with Conroe Regional Medical Center, MCHD has drastically impacted coronary care for the citizens and visitors of Montgomery County. That program has been replicated with other Cath Lab equipped facilities in and around Montgoemry County, including Memorial-Hermann The Woodlands Hospital and Tomball Regional Hospital.
Most recently, MCHD has added the Vidacare EZ-IO Drill. We have particiapted in a series of IRB apporved studies on the use and effectiveness of tibial and humeral placements. We have also implemented a CPAP protocol for pulmonary edema and drownings using CPAP OS.
AED Program
In 1998, MCHD took the lead role in providing automated external defibrillators (AED) to county fire departments and law enforcement agencies. To date, MCHD has placed AEDs at 16 fire departments, seven law enforcement agencies and located 15 in community businesses and public places.
The AED is state of the art technology that will analyze a patient's heart rhythm and, if necessary, allows the user to deliver an electric shock to a victim of sudden cardiac arrest. MCHD has been successful in training hundreds of people in using the 130 units throughout the county.
Prevention
Health care economists have long known that “an ounce of prevention is worth a pound of cure.” MCHD’s approach advocates an aggressive prevention program as a means to reduce the health care burden on Montgomery County.
Industry Outreach
MCHD believes that we must be a good neighbor to our neighboring agencies. We have opened our doors and our minds to fellow EMS providers. We provide informal system consulting, especially to the smaller, volunteer agencies that surround us. We have shared our educational offerings with training programs around the region. By sharing our ideas and programs, and seeing those of others, it is our hope that the entire region can learn from each other and grow to be a strong force in prehospital care.
Why invest in a high quality EMS?
Most people do not consider the quality of their Emergency Medical Services until they call 911. When you are forced to make that call, it is too late to demand a prompt response and high quality care. Fortunately, the MCHD Board of Directors has made that decision for the citizens and visitors of Montgomery County. They have mandated superior quality by setting increasing standards for the entire community. This ensures that all citizens, rich or poor, urban or rural, receive proper and efficient care in their time of crisis.
