Mike Knipstein of Williamson County EMS
Mike Knipstein is the Director of Williamson County EMS. TEMSA recently conducted aQ&A with Mike to learn more about his thoughts on the future of EMS inTexas.
TEMSA: What are the greatest challenges that you currently face in Williamson County?
Mike Knipstein: We are not a unique service when it comes to challenges. Like most EMS services we continue to face challenges related to recruitment, retention and reimbursement. We are blessed to have some very good paramedic programs in our area, so we generally have a good pool of new paramedics that apply with WilCo EMS.
However, as we look to recruit experienced caregivers it becomes more difficult, especially when it comes to recruiting someone with 10 or more years of experience. Our average caregiver has been with us for around seven and a half years, but we are beginning to see a decrease in this number as many are looking to advance their medical careers. We continue to try to identify ways that keep them challenged while advancing their knowledge. While pay is important, we know that is not the primary driver for many who enter EMS. The key for us is to see what drives that paramedic and lead effectively. As with all EMS agencies, reimbursement is a concern. We are beginning to see our uninsured rates increase, which drives down our revenue. Lastly is the balance between adding response resources to meet call volume demands and advancing our clinical care. This advancement is either through education or tools. Both of which can add additional demands on the budget all the while trying to maintain a manageable workload for our caregivers.
TEMSA: What are some of the greatest advances in EMS that you have witnessed over the past decade?
Mike Knipstein: Wow! To look back 10 years from now and to see where we have come is astounding. From an operational standpoint just seeing the technology we now use to dispatch ambulances and moving them to the most efficient place for coverage is a huge advancement. The quality of our telecommunicators and the job they do before we arrive helps a tremendous amount. The advancements that are available to assist with caregiver safety are huge, such as power loads and self-lifting stretchers.
The clinical advancements are even greater. If you think about it, we can activate cath labs from the field and have a patient in the cath lab in less than 30 minutes from 911 activation. We continue to push our first responders and paramedics in the advancement of their knowledge and skills. I think some of the biggest clinical advancement is coming from the data we are now able to analyze. A few years ago, we changed our advanced airway management from an RSI to DSI process as we identified we were potentially harming patients. It was data and the analysis of that data that drove that change.
TEMSA: Where do you see EMS in Texas in 10 years?
Mike Knipstein: I see EMS becoming more involved in the total health care of the patient. I think we will move from a supplier of patients to true medical providers. This will take a shift in mindset for our caregivers, but they are certainly up for the challenge. As part of that shift we will need to make sure as leaders we provide them with the knowledge and tools they need to be successful. We will move from the “you call, we haul” mentality to what is the best place for the patient to go to get the best treatment they need for their condition. With this we must push for changes in reimbursement. I see public education becoming a huge part of our business. For example, if we expect CPR survival rates to increase, we need toeducate more people on how to perform CPR and push for businesses to purchaseAEDs.
TEMSA: Why do you think that it is important for EMS agencies to be part of TEMSA?
Mike Knipstein: Networking and sharing of best practices are the best part for our agency. I know that I can reach out to others who are part of the organization to see what they are doing. You most likely see a theme of reimbursement in my answers. TEMSA is a huge advocate for all members and they ensure that we are aware of reimbursement issues. The thing that I enjoyed the most about the EMS Evolution Conference was the teamwork that you witnessed. Each agency was so open to sharing what they were doing and how it was making an impact in their community.