Wake County, North Carolina
In wake County, NC, (pop. 998,691) Emergency Medical Service (EMS) handles many calls that may not meet the strict definition of an emergency, placing a significant burden on resources and requiring skilled staff to triage the demands.
People with chronic illnesses may wait until their conditions have deteriorated into full-blown medical crises and then call EMS. EMS also regularly responds to substance abuse patients and people in mental health crisis, bringing them to the hospital for evaluation and then responding again hours later after they are discharged.
A shortage of experienced paramedics, coupled with the need for rapid assessment, intervention decisions, and myriad time-sensitive paramedic-level procedures, often under difficult circumstances, made it a challenge for Wake County to adequately staff ambulances.
The county decided to make full use of the resources it already had. It sent 19 paramedics for advanced training at a competitive eight-week academy coordinated and operated by two full-time administrative EMS chief officers.
Today, the county has reduced the need for repeated response to non-emergency calls by using 17 advanced practice paramedic (APP) units divided into two daily shifts. (APPs have extra training in assessment and clinical skills.) The APP units also regularly assist ambulance crews on critical-level calls and have been able to increase the number of home visits to high-risk populations.
By using APPs, Wake County is meeting its goal of making its EMS system more efficient by reducing the chances of, or minimizing, medical crises for people who have specific medical conditions.
Learn more about the EMS program of Wake County
Meet the Manager
