Skip to Main Content
 

Global Search Box

 
 
 
 

Files

File List


akron1177640876.pdf (2.45 MB)

ETD Abstract Container

Abstract Header

Emergency Medical Services in the Rochester Region of New York State: Organization, Services and Systems

Baldridge, Kenan Stone
http://rave.ohiolink.edu/etdc/view?acc_num=akron1177640876

Abstract Details

2007, Doctor of Philosophy, University of Akron, Urban Studies and Public Affairs.
In 1966, the U.S. Department of Transportation published what was to become a landmark study: “Accidental Death and Disability, the Neglected Disease in Modern Society.” This work reviewed the then current state of affairs of prehospital medical care in the United States. It painted a horrendous picture concerning the quality of care rendered to American citizens during the time of an emergency. The information presented so astounded the federal government and the medical community that many efforts were undertaken to respond to the findings of the work. New York State responded to the report some eight years later with the enactment of the Emergency Medical Services Act of 1974. Known as “Article 30,” this act set out lofty, but vague, goals for improving the quality of emergency medical care provided to the general public. It is the thesis of this study that the organization design chosen and the implementation methods and tools employed, were grossly inadequate to the task. Add to this a meager allocation of resources, and the State’s response became pre-destined to fail. In the Rochester Region, formal groups associated with health care or ambulance response did little. A handful of local leaders acted on their own initiative to respond to the problem. A federal grant provided funding for a university-based program concerning data collection, “coordination” of pre-hospital programs, and medical training for ambulance attendants, though its reach was very limited. There was only limited regional effort to respond to the new State level EMS policy. EMS service levels remained dismally low in many parts of the state. The quality of care provided to the public was highly questionable for a significant number of patients treated. This work seeks to determine whether EMS service provision in the Rochester Region of New York State meets national quality standards on a consistent basis, the reasons why or why not, and how progress actually gets accomplished. The implementation of statewide policies requires many choices. These choices must address many levels of government and many steps in the implementation process. These include choices of goals to be achieved as well as which underlying technical theories are believed useable for obtaining them, whether to use an existing agency, or construct a new administrative organization or structure. Lastly, choices must be made as to which inputs, outputs and outcomes to measure for evaluation purposes, if any at all. At the state level, the legislature chose to use a new organizational strategy, that of the EMS council system, which it hoped would somehow lead to progress. Additional choices were made that meant there would be little regulation and no evaluation. This left the ultimate control over service provision and control in the hands of the local EMS providers. The quality of the service provided was determined at the local level. The research questions were answered. EMS service provision in the Rochester Region of New York State does not meet national quality standards for providing meaningful and effective emergency medical care on a consistent basis. The quality of the EMS service provider is determined in large part by the most influential officer(s) of the service. The key decisions about quality are largely retained by the organization itself, rather than outside forces. The primary reason the region does not meet national standards on a consistent basis is because the State constructed a “system architecture” for EMS in New York with an organization design that compares poorly to characteristics of effective organizations. This left the State with an ineffective administrative system architecture to implement its policies. The EMS Council system was a poor choice. The fact that any progress was made at all was the result of local, pioneering leadership. Progress in quality EMS service provision in the Rochester region was made despite the EMS council system and State policy rather than because of it.
Raymond Cox (Advisor)
312 p.
Emergency Medical Services; New York State; Rochester Region; Emergency Medical Services Council; Implementation; EMS

Recommended Citations

Citations

  • Baldridge, K. S. (2007). Emergency Medical Services in the Rochester Region of New York State: Organization, Services and Systems [Doctoral dissertation, University of Akron]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=akron1177640876

    APA Style (7th edition)

  • Baldridge, Kenan. Emergency Medical Services in the Rochester Region of New York State: Organization, Services and Systems. 2007. University of Akron, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=akron1177640876.

    MLA Style (8th edition)

  • Baldridge, Kenan. "Emergency Medical Services in the Rochester Region of New York State: Organization, Services and Systems." Doctoral dissertation, University of Akron, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=akron1177640876

    Chicago Manual of Style (17th edition)

akron1177640876
1,034
© 2007, all rights reserved.
This open access ETD is published by University of Akron and OhioLINK.