Allina Health

Emergency Medical Services

Community Report 2013

 Caring
At Allina Health Emergency Medical Services,
everything we do comes from our deep
commitment to care—it’s the driving force
to provide the very best for our patients.

As emergency medical services (EMS)

clinicians, we know that the people we
encounter may be having the worst day of
their lives. But we have the opportunity to be
the best part of that day through the things we
do. Big things, like restarting a stalled heart.
Little things, like putting a hand on a patient’s
shoulder and offering a reassuring smile.

Nearly 90,000 times a year, people place their

dignity, their well-being, even their lives or the
lives of their loved ones in our hands. That’s
a profound responsibility, and we never stop
trying to be worthy of it. Every day, every night,
on every call, we strive to show we care.

EMT April Anderson provides both

reassurance and medical expertise
to a patient experiencing pregnancy
complications. Everything we do comes
It’s why we’re here.
from our deep commitment to care.

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 Helping
Allina Health Emergency Medical Services clinicians care for
approximately 1 million people in more than 100 communities
in the Minneapolis/St. Paul metropolitan area and out-state. We
employ 570 paramedics, emergency medical technicians (EMTs),
dispatchers, special transportation drivers, and maintenance,
administration and support personnel. We’re not-for-profit,
self-managed and self-sustaining.

But Allina Health EMS does much more than respond to

emergencies and provide medical transportation. As industry
leaders, we set performance standards and goals, measure
and document our successes, then implement and share new
techniques and devices shown to improve lifesaving care as well
as increase access to it.

We sponsor community outreach and volunteer programs

that range from helping make resuscitation equipment widely
available to donating bikes to kids in need so they can enjoy
healthier childhoods.

And we partner with public and private organizations whose

needs and values mesh with our own, throughout Minnesota and
beyond, to help them succeed, often in unique ways.

At Allina Health EMS, we care deeply about helping the

communities we serve.

One of our paramedic units responds to a

911 call on a busy Friday night. An Allina It’s what we do.
Health EMS dispatcher is already directing
the caller in pre-arrival patient care.

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 We Respond to We Provide
Emergencies Non-Emergency Services
In 2013, our 90+ vehicles responded to Allina Health EMS handles approximately
approximately 62,000 emergency calls across a 26,000 non-emergency calls and interfacility
1,600-square-mile area. patient transfers each year.

OUR PARAMEDICS AND EMTs respond to 911 OUR SCHEDULED AMBULANCE SERVICE
calls and handle both routine and emergency provides transportation for non-emergency
transfers between health care facilities 24 hours patients who are unable to ride in a wheelchair.
a day, seven days a week. Many are hospice or nursing home patients who
need skilled help when going to and from clinics,
OUR DISPATCHERS remain on the phone hospitals or therapy centers. We also provide
with 911 callers to give them the information scheduled ambulance service at all care levels,
they need to handle an emergency medical from basic life support to critical care transport.
situation, such as choking, sudden cardiac
arrest or imminent childbirth, until the
ambulance arrives. We work constantly to
maximize our performance in this area, and
we are well on our way to achieving our goal
of ACE (Accredited Center of Excellence)
accreditation from the International Academies
of Emergency Dispatch (IAED) in 2014.

OUR MOBILE COMMUNICATIONS UNIT

brings dispatching capabilities onsite to
prescheduled events and emergency situations.
This resource is shared among EMS agencies
statewide to assist with natural disasters and
other large-scale emergencies.
OUR WHEELCHAIR SERVICE allows our drivers
OUR SYSTEM STATUS MANAGEMENT and to assist with non-emergency wheelchair
MEDICAL PRIORITY DISPATCH SYSTEMS discharges from Allina Health hospitals in the
ensure that someone who is experiencing an metro area.
injury or other medical emergency receives a
response from a properly equipped ambulance OUR GREATER MINNESOTA PROGRAM
and from professionals appropriately trained to transports patients to and from medical care
handle that particular emergency. providers in the Minneapolis/St. Paul area.

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 Emergency responses are just one way
we serve. We also provide non-emergency
services, special event coverage and
community paramedicine.
We Stand By at Special Events
From heat stroke to heart attacks, medical emergencies often
happen in crowded areas, impeding potentially lifesaving medical
responses. That’s why we collaborate with sponsors of special
events taking place in our primary service area to pre-plan and
station our clinicians at civic gatherings, sporting events and the
like. Examples of such coverage include:
LIFE SUPPORT GOLF CART A paramedic certified in advanced life support, or an EMT certified in basic
life support, will patrol the event site in a specially equipped golf cart.
BASIC OR ADVANCED LIFE SUPPORT UNIT COVERAGE Two EMTs with an ambulance equipped to
provide basic life support, or at least one paramedic and one EMT with an ambulance equipped to
provide advanced life support, will stand by.
BIKE TEAM COVERAGE A team of EMS professionals that includes at least one paramedic will circulate
throughout hard-to-reach areas on bicycles. These include parade routes, race courses and parks. The
team carries equipment to stabilize patients and arranges for them to be transported from the area.
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We Extend Our Reach Through
Mobile Integrated Health Care
In 2013, Allina Health EMS began a pilot project in Anoka County,
Minn., to serve patients with a history of repeated emergency
department visits, behavioral health issues, or frequent hospital
readmissions for congestive heart failure, pneumonia or heart
attack. In this program, our goal is to connect these patients, many of whom are not adept at navigating
the health care system, with the resources and clinicians they need while reducing nonessential
emergency room visits and hospital readmissions.
The project employs community paramedics, who have undergone an additional 200+ hours of
specialized training and are working in the mobile integrated health care environment. In a typical
scenario, a patient who meets the criteria is visited by a community paramedic, who can offer an
alternative care plan.
Currently, Minnesota is the only state in the nation to certify community paramedics with this new
credential. Allina Health EMS employs about 20 such paramedics, and the program is growing.
 Pursuing Clinical
Excellence
“Allina Health EMS is much more than an ambulance and
medical transportation service,” says Medical Director Charles
Lick, MD. “One of our highest priorities is aggressively
investigating new EMS technologies and techniques,
determining their value based on the latest science, then putting
those methods and devices to work as early as possible.”

This focus has evolved along with the growing recognition of

the value of evidence-based medicine. “As EMS departments
became more sophisticated, we began to realize that we should
become more data-driven so that we could document reasons
for everything we did,” says Susan Long, director of Clinical and
Support Services. More recently, this change is also being driven
by health care reform: Why should individuals and insurers pay
for things that have not been shown to work?

Our approach has given us a reputation in the EMS field as not

just early adopters, but innovators. More important, it lets us
bring the latest proven clinical advances to our patients more
quickly than most EMS systems.

Operations Manager Jeff Lanenberg

explains the LUCAS automated CPR device
to candidates in our New Employee Academy. It’s how we stand out.
Only the best candidates graduate from the
program and are selected for field work.

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 Here are some of the clinical areas in which we’ve been
at the forefront of the industry:
NO-HANDS CPR We attribute our high
cardiac arrest survival rate— which is more
than double the national average—to our
forward thinking approach. For example, in
2007, we implemented the LUCAS® portable
computerized device for performing automated
CPR. “We were the first to use the LUCAS
device, and we have widely shared our results
and the knowledge we gained from its use with
others,” says Dr. Lick.
According to the manufacturer, Allina Health
EMS has used the LUCAS device more than
any other single EMS system—more than 1,600
patient uses to date.
GETTING THE BLOOD FLOWING Another
factor responsible for our high cardiac arrest
survival rate is our widespread use of the
ResQPOD and ResQGARD devices. The
® ®
former augments blood flow to the vital organs
during CPR, while the latter increases blood
pressure in patients with low blood pressure
from a variety of causes.
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EVALUATING CPR PERFORMANCE Since
September 2013, we have been using CODE-
STAT™, a software system that extracts data
from EKGs and allows us to evaluate our
clinicians’ performance on every cardiac arrest
call. “I send a graphical representation of how
well the CPR was managed to the crew within
24 hours of the event for their self-review,” says
Carol Frazee, a paramedic and field training
officer who oversees the system. Studies
show that such timely feedback improves
performance—which, hopefully, will translate
into increased patient survival.
MAPPING LIFESAVING TECHNOLOGY Allina
Health EMS is one of the first EMS systems in
the nation to be linked to the Atrus National
AED Registry™. This system alerts participating
911 agency dispatchers to the location of
automated external defibrillators (AEDs) so they
can be found and used quickly when needed
to help victims of cardiac arrest. To date,
approximately 2,500 AEDs have been listed in
the registry statewide.
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 We Share What We Learn
“At Allina Health EMS, our numbers are
large enough that we have enough data to
do statistically valid research comparatively
quickly,” Susan Long says. “And we feel we
have an obligation to help the industry by
sharing the results of that research.”
For the past 10 years, the Clinical Services
department at Allina Health EMS has sponsored
Pulse Check Hot Topics in EMS, an annual
conference for EMS clinicians, fire and police
departments and others. Presentations at
the 2013 conference included “Autism and
First Responders” and “Trauma: A Patient’s
Perspective,” as well as a panel discussion on
community paramedicine.
In 2013, we created something unique: a clinical
resident fellowship in our Division of Applied
Research, intended to allow paramedics to
develop the skills needed to conduct and
disseminate research. In September, paramedic
supervisor Jon Kamrud was named our first
fellow in this program.
Our Care Goals Help Us Improve
Here is some of the research we have presented Few EMS agencies nationwide measure the We also use our Care Goals to train our people
in such venues: impact of clinical interventions as closely as we to do a better job of documenting data and
do. At the beginning of each year, we commit outcomes, which helps with consistency. Setting
• Our PROSe (PREHOSPITAL RECOGNITION ourselves to a patient Care Goal, a specific Care Goals also helps us “hard-wire” best
OF SEPSIS) study was a pilot investigation of clinical improvement that we want to achieve practices into our organization year after year.
a procedure not typically performed by EMS by the end of that year. Why do we do this? “It has allowed us to change the behaviors
providers. It found that the use of lactate Because our clinicians are always looking for of the entire ambulance service,” explains
meters and temporal artery thermometers better ways and reasons to do things. Associate Medical Director Paul Satterlee, MD.
by paramedics could help diagnose sepsis
approximately two hours sooner than it is
currently detected.
 ur study of the prevalence of CERVICAL
•O
SPINE FRACTURES AMONG ELDERLY
PATIENTS WHO SUFFER HIP FRACTURES
during low-level falls concluded that less
aggressive use of spinal immobilization may
sometimes be warranted for such patients.
 nother study found that MECHANICAL
•A
CHEST COMPRESSION WITH THE LUCAS
DEVICE does not appear to increase the risk
of related injuries or complicate recovery in
cardiac arrest survivors.

Disseminating what we’ve learned in professional
•O
publications such as the Journal of Emergency
Medicine and the Journal of Emergency
Medical Services (JEMS) helps clinicians and
their patients everywhere while increasing
our own presence in the industry. So does our
participation in conferences sponsored by such
groups as the National Association of EMS
Physicians (NAEMSP) and the American College
 ur research also found that LIMITING
THE USE OF LIGHTS AND SIREN to only
those situations for which it’s truly warranted
improves safety and benefits nursing home
residents by alleviating anxiety and disruption.
A NEW WAY TO PROTECT OUR PEOPLE, OUR PATIENTS AND THE
PUBLIC Research shows that paramedics and EMTs nationwide are approximately five times
more likely to be killed in a crash than the average worker. In fact, we experienced firsthand the
devastation of an EMS vehicle crash in early 2014, when one of our ambulances was involved
in a serious collision. To protect our employees, our patients and the motoring public, and
to decrease maintenance, liability and insurance costs, we began installing a system called
Road Safety® in all our vehicles in 2013. Road Safety provides each driver with real-time audio
feedback on speed, acceleration, braking and cornering, allowing for immediate correction
and safer operation. Early results look promising, and Road Safety will be fully installed and
operational in 2014.

of Emergency Physicians (ACEP).

14 15

“Setting annual Care Goals has helped us
improve our performance,” says Associate
Medical Director Paul Satterlee, MD.
Our 2013 Care Goal was to optimize the
treatment of patients who are evaluated
by ambulance staff but not transported to
a health care facility. These patients have a
higher potential for bad outcomes than those
who are taken in for further evaluation. While
many do have minor complaints that don’t
require an emergency department visit, some
choose not to go in because of other factors,
such as concerns about cost, drug or alcohol
use, or a lack of recognition of the severity
of their condition. But the patient education
and documentation that occur during these
interactions are important.
In working to achieve this and our previous
Care Goals, we followed a similar protocol,
explains Dr. Satterlee. “We reviewed our
previous experiences with this type of call,
looked at cases of poor outcomes or near
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misses, and identified recurring contributing
factors and clinical indicators,” he says. “In this
case, we then developed a list of clinical factors
that, if present, required consultation with a
physician before our clinicians left the patient.”
“For each of our Care Goals, we also reviewed
our charting habits and identified areas
of documentation that were consistently
inadequate,” Dr. Satterlee adds. “We then
tracked each case, providing feedback to
clinicians if they did well, if any documentation
was absent, or if clinical indicators were
overlooked or not fully assessed. We provided
regular education on documentation and
measured our rates of adherence to protocols
and documentation.” The results were
impressive: We achieved a 12.8 percent
improvement in the number of patients who
received optimal care.
In previous years, our Care Goals have included
optimizing our care of the following:
PATIENTS IN SUDDEN CARDIAC ARREST (SCA) PATIENTS WITH SHORTNESS OF BREATH
These patients have a low survival rate nationally, Shortness of breath can have a number of
despite many recent efforts to improve causes, from simple to life-threatening, most
treatment. However, a number of interventions often congestive heart failure, asthma, COPD or
are being shown to improve survival rates, acute heart attack. Each has specific and unique
particularly when they are used together. With treatment requirements, but we found that too
that in mind, we incorporated pit-crew CPR and many of our patients were treated for any and
continued our emphasis on using the ResQPOD all possible causes rather than targeted therapy.
and mechanical CPR device (LUCAS) with RESULTS: 13.3 PERCENT IMPROVEMENT
minimal breaks in chest compressions.
RESULTS: OUR SCA SURVIVAL RATE IS NOW PATIENTS WITH ACUTE MYOCARDIAL
AMONG THE BEST IN THE NATION INFARCTION Because the blocked artery to the
heart must be identified and the obstruction
PATIENTS WITH PRESUMED ACUTE STROKE resolved quickly, we took steps to recognize
It is imperative that EMS accurately recognizes these patients promptly, doing an EKG and
acute stroke, treats it quickly and efficiently accurately identifying the abnormality that
and alerts the receiving hospital of the indicated a STEMI. We also ensured that our
pending arrival. We educated all our clinicians treatments were consistent with the programs
in the basics of stroke, its presentation and at the hospitals we take patients to and that our
assessment tools, incorporated our hospital interactions with those hospitals were seamless.
system’s best practices and ensured that our RESULTS: 19.2 PERCENT IMPROVEMENT (99
protocols fit with the hospitals’ needs. PERCENT OF STEMI PATIENTS NOW RECEIVE
RESULTS: 29.4 PERCENT IMPROVEMENT CARE UNDER THE LATEST BEST PRACTICES)
OUR CARES NUMBERS ARE STELLAR The U.S. Centers for Disease Control
and Prevention’s Cardiac Arrest Registry to Enhance Survival (CARES) was created to help EMS
providers improve their performance in cases of out-of-hospital cardiac arrest (OHCA). It provides
agencies with a confidential, Web-based program that allows EMS providers to compare their
performance with other participating communities. Data show that Allina Health EMS boasts
significantly higher OHCA survival rates than the rest of the country. In the first half of 2013, the
figures for Utstein Bystander Survival (OHCA cases that were witnessed by a bystander, found in a
shockable rhythm and received some bystander intervention, such as CPR and/or AED) were 69.2
percent for Allina Health EMS, 42.9 percent for Minnesota and 28.9 percent nationally. In 2013, we
had 741 cardiac arrest calls, worked 504 of those, transported 278 and had 58 survivors.
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 Living Up to
Our Values
At Allina Health EMS, we have the unique opportunity to act
as ambassadors for the Allina Health Values: Integrity, Respect,
Trust, Compassion and Stewardship.

As emergency responders, our values are constantly on display

in public. We bring them with us into people’s homes at all hours
of the day and night, and often under extremely difficult or even
tragic circumstances. At times like that, our values guide us and
give us strength. More important, they can have a profound
influence on patients, family members and others we encounter
in the course of our work.

Our enduring belief in these values is what defines us, both as

individuals and as an organization. Every day, at every level, it
shapes our attitudes and our actions.

Paramedic Jeremiah Gleitz’s smile reflects

his commitment to such values as integrity,
respect and compassion. As emergency It’s who we are.
responders, our values are constantly on
display in public.

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 These are the principles that underlie our decisions and
operations at every level.
INTEGRITY
WHAT IT MEANS:
We match our actions to our words.
HOW WE LIVE IT:
“Integrity means keeping promises and owning
your actions. If I make a mistake, I admit it and
try to learn from it, and share what I learned so
others don’t repeat it.”
RENEE ROSENBERG, SUPERVISOR
RESPECT
WHAT IT MEANS:
We treat everyone with honor, dignity and
courtesy.
HOW WE LIVE IT:
“I approach everything I do by asking myself,
`Is this what I would like done to my mom?’ We
often find patients in embarrassing situations—
perhaps they’ve fallen in the tub—and I try to
minimize their discomfort in any way I can, such
as by making sure they are covered up as much
as possible or by asking neighbors to step out
of the room momentarily.”
CAROL FRAZEE, PARAMEDIC
TRUST
WHAT IT MEANS:
We act in the best interests of our patients,
physicians, communities and each other.
HOW WE LIVE IT:
“Trust is earned in all the little things we
do—driving courteously, presenting ourselves
professionally, explaining to patients what we’re
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doing to them and why. We also live up to the
trust the community places in us by pursuing
the latest medical knowledge and maintaining
our skills and equipment so we’re prepared for
any possibility.”
JEFF LANENBERG, OPERATIONS MANAGER
COMPASSION
WHAT IT MEANS:
We create a caring environment for our patients
and one another.
HOW WE LIVE IT:
“Compassion as a corporate value recognizes
that even those of us who do not practice
medicine still participate in health care. I often
drive patients who are under a lot of stress, and
knowing this, I don’t let their behavior set the
tone for our interaction.”
ROSE HOLMES, SPECIAL TRANSPORTATION DRIVER
STEWARDSHIP
WHAT IT MEANS:
We use our resources wisely.
HOW WE LIVE IT:
“Stewardship can be as simple as driving
smoothly to improve fuel mileage and decrease
unnecessary repairs. The money we save can be
put back into buying new medical equipment
or providing enhanced training to help us take
better care of patients.”
MATT BOUTHILET,
PARAMEDIC FIELD TRAINING OFFICER
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 Our People
All Allina Health EMS paramedics, EMTs and
dispatchers are required to maintain state and,
in some cases, national certification, and our
Continuing Education department helps them
meet the requirements by subsidizing the cost
of necessary classes.
An innovative staff development program
is our monthly case review, an EMS version
of health care’s mortality and morbidity
conferences, at which individual patient cases
are reviewed. This training is shared via the
Web, allowing partner agencies, as well as our
own geographically dispersed employees, to
participate remotely. In 2013, we even had EMS
friends in Croatia join us for these reviews.
In return for having high expectations, we
provide our employees with a high level of
support. “We expect our people to
know the protocols for their job and
treat others well, and to know that
in turn, we will have their backs,”
says Allina Health EMS President
Brian LaCroix. talk about ways we can improve, then
Even though many of our
employees work different shifts
and in widespread locations, we try
hard to stay in touch with them and
let them know what we’re doing
and why. “We encourage them
to participate in decision making,
provide them with clear direction,
give them the tools and support they need,
then get out of the way and let them do their
jobs,” LaCroix adds. As a result, Allina Health
EMS has particularly low employee turnover: 15
percent of our caregivers have been with us for
20 years or more.
Our employees are encouraged to share their volunteering and also determines where
concerns and feedback with us and to know charitable contributions are made.
that we will work with them to address any
issues and suggestions they may have.
“I can go to my supervisors at any time
with any personal issue I might have and
trust that they will work with me to help
resolve it,” says Emergency Medical
Dispatcher Anton Fehrenbach. “And when
we dispatchers meet with each other to
bring our ideas to management, we feel
confident that they will respond. This
relationship starts at the top,” he adds.
“Because our supervisors treat us well, we
in turn work harder for them.”
Each year we set goals for participation, and
after an employee logs 20 volunteer hours with
A Culture of Giving a qualifying organization, a $100 contribution
is made to the nonprofit organization of his or
Employee volunteerism and community her choice. Each employee can do this up to
involvement are part of our culture. A program three times a year. As of the end of 2013, Allina
called Mission Matters helps employees Health EMS employees had completed 6,221
get involved in their communities through hours of community service.

GUARDING AGAINST BURNOUT, STRESS AND BOREDOM According to
Lori Boland, senior research scientist at Allina Health, studies looking for evidence of burnout, stress
and trauma have generally focused on police officers and firefighters, and few, if any, ambulance
services in the U.S. have systematically assessed these risks. This makes our ongoing internal
initiative in which we survey our field staff’s emotional and mental well-being rather unique in the
industry. We also conduct a yearly employee engagement survey that measures to what degree our
people stay motivated and personally invested in the jobs they do. Allina Health EMS also has a
half-time chaplain, Russ Myers, who is deeply involved in employee well-being.
OUR LEADERS ARE ENGAGED IN THE INDUSTRY Allina Health EMS leaders
are active in professional organizations. Our president, Brian LaCroix, serves on the board of the
National EMS Management Association. He is also chairman of the Century College EMS Advisory
Committee and immediate past chairman of the Hennepin County EMS Council. Susan Long,
director of Clinical and Support Services, is president of the North Central EMS Institute, and Bruce
Hildebrandt, our operations manager, is a board member of the Institute’s sister organization,
the North Central EMS Cooperative. William Snoke, our director of external affairs, serves on the
Minnesota Ambulance Association, as do our operations directors, Kevin Miller (incoming president)
and Jeff Czyson (board member), as well as our regional operations manager, Brian Nord (board
member). Czyson also serves as chairman of the Dakota County EMS Council.

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 Working Together
“Allina Health EMS provides ambulance service in more than
100 communities, but our help goes well beyond that through
outreach initiatives,” says Operations Director Jeff Czyson.
“These efforts are designed to improve the overall health of all
our citizens, and we began doing this before health care reform
took hold because it’s simply the right thing to do.”

Events such as safety fairs, bike helmet programs, car seat

clinics, senior citizen health fairs, as well as CPR, AED and first
aid classes, are all geared toward prevention. Participation in
career days, parades and coverage of special events, including
pre-planning and providing onsite medical coverage for major
events held in the Twin Cities area, increases our visibility and
raises awareness of career opportunities in EMS.

Paramedic/RN Barb Schley and Critical Care

EMT Gui Muvundamina are flanked by members
of the Spring Lake Park-Blaine-Mounds View Fire It’s how we serve.
Department. We work with more than 100 partner
organizations in our community outreach efforts.

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 Here’s a more in-depth look at a few of our major
community outreach programs:
MAKING COMMUNITIES
HEART SAFE
Sudden cardiac arrest (SCA) can happen
anywhere, at any time, to anyone, including
seemingly healthy young people. And unless
treated immediately, it’s almost always fatal.
That’s why, 13 years ago, Allina Health launched
Heart Safe Communities. This effort, founded
by our medical director, Dr. Charles Lick, seeks
to prevent SCA deaths by making grants
available for obtaining automated external
defibrillators (AEDs) and placing them in public
and private places; developing SCA training
and educational materials for public use;
working to increase awareness of SCA and
heart disease; and training people in bystander
CPR and AED use.
“Today, more than 2,500 AEDs have been
placed and maintained in Minnesota and
western Wisconsin, and close to 50,000
individuals have been trained in their use
as well as in CPR,” says Allina Heart Safe
Supervisor Katie Tewalt.
In 2009, Allina Health brought the Heart Safe
designation program to Minnesota, and by
2013, it had grown to a statewide partnership
with other agencies. The designation
acknowledges a city, county or organization’s
efforts to prepare its staff and citizens to
recognize when someone suffers a sudden
cardiac arrest and know how to respond. To
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date, more than 25 communities have earned
the designation.
HELPING KIDS BE HEALTHY
“Our outreach mission includes fostering
volunteer opportunities among our employees,
their friends and families in 82 communities,”
says Executive Assistant Kathy Quinn.
The goal of one nonprofit volunteer program
that we sponsor is to help children in need
enjoy happier, healthier lives by providing them
with bicycles. Every October, Allina Health
partners with Free Bikes 4 Kidz to collect
bicycles from employees and other members
of the community. In 2013, thanks to the help
of 900 volunteers, more than 5,000 bikes were
collected and, when necessary, reconditioned.
Despite the subzero temperatures, volunteers
then distributed the bikes to kids in December,
along with helmets and booklets on bike safety
and concussion education.
PROVIDING THE HUMAN TOUCH
Allina Health EMS supports community groups
that are dedicated to the well-being of EMS
personnel and their families. For example, we
raise donations from employees to support the
Minnesota EMS Honor Guard, which ensures
that EMS and other public safety workers who
die in the line of duty are provided with a
dignified funeral service and family support.
SHERBURNE
ISANTI
ANOKA
WRIGHT
RAMSEY
HENNEPIN
M c LEOD
DAKOTA
SCOTT
NICOLLET DETAIL AREA
BROWN
COMMUNITIES WE SERVE The 911 primary service area of Allina Health EMS stretches
across portions of 11 Minnesota counties, with non-emergency services having an even broader
geographic reach. Bases of operation are spread throughout the area, and multiple posting sites
are incorporated into our deployment strategy. Principal report-to-work locations are in the cities
of Apple Valley, Buffalo, Cambridge, Hutchinson, Mounds View, New Ulm, Savage and St. Paul.
One million residents (20 percent of the state’s population) live within our primary service area,
and literally millions more travel through at places like the Minneapolis/St. Paul International
Airport and the Mall of America.
A team from Allina Health EMS works with the And to help protect our community’s young
Metro Critical Incident Stress Management people, we participate in several mock
(CISM) Team, which provides crisis counseling automobile crashes at area high schools
to EMS personnel and first responders who throughout the year. These emotional scenarios
wish to receive it after a traumatic work event. are a powerful way to teach students about the
“It’s caregiver talking to caregiver,” says Chuck devastating impact that the decision to drink
Kaufman, Communications Center director. and drive—or to get in a car with a driver who
has been drinking—can have.
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 We Partner With Others
We live our mission, vision and values through
partnerships within the 100+ communities
where we provide ambulance service, as well as
in the broader community of patients who look
to us to provide exceptional care.
“Because we’re a not-for-profit organization,
the partnerships we choose reflect our
commitment to being a good corporate
citizen working to solve community health care
challenges,” says Director of External Affairs
William Snoke. In fact, in 2013, Allina Health
was the proud recipient of The International
Leadership Institute’s International Corporate
LOBBYING FOR POSITIVE CHANGE
of the Minnesota Ambulance Association. This trade association represents Minnesota’s EMS
providers by working for and monitoring legislation that impacts EMS recruitment and retention,
financial issues, education and leadership.
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Citizen Award, primarily due to work done in
Kenya by Operations Manager Jeff Lanenberg
and other Twin Cities public safety leaders.
While growing and making money are not our
foremost objectives, being financially healthy
is essential to our ability to fulfill our mission,
and growth is a component of any healthy
organization. Helping our partners be successful
has helped us to double in size in the past six
years. In turn, we learn from our partners and
their leaders, a symbiotic relationship that
advances the quality of emergency medical
services throughout the region.
Allina Health EMS is an active member
Here are some of the unique and innovative ways
in which our partnerships work:
• We have close working relationships with 20
911 call centers statewide. Their emergency
medical calls are transferred to us so
that they are handled smoothly, with no
redundancies or dropped calls.
• Partnerships with the cities of Coon Rapids
and Roseville reflect our commitment to using
evidence-based medicine in identifying and
evaluating innovative and leading-edge first
responder delivery models.
• Several Minnesota communities contract with
us to provide ambulance service under their
locally controlled licenses. These include
Apple Valley, Lakeville and Farmington (ALF),
as well as Hutchinson. “We used to operate
our own ambulances but found ourselves
increasingly facing challenges with issues
like education, technology and compliance,”
says Steve Mulder, MD, president and CEO
of Hutchinson Health, a private, nonprofit
organization. “Allina Health EMS excels in
these areas due to their economies of scale,
their exclusive focus on EMS and their high
level of training and expertise. As a result,
they have been able to maintain the high
level of personal service our community
expects, improve our ambulance response
times and provide broader coverage of
shifts,” Mulder adds.
• We partner with the city of Elk River to
provide paramedic staffing, teaming up with
local fire department EMTs.
• We provide education to local fire and
police departments to ensure the availability
of properly trained first responders. Our
equipment replacement programs also allow
local agencies to restock disposable supplies
used on calls.
•O
 ur certified emergency managers provide
regional training with multple agencies for
large-scale incidents. This collaboration with
local partners has extended to supporting and
participating in community events, conducting
“active shooter” training in Arden Hills and
Roseville, and leading ambulance strike team
deployments to the 2009 Red River Valley
flooding. A number of our clinicians also staff
the MN-1 Disaster Medical Assistance Team
(DMAT), which has deployed to areas struck by
numerous disasters, including Hurricane Sandy.
• Allina Health EMS leaders have more than
500 years of combined EMS management
experience that we routinely share. For
example, we have provided management
consulting to help the city of River Falls
evaluate its ambulance service, and training
to Maplewood paramedics on legal issues.
29
 Safeguarding Our
Financial Health
Maintaining financial strength is one of the core
responsibilities of any EMS system. That’s particularly
important as health care and reimbursement practices
evolve nationwide.

At Allina Health EMS, we take this responsibility

seriously, especially because we receive no tax subsidies
from the local communities we serve. Our entire budget
is supported by fees for service, allowing us to provide
exceptional prehospital care without any added tax
burden to our communities.

Our careful stewardship of our finances also allows us to

give back to the community in the form of grants, CPR
training, community health and safety initiatives, and other
forms of outreach.

It’s part of keeping

our promise.
“Fiscal health is essential to excellent patient
care,” says Allina Health EMS President Brian
LaCroix. “It’s part of our commitment to the
communities we serve.”

30 31
 2013 REVENUE SOURCES EMPLOYEE ENGAGEMENT
2005 2006 2007 2008 2009 2010 2011 2012 2013

911 CALLS
71.5% 87%
84%
80%
72%
Our Balanced SPECIAL
67%

TRANSPORTATION 51% 52%

Approach Pays Off 2.6% 41%
34%
INTERFACILITY
CALLS
OTHER
23.2%
The economics of health care are 2.7%

fundamentally changing throughout the U.S.,

creating ever-increasing financial challenges.
In this environment, the balanced approach
we take in managing our organization lets us
both continue to meet day-to-day needs and
911 Calls $38,286,568
Employee Engagement is much more than just employee satisfaction. An engaged employee is a person who
Interfacility Calls $12,419,276
is fully involved in, and enthusiastic about, his or her work and committed to the interests and objectives of
Special Transportation $1,408,771 the organization. Since we began measuring, we’ve seen employee engagement increase by 2 1/2 times.
Other (FlightCare, Education, etc.) $1,423,036
TOTAL* $53,537,651

ensure long-term success. * Includes more than $7M in patient bad debt absorbed by Allina Health EMS NUMBER OF RESPONSES NUMBER OF EMPLOYEES
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

One example of this is the salaries and 87K

benefits we’re able to provide our employees, 2013 EXPENSES 90K 570

which allow us not only to attract the best

60K
candidates, but also to retain them. In fact, 455
72K
compared to other EMS systems, we’re proud 423 473
50K
59.9% 395
45K 376
to have one of the lowest employee turnover 42K
55K 375
414
424

rates in the nation (just 7 percent annually, 46K 385

43K 362
40K
with half of those moving to other positions
2.8%
within Allina Health). 15.2% 4.9% 1%

5.1% FINANCIAL PERFORMANCE

4.4%
“A healthy retention rate helps us avoid the
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
high cost of constant hiring and training,” 2.8% 3.8%
says Kevin Miller, out-state operations
Salaries & Benefits $32,101,071
director. “And perhaps more important, Supplies & Drugs $1,484,343
it results in a team of highly qualified, Services (Laundry, Equipment Maintenance, etc.) $528,258
experienced clinicians who care deeply about Depreciation $2,640,774

their organization, their patients and the Corporate Legal, Payroll, HR, IS & Financing $2,748,325
Utilities, Rent & Maintenance $2,041,210
communities they serve.”
Other (Minnesota Care Tax, Insurances, Workers’ Comp) $2,333,355
Fuel $1,521,920 $36M $48M $47M $59M $54M $65M $74M $81M $88M $107M $118M
Here’s a snapshot of how our approach pays Capital Use (Vehicle & Equipment Purchases, etc.) $8,138,395
$23M $23M $27M $31M $29M $34M $39M $37M $43M $45M $53M

off with strong finances and healthy growth: TOTAL EXPENSES $53,537,651 GROSS REVENUE NET REVENUE

32 33
 Our Vitals

Number of times we Number of ANNUAL Number of hours of

responded to a REQUEST VISITORS TO THE MALL PERSONAL VOLUNTEER Percentage INCREASE NUMBER OF PHONE Number of times
FOR AMBULANCE OF AMERICA (within our SERVICE donated by Allina IN TOTAL MILES driven CALLS managed by we responded to
SERVICE in 2013: primary service area): Health EMS employees: between 2012 and 2013: our Dispatch Center: calls INVOLVING
87,925 40 million 6,221 3.4 323,000 AN OBSTETRIC
EMERGENCY: 385
Number of CAREGIVERS Number of IVs STARTED NUMBER OF CHARITIES Percentage DECREASE, TOTAL NUMBER OF
AND SUPPORT STAFF we BY OUR PARAMEDICS that benefited from Allina BETWEEN 2012 AND 911 CALLS logged: Number of times
employ: 570 in the field in 2013: Health EMS employee 2013, in total fuel burned, 80,000 our dispatchers gave
22,064 volunteer activities: thanks to IDLE AND pre-arrival instructions
Number of Allina 97 SPEED REDUCTION Number of callers our over the phone to
Health EMPLOYEES Number of times we used EFFORTS (despite increase dispatchers provided help a 911 caller
SYSTEMWIDE: 23,869 the LUCAS AUTOMATED Number of in miles driven): 2.1 with PRE-ARRIVAL DELIVER A BABY: 5
CPR device in 2013: 373 MILES OUR INSTRUCTIONS:
Number of FULL-TIME AMBULANCES DROVE: Number of gallons 33,000 Number of BABIES
RESIDENTS in our 911 Number of times we 3,938,242 of MOTOR OIL WE DELIVERED by our crews
response area: APPLIED CERVICAL RECYCLED: 1,400 Number of seconds of in the field: 12
>1 million COLLARS to patients with Equivalent number of ARMER 800 MHz RADIO
suspected neck injuries: LAPS AROUND THE Number of times USAGE: 30,427,200 Number of BABIES
Percentage of 3,289 EARTH at its equator: our vehicle service NAMED AFTER THE
Minnesotans who GET AN 158 technicians CLEANED Number of disposable ALLINA HEALTH EMS
ALLINA HEALTH EMS TOTAL YEARS OF AND RESTOCKED THE one-size-fits-all Tyvek CAREGIVER who helped
AMBULANCE when they EMS MANAGEMENT Equivalent round-trip AMBULANCES in our fleet: HAZMAT SPLASH SUITS deliver her: 1
call 911: 20 EXPERIENCE among our VOYAGES TO THE 14,196 USED per year: 6–12 (baby Fiona Garret)
supervisors, managers, MOON:
Number of PASSENGERS directors and president: 8.2
TRAVELING THROUGH 513
Minneapolis/St. Paul GALLONS OF FUEL we ABOUT ALLINA HEALTH Allina Health EMS, a part of Allina Health, is dedicated to the prevention
International Airport Average years of used: 305,013 and treatment of illness and enhancing the greater health of individuals, families and communities
throughout Minnesota and western Wisconsin. A not-for-profit health care system, Allina Health cares for
annually (within our primary EMS MANAGEMENT
patients from beginning to end-of-life through its 90+ clinics, 12 hospitals, 15 pharmacies, specialty care
service area): EXPERIENCE among our Average MILES PER centers and specialty medical services that provide home care, senior transitions, hospice care, oxygen and
33 million leadership team: 14.6 GALLON: 12.9 home medical equipment, and emergency medical transportation services. Learn more at allinahealth.org.

34 35
 allinahealth.org/ems
S412773 19476 0314 ©ALLINA HEALTH SYSTEM TM—A TRADEMARK OF ALLINA HEALTH SYSTEM