Last week at the IHI office in Boston, a few members of our staff had the opportunity to conduct the Red Bead Experiment with Don Berwick. The experiment shows that even with "willing workers" trying their best, inefficiencies are determined by the process itself, not by individual skill.

🚑 EMS leaders—are you ready to take improvement to the next level? Join Mike Taigman and I for a master course designed for EMS leaders to achieve results-driven improvement. Now accepting applications. #EMS #fire #ImprovementScience davidmwilliamsphd.com/ems-course/

#EMS folks! Join us for Empire State Grand Rounds on March 13 at 1300 (EST)! Dr. Dorsett will share why data integration is essential for the future of EMS. @naemsp.bsky.social @maiadorsett.bsky.social

Scientific advancements aside, this is economically irresponsible Every $1 spent by NIH generates $2.46 For example, in 2023, $47B in NIH spending generated ~$93B Halting NIH spending will LOSE the US a lot of money (and talent)

REFUSE TO BE PRESSURED - Blair Sadler Wise words for embracing a non-kneejerk leadership approach.

Them and the rest of the Freds having completed their tasks at #NAEMSP2025 admirably, OvFreds celebrated on the plane ride back home with a breakfast of cinnamon grahams and coffee. It was a great week, we’re glad to be home, and highlights and pics from the week to follow.

Kicking off the #EMSAdvocacy with “EMS as an Essential Service” through state legislation. As of April 2024, there are 15 states which designate EMS as “essential.” Did you know that LAWYERS were considered essential in 38 states? How do we define “essential?” #NAEMSP2025

Here's a 🧵 with some of the research and quality improvement presentations from #NAEMSP2025 this year. #EMSsky We investigated the # of abstracts presented at NAEMSP that make it to manuscripts, an indicator of science quality. 44% were published and it was higher in orals (60%).

How do you define quality in #EMS? There is no better person to answer that question than @maiadorsett! “Quality in EMS must prioritize patient outcomes.” Systems are complex and require attention to structural & process measures to build improved care. #NAEMSP2025

“Based on an analysis of over 35,000 EMS patients with long bone fractures, black patients were substantially less likely to be medicated for their pain.” Remle Crow PhD, FAEMS. #NAEMSP #NAEMSP2025 #FirstWatch #medsky

“Our aim is to reduce fatalities and other harms from opioid use disorder. Not all interventions are created equal.” Remle Crow PhD FAEMS Anjni Joiner DO FAEMS Melody Glenn MD MFA FASAM @emsdatadoc.bsky.social #medsky #NAEMSP #NAEMSP2025 #FirstWatch

The AMR response to Hurricanes Helene and Milton was the largest EMS disaster response in history. They sent: 480 ALS ambulances 250 BLS ambulances 16 rotor ambulances 2385 EMS providers Wow. 🤯 #NAEMSP2025

“If you want to improve outcomes, you need to focus on processes. Our job as leaders is to improve those processes.” Scott Bourn at #NAEMSP2025 providing a framework for reducing efforts on items that don’t result in Improvement to free up time for activities that do.

This is maybe my favorite single sentence regarding EMS care, and it’s a ripe area for Quality Improvement.

Kicking off the day with an overview of the #NAEMSP quality course! #NAEMSP2025

“We are seeing meaningful measurable to the quality of emergency medical care in the U.S. and around the world.”Nikki Little describing the impact of infusing improvement science throughout EMS. #NAEMSP #NAEMSP2025 #FirstWatch #MedSky

The incredible @maiadorsett.bsky.social shares how the @naemsp.bsky.social Quality Course became the star program it is today! #NAEMSP2025

@maiadorsett.bsky.social, @nikkiblittle911.bsky.social et al at are doing great work with the @NAEMSP Quality Improvement Course & kicking off #NAEMSP2025 discussing how it is quietly changing (improving) #EMS! We’ve come a long way since the landmark paper to push this initiative forward.

Geneva Whitmore, of Global Medical Response presents on a tool to assess risk of violence in EMS encounters. #NAEMSP2025

The DEI committee meeting to a packed room. Doing phenomenal work to advance equity in #EMS workforce and care. Wish I could capture the energy in this room. #NAEMSP2025

When @maiadorsett.bsky.social kicks off an afternoon of Quality sessions at #NAEMSP2025 she is not content with the paucity of audience members in the front row, and elects to walk the room. Sorry wallflowers, you get a presenter in close proximity!

Learning about Community Purposed Resuscitation at #NAEMSP2025 from Dr. Sylvia Owusu-Ansah. It’s a guarantee that you have disparities in your bystander CPR data, and there are demonstrated ways to improve those numbers.

The dynamic Dr. Ashley Huff delivering a terrific presentation on the challenges, and solutions, when your EMS work and EM work collide during a disaster. Another powerful and informative session at #NAEMSP2025

Four of the pillars of our Quality Improvement community getting Friday morning at #NAEMSP2025 started with a presentation on the evolution and current state of the NAEMSP Quality Improvement Course. What sessions are you most excited about today?

This is one of the reasons I love the #NAEMSP2025 annual meeting. You get to learn lessons from 5 years of MIH experience at LA County Fire direct from Dr. Clayton Kazan.

One of the sessions I’ve been most looking forward to at #NAEMSP2025 is Dr. Christopher Colwell presenting a roundup of the best trauma literature of the past year. A highly condensed and must-see educational session.

Being involved in a committee is a great way to contribute to the work that NAEMSP produces. I’m biased and I think the Quality committee is a great one to be involved in! Dr. Ian Medoro is our new Quality Committee chair and led us through a great in person meeting today at #NAEMSP2025

Dr. Sophia Gorgens gave a great presentation on preparing EMS providers for on the job microagressions to stop viewing these events as “just part of the job”. One of many great sessions in the New Speaker series at #NAEMSP2025

I knew it difficult to seek US #asylum, no idea how hard it is to request/get to appointment! Using CBP app means: have cell phone and internet, download app, fill it out in English/Spanish, use in specific MX areas, show up right time/place. #barriers to legal entry. @naemsp.bsky.social #NAEMSP2025

Connection is a component of solving so many problems. If we start with an intent to build connections we can reduce tremendous suffering in the world around us.

2024 highlight: Joint position statement - with EMS, PD and FD for collaborative approach to behavioral health emergencies #naemsp2025 www.tandfonline.com/doi/full/10....

A diagnosis of mental health does not mean current impairment. We need to stop penalizing physicians in licensing for mental health which stops them from seeking treatment. Amanda Humphries giving a phenomenal keynote at #NAEMSP2025. @naemsp.bsky.social

Dr. Allison Berndtson of UCSD Surgery presents on the traumatic injuries seen at the US-Mexico border south of our meeting location here in #SanDiego “It’s not about politics, it’s about people. Migration is a worldwide problem, not just here in the US.” #NAEMSP2025

Dr. Allison E. Berndtson is giving a powerful presentation on traumatic injuries at the US-Mexico border. The increases in length and height of the border wall creates a catastrophe of injuries. I’ve long been an open borders advocate and this only reinforces that stance. #NAEMSP2025

Our fearless leader @ncemsmd.bsky.social getting the main conference sessions started with a recap of the incredible work done by the chapters and committees at #NAEMSP2025

As "Empowering Leadership: Building Equity and Excellence into EMS Systems" with Dr. Rickquel Tripp, MD, MPH, and Dr. Ameera Haamid, MD, FAEMS, wraps up, attendees are leaving inspired and equipped to drive change in EMS leadership. A truly transformative session! #NAEMSP2025

We’re back in San Diego to direct our @naemsp.bsky.social 2025 Building Equity Precon! Our team is discussing unconscious bias, SDOH, health inequities in EMS - Finishing on concrete steps to build a more equitable workforce! @prettyrickymd.bsky.social #NAEMSP2025

One brilliant presenter after another at the Equity in EMS conference at #NAEMSP2025 . Now we get to wrap up this amazing day with @emsdatadoc.bsky.social giving is a crash course on using Data to address care disparities.

@haamidthemd.bsky.social reinforcing that the theme for the day of EMS equity is “you can’t find what you’re not looking for”. #NAEMSP2025

David Page, NRP shares opportunities and resources to get involved with Equity-related EMS research - “You can’t find what you aren’t looking for” (a common theme throughout the day). - #NAEMSP2025 Building Equity Precon

“We can use our privilege to protect and support others.” Rackquel P. Tripp MD, MPH @prettyrickymd.bsky.social #NAEMSP #NAEMSP2025 #FirstWatch #medsky

At #NAEMSP2025 Dr. Rickquel Tripp tutoring us on our Shields and our Swords. Getting us prepped to sharpen our steel for the battles ahead.

Making a privilege bead bracelet in the Empowering Leadership precon at #NAEMSP2025. @mtaigman.bsky.social with a powerful takeaway: “there is nothing I’ve done in my life that impacted whether or not I got a bead”. Another impactful exercise from a tremendous faculty!

Congrats to the faculty and directors of the NAEMSP Quality Improvement Workshop with a record number of attendees for their 2-day pre-conference! They work hard to teach #EMS leaders how to improve patient safety, quality of care, & patient outcomes! #NAEMSP2025

“Notice opportunities to use our privilege to address bias and microaggressions.” Mary Mercer, MD, MPH #UCSF #NAEMSP #NAEMSP25 #FirstWatch #medsky

@haamidthemd.bsky.social giving an overview of Equality vs Equity as we explore care disparities in US Healthcare at #NAEMSP2025 If you are looking for a precon at next years meeting, this should be high on your list!

Dr’s Rickquel Tripp and Ameera Haamid getting us started on Day 3 of #NAEMSP2025 with a session Building Equity into our EMS systems. The speaker lineup for this session is an inspiring group!

One of the most dangerous interventions provided by #EMS is sedation of the agitated patient. @drjeffjarvis.bsky.social is discussing NEMSQA measures at #NAEMSP2025 Please go review the draft measure for sedation and provide feedback. Deadline is January 11th! tinyurl.com/4atz8s3v

@qipunks.bsky.social leading a debrief after learning about PDSAs through deliberate play at the quality and safety course at #NAEMSP2025.

It’s always an inspiring time when @mtaigman.bsky.social uses Grateful Dead analogies to set up the take home Quality projects work!