I am a planner. It is crazy to make stupid plans. It is best to do it right the first time. I'll tell you a true story.
When I was hired to write our states emergency medical services plan we had nothing but a few EMT's, and paramedics and a few ambulances scattered around the state. We had no comprehensive system. If someone got sick, or injured, as often as not they just threw them in a car and hoped they made it to a medical facility.
In a large state the most important thing is to have trained people who can stabilize a patient at the scene, good communications, and then have a procedure in place for where the patient should go next e.g. burn patient, heart attack, etc.
Remember we are twice as big as Texas with few roads.
People had been working on a comprehensive EMS plan with 15 components for five years under PL93-154; and every year the feds turned down their plans. The latest guy, whom I replaced, had been working on the plan for a year and had left a memeo saying he did not think the plan could be written.
The planning director asked me what I thought. There was only 6 weeks left and if we did not get a plan together we would get no money at all as it was the last year. I told him we had to write the plan.
So they hired me to write the plan. When I sat down at the desk it was filled with all sorts of incoherent crap. Esoteric organization charts that were way too complicated and not viable politically, and all sorts of fanciful ideas that made little sense, IMO.
I cleared out all the crap and started a new plan from page one. I had exactly six weeks to complete it. They hired me at a high range and gave me overtime. I started working 7/12's having no idea how I would do it in time , as I also had to learn EMS. I had previously written the state plan for alcoholism and drug abuse, so I did know how to write a plan.
I wrote a very simple straight forward plan with goals, objectives and methodology for each of the 15 components with political checks and balances and one which could evolve from the community level on up.
I wrote in a State Office of EMS, with a statutory governors advisory council, to protect the office from politics. I then divided the state into regions and districts with local EMS councils along Native corporations (for administrative purposes) and and transportation patterns for triaging purposes.
We also funded massive EMT training for all firemen and policemen, which really helped with the stabilization at the scene.
That basic plan is still used today and we have one of the most sophisticated EMS systems in the world today.
Best to do it right the first time. And it also shows what a good job government can do. |
