RescueDigest Reads: FICEMS The Federal Interagency Committee on EMS Strategic Plan


The gears of FICEMS will no doubt grind slowly, but if your agency has any kind of EMS response component you’ll want to know which direction they’re turning.

There aren’t any shockingly new ideas here, but it is a good breakdown of where EMS in the United States needs to be moving.


Better coordinated EMS delivery in the United States.

From the introduction: Congress mandated creation of the Federal Interagency Committee on Emergency Medical Services (FICEMS) in 2005, in order to ensure coordination among Federal agencies supporting local, regional, State, tribal, and territorial EMS and 9-1-1 systems. The FICEMS was also created to improve the delivery of emergency medical services (EMS) throughout the nation.

  • FICEMS responsibilities include the following:
  • identifying EMS and 9-1-1 needs
  • recommending new or expanded EMS and communication technologies
  • identifying ways to streamline the process through which Federal agencies supportEMS
  • assisting local, regional, State, tribal, and territorial EMS in setting priorities
  • advising, consulting, and making recommendations on matters related toimplementation of coordinated State EMS programs

The FICEMS Strategic Plan consists of six strategic goals, each with their own objectives each tied to actions that the committee intend to take within the next five years.

Topics include:

Goal 1 – Coordinated, regionalized, and accountable EMS and 9-1-1 systems that provide safe, high-quality care.

  • Objective 1.1: Identify and promote the development and use of EMS performance measures and benchmarks.
  • Objective 1.2: Promote the comprehensive identification and dissemination of best practices in regionalized EMS and emergency medical care, including treatment for time-critical and sensitive conditions.
  • Objective 1.3: Promote measurement and reporting of the relationship between EMS care and outcomes, especially for time-critical and sensitive conditions.
  • Objective 1.4: Identify and promote best practices to reduce regional disparities in care, including supporting States in improving data quality.
  • Objective 1.5: Develop partnerships with State regulatory agencies to promote regionalized and accountable care systems.

Goal 2 – Data-driven and evidence-based EMS systems that promote improved patient care quality

  • Objective 2.1: Support the development, implementation, and evaluation of evidence-based guidelines (EBGs) according to the National Prehospital EBG Model Process
  • Objective 2.2: Promote standardization and quality improvement of prehospital EMS data by supporting the adoption and implementation of NEMSIS-compliant systems
  • Objective 2.3: Develop relationships with Federal and non-Federal stakeholders to support the development of scientific evidence for prehospital care
  • Objective 2.4: Improve linkages between NEMSIS data and other databases, registries, or other sources to measure system effectiveness and improve clinical outcomes
  • Objective 2.5: Promote the evaluation of the characteristics of EMS systems that are associated with high-quality care and improved patient outcomes
  • Objective 2.6: Explore the use of technology that enables enhanced information sharing for increased situational awareness, operational efficiency, and scene safety

Goal 3 – EMS systems fully integrated into State, territorial, local, tribal, regional, and Federal preparedness planning, response, and recovery

  • Objective 3.1: Develop and use reliable and consistent measures of EMS system preparedness
  • Objective 3.2: Develop a rapid process for providing guidance on emerging EMS issues
  • Objective 3.3: Improve EMS system preparedness for all-hazards, including pandemic influenza, through support of coordinated multidisciplinary planning for disasters
  • Objective 3.4: Develop strategies to close the gaps identified in the preparedness component of the “National EMS Assessment”
  • Objective 3.5: Develop training and exercise standards within NIMS guidance to promote interoperability

Goal 4 – EMS systems that are sustainable, forward looking, and integrated with the evolving health care system

  • Objective 4.1: Foster EMS participation in regional and State Health Information Exchanges (HIE)
  • Objective 4.2: Foster and evaluate the development of innovative delivery models for EMS systems that could lead to changes in the reimbursement model
  • Objective 4.3: Provide coordinated Federal support for incorporating enhanced EMS and 9-1-1 technology for both patient and provider
  • Objective 4.4: Apply lessons learned from military and civilian incidents to the EMS community
  • Objective 4.5: Address the challenges of emergency care in areas where there are special concerns posed by geography or in which access may be limited

Goal 5 – An EMS culture in which safety considerations for patients, providers, and the community permeate the full spectrum of activities

  • Objective 5.1: Promote the reporting, measurement, prevention and mitigation of occupational injuries, deaths, and exposures to serious infectious illnesses in the EMS workforce
  • Objective 5.2: Evaluate factors within EMS practices that contribute to medical errors or threaten patient safety
  • Objective 5.3: Support the development and use of anonymous reporting systems to record and evaluate medical errors, adverse events, and “near misses”
  • Objective 5.4: Evaluate FICEMS role in supporting implementation of the “Strategy for a National EMS Culture of Safety”
  • Objective 5.5: Promote the use of detection equipment, training, and personal protective equipment known to enhance the safety of EMS personnel

Goal 6 – A well-educated and uniformly credentialed EMS workforce

  • Objective 6.1: Promote implementation of the “EMS Education Agenda for the Future” to encourage more uniform EMS education, national certification, and state licensing
  • Objective 6.2: Support State, territorial and tribal efforts to enhance interstate legal recognition and reciprocity of EMS personnel
  • Objective 6.3: Work with State EMS Offices to support the transition of military EMS providers to civilian practice
  • Objective 6.4: Promote the implementation of the “EMS Workforce Agenda for the Future” to encourage data-driven EMS workforce planning

The FICEMS Strategic Plan also includes appendices including a RACI project matrix that you may find helpful as a format for some of your own projects. This is a method to help ensure that for each action item it is considered who is Responsible, Accountable, Consulted and Informed.

WHERE TO GET IT: at FICEMS | Federal Interagency Committee on EMS | NHTSA EMS


If the goals and objectives mentioned here match any of your personal or agency priorities, it’s good to know that you’re not the only one working on these. Consider using the framework and references of the FICEMS Strategic Plan to support your local plans and projects.

The United States is very large country with different EMS needs in diverse regions. That being said, the sheer number of separate EMS systems in the US makes it near impossible to move prehospital healthcare forward, especially with the often arbitrary set up of different models for EMS delivery. The purpose of FICEMS is to help focus the efforts of the many individuals and agencies working to advance EMS.

It seems that every day now in emergency services leadership is an exercise in change management. It may take much longer than five years for FICEMS to reach its strategic goals, but for now it’s crucial for your service to know which direction it’s heading.


“There is frequently a lack of evidence about the effect of current EMS practices on patient outcomes.”

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About romduck

Rom Duckworth is a dedicated emergency responder, author, and educator with more than thirty years of experience working in career and volunteer fire departments, hospital healthcare systems, and private emergency medical services. Rom is a career fire captain and paramedic EMS Coordinator for the Ridgefield (CT) Fire Department and director of the New England Center for Rescue and Emergency Medicine. Rom holds a master’s degree in public administration, is a graduate of the National Fire Academy’s Executive Fire Officer program, and is the recipient of the NAEMT Presidential Award, American Red Cross Hero Award, Sepsis Alliance Sepsis Hero Award, and the EMS 10 Innovators Award. Rom is the author of "Duckworth on Education," as well as chapters in more than a dozen EMS, fire, rescue, and medical textbooks and over 100 published articles in fire and EMS magazines. A member of the NAEMT Board of Directors, as well as other national and international advocacy and advisory boards, Rom continues to work for the advancement of emergency services professions. Contact Rom via