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EMSWORLD.com | AUGUST 2017 15 orientation and onboarding processes. Staffing, regulatory compliance and daily operational challenges do not typically find their way to the top of the list for medical directors, nor should they. Operations, on the other hand, is focused on staffing, response volume, compliance issues such as response times, and ensur- ing the system functions and provides the tools, policies and procedures to make certain staff can respond and provide the care needed by each patient. Adhering to protocols and maintaining the certifica- tions required to work under the medical director's license are part of the job but not necessarily the focus of each day. Everyone is driven to provide quality medical care. Medical oversight and opera- tions both want to meet the standard of care. But the standard of care is not always a black-and-white or even measurable objective. Standard of care is generally a continuum of acceptable care ranging from minimally acceptable to optimal. Any- where along that continuum is still within the acceptable standard. It is only when care falls outside that continuum that it potentially violates a standard of care. It is especially difficult for medical directors who want to provide optimal care to lower their expectations and support a lower level of care that's still within the accept- able standard. Another area of conflict relates to prac- tice and procedures. Prehospital health- care providers tend to be action-oriented people. They want to "do" and take care of those in need. Providers tend to take umbrage at anything that puts limitations on their ability to "do" things. But medical oversight tends to see the situation differ- ently: Medical directors look at published data and usually fall into one of three groups: early, moderate or late adopt- ers. They also tend to focus on doing only those things medically necessary to get the patient safely to the emergency depart- ment. Where operations and medical over- sight come into conflict in this scenario is when medical oversight wants to change a policy or procedure and operations views it as a limitation on their previous scope of practice. An example of this would be limiting intraosseous insertion to one site or only allowing endotracheal intubation if attempting BVM ventilation or placing a supraglottic airway is unsuccessful. While medical oversight and operations sometimes have conflicting drivers, they also have drivers that are synchronized. The challenge is balancing these drivers while retaining the goal of providing the best possible care for the patient. Finding the balance and honoring the importance of both perspectives is critical to the over- all success of a system, especially as EMS Veinlite EMS PRO ® The UlƟmate Vein Access Device for Emergency Patent Number US 7,874,698 B2 ®Registered Trademark of TransLite, LLC. Designed and manufactured in the USA. www.veinlite.com Integrated white exam light for low-light situaƟons SAVE $50 ON ALL MODELS ENTER CODE EMSW0817 at Veinlite.com For More Information Circle 16 on Reader Service Card