Call to Action – National Ambulance is Responding to Needs in the Marketplace

That’s the culturally correct name that two Russian emigrants and eventual EMTs, Avdey and Kirill Adzigirey, and others who work them, have given to a patient simulator at National Ambulance in Springfield, a venture they launched seven years with one vehicle and an abundance of entrepreneurial spirit.

Over the years, ‘Vladimir’ has been a focal point of continuing education efforts at the company, which has grown exponentially since it was started. And he’s now one of many learning tools being put to use in the latest extension of what has become a multi-faceted business operation.

It’s called the EMT Academy, which shares space with the ambulance service at 525 St. James Ave. It was launched in August with a number of goals and expectations.

Chief among them is helping the region meet an anticipated need for more emergency medical technicians in the years and decades to come as the population ages and the need for such professionals grows. But another motivation is to meet National’s own needs for EMTs as it continues its growth trend — and not just with bodies, but rather with individuals trained in what David Malloy, business development manager for the company since 2009, called the “Adzigireys’ way of doing business.’

Elaborating, he said this is a sharp focus on customer service, a trait that is either missing at many operations or mistakenly taken for granted by the public at large.

“Most people wouldn’t think that customer service is a behavior needed in the emergency field, especially when saving a life, but only 30{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of our calls are truly ‘life threatening,’” said Malloy, who also handles public outreach for the company and markets the EMT Academy, noting that National Ambulance, like many similar companies, is contracted with nursing homes and assisted living centers for routine, non-emergency, transport of residents to medical appointments or to their homes.

Treating others with respect, regardless of the level of emergency, is necessary but not always delivered, he said, referring to the existence of something known within the industry as the “paragod attitude.”

“We want medical professionals that will treat others with respect, and not have that attitude,” he told HCN, referring to the so-called “prima donna paramedic” who comes complete with a god complex (more on that later).

“Assimilating new EMT hires and bringing them to our way of doing things is sometimes a challenge,” Malloy went on. “Change is hard when you’ve been doing something a certain way for 10 years and we’re asking you to do it a different way.”

David Spafford, education coordinator for National Ambulance and now the program director for EMT Academy, has 25 years of experience as an EMT and 10 years as a full-time firefighter prior to that. Since 2009, he’s been training practicing EMTs regarding any new education that would affect their jobs, and has additional reasons for wanting that educational control of new EMTs from day one.

“Protocols fall under the EMT certification and are system-wide,” he explained. “Policies and procedures may be different from company to company, but when we have control of the initial training of who we hire, it will reduce the amount of training we have to do on the job.”

For this issue and its focus on Healthcare Careers, HCN takes an indepth look at one of the region’s more intriguing healthcare-sector business success stories, and, more specifically, at its latest endeavor, which is a response to marketplace needs — in more ways than one.

Malloy said plans for the EMT Academy started to take shape more than two years ago.

Company officials recognized an opportunity to expand their venture through a new, different, and potential-laden revenue stream, and help the region meet growing needs for emergency medical technicians.

Heightened demand for such individuals is part of the reasoning behind creation of the academy, he noted, but another is that the EMT position is very often a stepping-stone to many other careers within the healthcare field. As individuals move into these positions, more entry-level personnel are needed. One of the facility’s goals is keep the pipeline filled.

The other goal, as stated, is to give National Ambulance a steady supply of EMTs versed in the company’s way of doing of business.

The process of receiving accreditation from the state Department of Public Health’s Office of Emergency Services took more than a year, Malloy noted, adding that the rigorous procedure involved an indepth analysis of how the school would be operated, a site visit to inspect teaching equipment, and questions about how students would be tracked over graduation.

For now, the academy will focus on basic EMT certification, the lowest level attainable, and eventually work toward accreditation for training of advanced EMTs (or AEMTs), and paramedics, said Malloy, adding that the three levels within the profession are designated by the types of procedures that can be performed in the field without additional supervision and the drugs that can be administered.

Elaborating, he said that EMTs can perform cardiopulmonary resuscitation (CPR), bandage wounds and splint injuries, recognize signs of heart attack, stroke, and shock, and administer up to six approved medications (aspirin, epinephrine auto-injector pen for allergic reactions, inhalers for asthma, oral glucose for diabetics, nitroglycerin for heart attacks, and Narcan for heroin overdoses), which are the most common emergency needs.

Meanwhile, AEMTs can perform all the above, plus intubation and intravenous therapy (IV). The paramedic can perform what EMTs and AEMTs can, but they can also execute intraosseous (IO), or bone IVs, in addition to administering a much larger list of medications, without supervision.

Spafford said the basic EMT certification requires 180 hours of training, while paramedic certification requires 1,200 hours, with half of all training being performed in the field. While the academy does not offer placement, Spafford said, the ability to observe those in class as they progress, provides National Ambulance with the opportunity to choose future employees that fully embrace the company’s philosophy when it comes to customer service and that aforementioned ‘paragod attitude.’

In some cases, Spafford noted, EMTs from other ambulance companies — one of the sources of personnel for National — have been in the field for more than a decade, and are used to doing things “their way.”

Spafford admits there are EMTs who have an attitude of ‘I’m saving your life right now; I don’t have to be nice to you.’ And you can’t have that attitude here.”

Malloy concurred. “Many people that are attracted to the role of an EMT or paramedic are take-control people and it’s a behavior that is necessary,” he explained, adding that in the customer service setting, this attribute is something that the EMT Academy training will help individuals control and use in a positive way.

“We have to help them channel that behavior in an appropriate fashion,” added Malloy. “That’s where it’s important for us to make sure that our employees know that distinction.”

Malloy told HCN that the academy is now part of multi-faceted business venture shaped by the Adzigirey brothers, who emigrated from Moldova 20 years ago.

The 9,000-square-foot St. James Avenue property houses both National Ambulance and the EMT Academy, and a 38,000-square-foot property on 370 Albany St. houses the Albany Street Auto repair center, which services other companies’ fleet vehicles as well as personal vehicles.

Company officials are hoping the academy can replicate the rapid and profound growth of both the ambulance company and repair shop, but they acknowledge that there will be challenges.

The school opened last August with 10 students — a number Spafford called “manageable” — and has ambitious goals to soon reach its capacity of 30 for the 15-week course.

Applicants for admission must be 18 years of age, be able to read and write English, possess a valid driver’s license, lift 125 pounds, and pass a Massachusetts Criminal Offender Record Information (CORI) check, said Spafford, adding that for some individuals, these requirements themselves pose a stern test, as does the cost of the education; $950 for the 15 weeks and approximately $350 in fees for testing and certifications. Since the company does not offer financial assistance, some that wanted to attend, couldn’t, but Spafford had some students waiting to start before he had accreditation in hand.

“The need ebbs and flows,” said Malloy. “It’s cyclical and we’ll be fine for several months but then some EMTs will go on to become paramedics or other medical careers, and we then have spaces to fill.”

Being an EMT can be a career in it’s own right, but only 10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of certified EMTs remain at that level, Spafford said, because the certification also provides entry level training for the allied health field.

“Nurses, physician assistants, respiratory therapists, firefighters, police officers, athletic trainers all start out, usually, with basic EMT training,” Spafford explained, giving numerous examples of those he knows who have personally gone on to lucrative careers in the Central Intelligence Agency (CIA), state police, and medical professions.

To raise awareness of the academy, Malloy has embarked on an aggressive marketing campaign that includes an informational website — www.EMTacademy.org — as well as a banner on the National Ambulance building, local job fairs, and a plan is in the early stages to focus on certified nursing assistants and licensed practical nurses, professionals who often stand to benefit professionally from EMT training.

The immediate goal is to be running full spring and fall classes by next year.