Training

The Training Section is responsible for ensuring that all Emergency Medical Responders in Forsyth County are adequately trained, credentialed, and prepared for any incident they may encounter. The Training Section takes “best practices” learned through the quality management process, and transforms that information into operational practice. The Training Section uses a wide array of teaching modalities including traditional classroom, online education, one on one training, and patient simulation training. The section is comprised of three training officers.

The Training Section plays a significant role in the recruitment, assessment and training for new employees. Once the selection process is completed, new employees are assigned to the training division for a new employee orientation period. Progress is monitored to ensure new employees are given the best opportunity to succeed. Following the completion of orientation, the training section along with the shift officer track the progress of new employees through a field internship. The training section also works closely with administration and the medical director to help facilitate the career progression of each employee.

Additionally, the section provides continuing education that meets the National Registry requirements, OSHA standards, NC OEMS rules and regulations as well as any training needed to meet other governmental guidelines. The training section also facilitates training and evaluation to help ensure that every EMS employee is physically fit to provide safe patient care.

There is year round community involvement that includes accident prevention and awareness for school aged children. In addition, the department is involved in public events that promote healthy lifestyles and create public awareness about time sensitive events such as brain and heart attacks. The training section is very active in teaching first aid and CPR throughout the county. A close relationship between EMS and the community is forged by the training section.

Logistics

Logistics

The Logistics Section of Emergency Services is managed by the Equipment Officer and two Equipment Technicians. The Equipment Officer works Monday through Friday 8-5 while the Equipment Technicians work Twelve hour days, opposite each other, to provide a technician every day from 07:30 to 19:30. Our duties are expansive and subject to change on a moment’s notice but in general the Logistics Section is responsible for the purchase and distribution of equipment, supplies, and uniforms for the department. We also provide logistical support on special standbys and still perform at our Paramedic / EMT levels of certification when needed to assist the Operations Section with special responses with our Bus Ambulance, Medical Support Unit, and ATV Ambulance.

Quality Management

Quality in EMS is defined as providing the right care to the right patient in the right amount of time. We evaluate our clinical quality at FCES by using the six dimensions set forth by the Institute of Medicine. We ensure that our care is:

  • Safe
  • Effective
  • Patient-centered
  • Timely
  • Efficient
  • Equitable

Some of the major components related to our quality management program are:

  • Maintenance of a quality information system.
  • Evaluation of a continuous quality improvement program.
  • Staff development.

In addition to internally managing our clinical quality, we have a committee of internal and external stakeholders that make up our Quality Management Committee (QMC).

The QMC is made up of physicians, nurses, medical personnel, EMS educators, and EMS providers. These internal and external stakeholders meet on a bimonthly basis to review data that is reported to the QMC for the purpose of evaluating ongoing quality of patient care and medical direction.

We also employ a Quality Management Coordinator. They are responsible for overseeing the QMC and providing key insights into improving the performance and care of our EMS system and personnel. Some of their key job responsibilities are listed below.

  • Performs data extraction and analysis from existing data sources:
    • ePCR System
    • CAD
    • PREMIS
  • Manages and evaluates the usage of the ePCR system and a formal training process.
  • Provides timely reports to Medical Director, Administration and Training Section.
  • Provides feedback to individual practitioners on skills and activities.
  • Participates in sharing patient outcome data with our local hospitals, the Trauma Registry, RACE and the CARES Database.
  • Utilizes PREMIS data and EMS Toolkits to benchmark FCES performance against similar agencies in North Carolina.

EMS Division History - 1968 to Present

The Forsyth County Ambulance Service Department was established by the Forsyth County Board of Commissioners in January 1968. Until that year, as in most communities in North Carolina, local funeral homes had provided all ambulance services throughout the County. However, as a result of new Federal and State laws regarding minimum wages and ambulance standards, all funeral homes discontinued the provision of ambulance service in Forsyth County.

Because all other private and public agencies were unable to provide emergency ambulance services to all citizens of the County, the Board of County Commissioners accepted the responsibility and the Forsyth County Ambulance Service (FCAS) was born. Two (2) local funeral homes donated used ambulances and continued to provide “emergency back-up” service until FCAS was operational in all areas of the County. The first ambulance, a 1959 Cadillac, was affectionately known by all as the "Blue Goose." FCAS started with five (5) ambulances, thirty-two (32) partially trained ambulance attendants, minimal equipment and supplies and no radio equipment, except for some "walkie-talkies" provided by the Winston-Salem Police Department (WSPD). Ambulances were dispatched by the Forsyth County Fire Department. The starting salary for an Ambulance Service employee was $1.81 per hour.

Personnel received training in standard and advanced first aid, special ambulance attendant training, defensive driving, simulated emergency accidents, emergency childbirth procedures, and emergency aircraft evacuation procedures.

Although numerous improvements to the service had already been implemented, FCEMS Management saw the need to improve the level of care the Department was providing to the citizens and visitors of Forsyth County. An intensive educational program consisting of 700 hours of training was developed and was sponsored by FCEMS and Forsyth Technical Institute. The course was heavily supported by both the Bowman Gray School of Medicine and Forsyth Memorial Hospital. Dr. L.W. Stringer, FCEMS Medical Advisor, served as Medical Director for the course and provided much of the instruction. On October 30, 1975 FCEMS graduated twelve (12) personnel from one of the first Paramedic classes in North Carolina. All personnel went on to become certified as Mobile Intensive Care Technicians (MICT) through the North Carolina Office of Emergency Medical Services (OEMS). Pre-hospital Advanced Life Support (ALS) care in Forsyth County was born, and FCEMS was quickly establishing itself as an EMS industry leader in North Carolina and the Southeast.

Call volume increased significantly in 1978 to over 19,400. More than 75% of the calls FCEMS was running required ALS care. The second Paramedic Class began, with the students graduating in late 1979. By 1980, all FCEMS ambulances were equipped with ALS gear and staffed by at least one (1) MICT. The QRV Program was expanded, placing three (3) additional “Medic” trucks in outlying areas of the County; Medic 2 was assigned to the Rural Hall Fire & Rescue station, Medic 3 was placed in the Kernersville Fire Department, and Medic 4 was positioned in the Lewisville Fire & Rescue station. All Medic trucks were staffed by one (1) Paramedic and equipped with a full complement of ALS gear. Rescue 1 underwent a name change to Medic 1 and continued to operate from the main station in Winston-Salem. The Medic trucks responded on all emergency calls in their district for the purpose of stabilizing the patient prior to arrival of the ambulance that was responding from the main station.

By the late 1980’s, FCEMS had outgrown the facilities at the Reynolds Health Center and was in dire need of a larger facility with its own space for training purposes. A Groundbreaking Ceremony for the new FCEMS Headquarters Building was held on April 27, 1989 at 911 E. Fifth Street in Winston-Salem. Construction began immediately, and on August 6, 1990 a Building Dedication Ceremony was held at the new state-of-the-art FCEMS home. The building included:

  • 4 Administrative Offices (Director, Asst. Director, Equipment/Training Officer, and Office Manager)
  • 1 Conference Room
  • 1 Training Room
  • 1 Kitchen
  • 1 Day Room
  • 1 Supervisor's Office (Captain)
  • 1 Asst. Supervisor's Office (Lieutenant)
  • 8 Bedrooms
  • 14 Ambulance Bays

The Winston-Salem Fire Department (WSFD) began running as First Responders on “medical” calls in the late 1990’s. County volunteer squads had historically provided “first response” coverage within the City of Winston-Salem, however, excessive call volume made it impossible for these agencies to continue the service. FCEMS and WSFD partnered to complete the necessary education program. All WSFD personnel were trained/certified at the EMT-D level and underwent oral boards with the FCEMS Medical Director prior to functioning in the field. This partnership has been invaluable to the provision of the best pre-hospital care available.

Committed to public safety, the safety and well-being of its employees, and providing the best patient care possible, FCEMS began a process in 2002 to migrate the entire Department to a 12-hour work schedule over the next decade. As new positions are added to the Department each year, existing employees are matched with them to operate ambulances, at the busiest stations first, on a 12-hour shift.

The FCEMS Headquarters Building was renamed The Graham W. Pervier EMS Building on September 14, 2006 in honor of our retiring County Manager, by order of the Forsyth County Board of Commissioners. Mr. Pervier was always a supporter of EMS, not only in Forsyth County, but in the State of North Carolina, serving for many years as the Vice-Chairman for the North Carolina EMS Advisory Council.

In 2009, the FCEMS Department became the EMS Division of the newly created Forsyth County Department of Emergency Services.

In 2012, FCES took delivery of a one-of-a-kind (at the time) ambulance bus. Designed to transport 21 stretcher patients at one time, or 28 ambulatory patients, FCES Bus-1 features technological advances never before seen in the mobile environment. Bus-1 was purchased with funds provided by the U.S. Department of Homeland Security.

FCES Bus-1

FCES Bus-1

Today, Forsyth County Emergency Services - EMS Division has an annual call volume that is rapidly approaching the 40,000 mark, operates sixteen (16) ambulances around-the-clock, two (2) additional ambulances during “Peak-load” hours, has an annual budget of $11.8M and collects approximately $8.25M a year in ambulance revenue. Just as it has since 1968, FCES prides itself on being a leader in the EMS industry by providing the best pre-hospital emergency medical care available in a compassionate and cost-efficient manner. The “Road to Excellence” has been long and arduous. However, with the commitment of numerous dedicated employees, success was never optional. It is this same commitment, demonstrated everyday by every FCES employee, that will ensure that FCES remains a leader and meets the many challenges of tomorrow that face the EMS industry.