Introduction to U.S. EMS Agenda 2050

Upon reflection over my past few years, thinking about the future is truly a unique experience. It allows for one to wander within the limits of your own creativity. It also potentially allows the stresses and fear of uncertainty to fester and experience the uncomfortable feelings of leaving what is known today. Ironically, the issues and conflicts we are experiencing today are somewhat comforting. Within the potentials of thinking about the future, is a real opportunity for a dialogue to envision a future and forming the guide to get there. This is essentially what a U.S. EMS Technical Expert Panel (TEP) of ten have done over the past two years. This letter is to introduce an overview of EMS Agenda 2050 as a spark for a global audience to reflect, think about their future of EMS, and engage in their own dialogue. In short, EMS Agenda 2050 is a guiding document for U. S. EMS, which was federally funded and supported. It follows the original 1996 federal document Emergency Medical Services for the Future, which was tasked with crafting a vision for U.S. EMS. Generally speaking, the Agenda 2050 process had two goals beyond articulating a vision. It was to be heavily influenced by the EMS profession and was to be a unifying document. Two strawman documents were used to spark thought, reaction, and feedback. Four in-person regional meetings were held utilizing a world café format with probing questions to facilitate dialogue and capture input. Smaller sessions were held at national and state conferences. Digital initiatives were launched with the assistance from national EMS organizations to submit feedback. National EMS organizations also designated liaisons to engage in the Agenda 2050 process. Captured feedback was continuously reviewed by the TEP throughout the process. EMS Agenda 2050 formed around a central value of being people centered. The word people was intentionally used with a broad and inclusive context in mind. This allowed for the document to be formed around a vision that was not limited to being patient, provider, or community centered. The value helped to form six guiding principles: Inherently Safe and Effective, Integrated and Seamless, Reliable and Prepared, Socially Equitable, Sustained and Efficient, and Adaptive and Innovative. The principles were not presented in a particular order of importance. All of the guiding principles formed with a people centered mindset and were rooted in feedback and professional passion. Inherently safe and effective focused on all systems of EMS embracing a culture of safety with practices that reduce harm and yield good outcomes. All of which support meaningful technology and policies that reduce safety risks in EMS. Integrated and seamless described strengthening the bridge between EMS and healthcare services and systems beyond just the local ER. Included, a more collaborative system of medical oversight and network of resources, professionals, and partners in public safety to deliver care and preparedness. Reliable and prepared in EMS set a vision for adequately staffed by a compensated workforce that is holistically well cared for. Another component articulated a need to reduce variability amongst EMS systems, shifts, and communities in order to provide more consistent evidenced based care. The socially equitable principle advocated how the setting where an individual receives care ought to have a minimal impact on the quality of care provided and their outcomes. All demographics and patient profiles ought to receive consistent high-quality care. Sustainable and efficient defined EMS as an essential service with allocated resources based on needs, system design, and improving patient outcomes. Adaptable OPEN ACCESS ARTICLE