Intro.1.0
About Professional Ambulance Service

What We Do

Professional Ambulance (PRO) provides emergency medical services (EMS) to the City of Cambridge, Massachusetts in conjunction with the Cambridge Fire, Police and Emergency Communications Departments. Additionally, we provide EMS to Harvard University and the Massachusetts Institute of Technology. PRO has proudly served the citizens, students, and visitors of Cambridge for over 35 years.

Bordered by Boston, Somerville, Arlington, Belmont, and Watertown; Cambridge is approximately six square miles with the country's fifth highest population density. Ethnically and culturally diverse, the resident population of 100,000 swells to nearly 400,000 during the day. The City of Cambridge is a bio-tech center with six miles of riverfront, over one-hundred hi-rise structures, and 5 mass transit stations including a commuter rail that traverses the city. Three universities, two colleges, three hospitals, and a 900,000 square foot shopping center also call Cambridge home.

Relatively small in size, PRO staffs a fleet of 10 ambulances with fifty field providers. Our paramedics and EMTs work in a tiered system utilizing both basic life support (BLS) and advanced life support (ALS) ambulances supported by state-of-the-art technology including automatic vehicle location (AVL), global positioning system (GPS), computer aided dispatch (CAD) and LIFEPAK 12 cardiac monitor/defibrillators. PRO's ongoing Continuous Quality Improvement Program mandates retrospective review of 100% of calls and includes monthly M&M rounds with medical directors. PRO's Staff Development program is dedicated to providing training and support to all field providers. Annually, we respond to over 19,000 calls including over 14,000 emergencies.

Mission

To Provide Superior Emergency Medical Services From Our Patient's Point of View.

PRO is committed to delivering high-performance ambulance service by achieving the highest levels of:

• Clinical Excellence;
  
  
• Response Time Reliability;
  
  
• Economic Efficiency;
  
  
• Customer Satisfaction; and,
  
  
• Employee Satisfaction.

PRO will measure all of these system elements from the perspective of our patients, customers, and employees while working continuously to improve on each and every one of them.

Management

Larry Stone, President- As the founder and President of Professional, Larry is the driving force and conscience of the company. Larry is an EMT, Emergency Medical Dispatcher, and regularly participates in company training and continuing education. He is always accessible to the staff as well as the people and the entities that PRO serves. Larry has continuously maintained his office space in accessible areas enable him to interact with the staff and remain a part of daily operations. Larry has been recognized by many community organizations for his unwavering commitment to the community he serves. He has been featured in JEMS and the Boston Globe for his work in EMS.

Bill Mergendahl, CEO- Bill has been with Professional since 1987 and has served in his current position since 1990. He is responsible for all aspects of the daily operation and administration of the company and continues to work as a field provider. Bill has extensive experience in reimbursement and regulatory issues. Continuously involved in EMS system issues, Bill participates in state, regional and local committees, including the Statewide Diversion Taskforce and the Cambridge LEPC. Currently he serves on the Board of Directors of the Massachusetts Ambulance Association and the Metro Boston EMS Council. Bill holds a law degree from Northeastern University School of Law and is a paramedic.

Rachid Sbay, Director of Operations- Rachid has over 14 years of EMS experience and has been involved with PRO in various roles since 1993. Rachid originally began working as an EMT and he has been a paramedic for over 11 years. First, as a Field Supervisor, Rachid served as a presence in the field for both patients and providers. In his current role, he is responsible for all administrative duties within the operations function, as well as all field operations.

Keri Cook , Director of CQI- Keri has been with Professional in various capacities since 1989. She is a paramedic and assumed her current position in 2006. Keri is responsible for all aspects of PRO's Continuous Quality Improvement Program. In this role, Keri reviews all patient care reports, collects clinical data, and manages several special projects. Keri also coordinates the hiring process at PRO interviewing all candidates. Keri manages these programs while still continuing to serve as a field paramedic.

Laura Terry, Director of Administration- Laura has over 10 years of communications experience that she brought with her to PRO. She is responsible for PRO’s dispatch function and Communications CQI Program. Laura also plays another vital operations role in coordinating the schedules of all field providers.

Teresa Cruz, Director of Reimbursement- Teresa has been with Professional since 1990. She has served in her current role since 1993. Teresa is responsible for all aspects of the accounts receivable function at PRO. She coordinates the office staff and has implemented all of PRO's initiatives in electronic billing and collections. Teresa has often served as an experienced resource for outside entities with questions regarding EMS billing issues.

Service Area

Cambridge EMS System

In the summer of 2003 PRO and CFD, with the support of Cambridge Emergency Communications and South Middlesex EMS submitted a proposal to develop a model EMS system based on our unique public/private partnership. At that time the current EMS system had served Cambridge well. As the system evolved with increasing call volume and preparedness becoming a preeminent issue, it was apparent that CFD should begin providing ALS level care to address the myriad situations that the City of Cambridge could be confronted with. The addition of CFD ALS resources to an already high functioning EMS system represented an opportunity for Cambridge to increase the level of emergency care being delivered to its citizens. The new EMS system would serve as a model predicated on focus and flexibility.

In Spring 2005, after months of preparation, the new system went online. The system is based on the deployment of multiple, one paramedic (P/B) staffed resources and has proven to be highly effective. Participants focus on what they do best; CFD focuses on rescue, mitigation, and ALS first response to an incident as PRO focuses on ALS patient care, patient transport, and EMS system functions.

This flexibility allows for delivery of the highest level of care to patients, in the most efficient manner with ALS reaching virtually every emergency patient in one of the busiest service areas in Massachusetts. In the vast majority of cases, we are better able to staff to the condition of the patient by providing two paramedics at the scene and two paramedics in the back of the ambulance to care for the highest acuity patients.

The effectiveness of Cambridge EMS relies on the presence of several key elements, all vital to the provision of the highest level of quality EMS for any community. These elements are derived from the NHTSA EMS Agenda for the Future. They are:

• Integration of Health Services
  
  
• EMS Research
  
  
• Legislation and Regulation
  
  
• System Finance
  
  
• Human Resources
  
  
• Medical Direction
  
  
• Education Systems
  
  
• Public Education
  
  
• Prevention
  
  
• Public Access
  
  
• Communications Systems
  
  
• Clinical Care
  
  
• Information Systems
  
  
• Evaluation

Specific elements and roles related to emergency responses within the Cambridge EMS system are:

Emergency Medical Dispatch - Cambridge Emergency Communications Department: Trained Emergency Medical Dispatchers (EMDs) provide call-taking, dispatch to fire and rescue units, CAD entry, and pre-arrival instructions.

ALS and BLS First Response and Rescue - Cambridge Fire Department

Engine / Ladder Companies: Staffing: 3 - 4 firefighters trained to the BLS Level. Firefighters provide rescue, initial on-scene triage, and initiate medical care at the BLS Level (first responders and/or EMTs) utilizing SAEDs and BLS equipment.

Rescue Company: Staffing: 4 firefighters including at least one Firefighter/Paramedic. Firefighters with highly specialized training provide specialized rescue, fire suppression, hazmat response, special details, etc., and initiate medical care at the ALS level utilizing a full complement of ALS and Rescue equipment. Rescue is also a transport capable ambulance during times of extreme system demand.

Squads: Staffing: 2 Firefighters, at least one Firefighter/Paramedic. Firefighter/Paramedics and firefighters with highly specialized training provide medical care at the ALS level, specialized ALS rescue, fire suppression, hazmat services, etc., utilizing a full complement of ALS and rescue equipment.

ALS and BLS Transport - Professional Ambulance Service

Paramedic Ambulances: Staffing: 2 Paramedics or 1 Paramedic & 1 EMT initiate, continue and/or assume medical care, relieve front-line fire rescue personnel for additional responses, and transport patient to the hospital.

Basic Life Support Ambulances: Staffing: 2 EMTs. In periods of peak demand, two EMTs initiate or continue medical care, relieve front-line fire rescue personnel for additional responses, and transport patient to the hospital.

Medical Direction

South Middlesex EMS (SMEMS) has provided every aspect of medical oversight playing a vital role in quality assurance and education since the inception of ALS in Cambridge and surrounding communities. Drawing on the resources of several area hospitals including Mount Auburn Hospital and Cambridge Health Alliance, SMEMS has established itself as a medical control entity of the highest caliber. Dr. Gary Setnik, SMEMS Medical Director, and John Conceison, SMEMS Executive Director, have been a part of SMEMS leadership since its inception. It is through their expertise and experience, and the expertise and experience of each and every medical control physician in the system, that outstanding medical oversight and physician resources have always been available.

Longstanding formal relationships currently exist between all Cambridge EMS entities and field providers and SMEMS medical control. SMEMS requires specific credentialing for all ALS field providers and medical control physicians. Monthly SMEMS ALS M&M Rounds are well attended by both Cambridge EMS field providers and medical control physicians. CFD, PRO, and SMEMS offer a combined total of over 100 hours of OEMS approved free EMS continuing education, every year at convenient times and locations. Refreshers and recertification classes are also readily available and accessible to all.

Intro.2.0
PRO's History

Larry Stone and Chester Eskholme founded Professional Ambulance Service in 1969. Both men had strong ties to the Cambridge-Somerville community with Larry bringing medical experience from having served aboard a Naval Hospital ship during Vietnam. Their combined knowledge of the area and the fact that they were two of the only 500 certified Emergency Medical Technicians in Massachusetts created a perfect match for starting an ambulance company. With a single ambulance and an office on the Cambridge-Belmont line, Larry and Chester proudly served all communities that requested their assistance.

Eager to grow, PRO signed an agreement with the City of Cambridge in 1972 to provide back-up ambulance services to the Cambridge Fire Department. With the addition of a second ambulance that year they began to focus their attention on the Boston area. PRO transported patients for Boston City Hospital, multiple nursing facilities, and private residents. The increased call volume necessitated additional ambulances and a second location.

By 1973, Larry and Chester opened another location in the City of Boston. They wanted to serve Boston's larger facilities, specifically the Children's Hospital. At this time EMS was still in its infancy and few providers were capable of handling specialized transports. The Children's staff needed to transport critically ill or injured children from outlying facilities back to their hospital for proper care. PRO solved the staff's dilemma by building a custom ambulance for these transports, thereby securing the Children's contract.

Throughout the years, PRO recognized steady growth despite increased competition from new providers. PRO's reputation as an EMS leader in the Metro-Boston area was well earned and established by 1979. Even then, Larry and Chester were still regularly working as partners on an ambulance. Tragically, Chester suddenly passed away from an aneurysm in 1980 leaving Larry as the sole owner of the business. At this point, Larry brought in his wife Cathy to provide administrative and business support. Eventually, Larry and Cathy would also bring in their three daughters to serve in PRO's billing department.

In 1986 PRO initiated its Advanced Life Support (ALS) service. Standing orders, online medical direction, and physician oversight were all handled by a newly formed association of area hospitals, South Middlesex Emergency Medical Services (SMEMS). Physicians from The Cambridge Hospital and Mount Auburn Hospital provided medical control for the paramedics working on the ALS ambulances. By 1988, ALS was available 24 hours a day, 7 days a week. In 1990 Bill Mergendahl, an EMT and dispatcher at PRO throughout his undergraduate years at Boston University, assumed responsibility for daily operations. Throughout the 1990s business continued with a growing focus being placed on City of Cambridge programs for the elderly, youth and under served. During this time, Bill evolved into his current role as CEO with Larry as PRO's President. Recent years have seen dramatic changes in EMS and at PRO.

After the tragic events of September 11, 2001 a renewed emphasis was placed on emergency preparedness. PRO extended its commitment to training and education within the community. In early 2002 PRO began what would become a continuous project to update antiquated systems and equipment taking advantage of state-of-the-art technology whenever possible. These changes enabled PRO to redouble and formalize its efforts in the areas of Continuous Quality Improvement (CQI) and Staff Development. On April 1, 2005 the already unique symbiotic public/private partnership between PRO and the Cambridge Fire Department was greatly enhanced as the Cambridge Fire Department initiated its ALS service.

Today, PRO is still a family owned and operated organization. Several dedicated, long-time employees have helped PRO retain its unique character during a period of ambulance service consolidation and companies becoming more "corporate". Just as in 1969, the patients and employees are treated as family and the equipment is maintained as if it were their own. More than anyone, Larry knows what it's like to work on an ambulance and understands how important it is to appreciate your job. You'll still find Larry working on an ambulance at a charitable event, a community function, or even a local football game, imparting his values to every newly hired employee.