First, maintain open lines of communication with your EMS services. Each service is attempting to implement the required training and administrative pieces over the next few months as quickly as possible. Unfortunately, due to the additional training requirements, some services will be capable of using the newly expanded PIFT scope of practice before others. However, paramedics with prior versions of the PIFT training can continue to transport patients using only those 19 medications as before until June 30, 2007.

Second, realize that this is a learning process for the paramedics, services, and the hospitals involved. Patience and cooperation are the keys to success.

Third, ask questions of your EMS service chiefs about when and how they will be implementing this program.

Forth, remind your staff that the paramedics will be asking for additional paperwork, more in-depth patient reports, and clarification of orders for a specific reason- it is required as part of the stability assessment that must be completed before a PIFT transfer can occur.