Setting Up an EMS Agency
For ambulance services, fire-based EMS divisions, inter-facility transport companies and community-paramedicine programs. The emphasis is on units and crews, controlled substances, expiring supplies and protecting patient information.
Patient data
Resgrid is not an ePCR. Keep patient care records in your ePCR system; use Resgrid calls, records and chat for dispatch, response, logistics and QA. Enrol in Advanced Data Protection if call notes or records will contain patient identifiers, and treat that as one control inside your own HIPAA program.
1 — Department settings
| Setting | Value |
|---|---|
| 24-hour time | On. |
| Staffing reset | Off (crews are on shift, not on call). |
| Require password reset via email | On. |
| Modules | Shifts, Checklists, Inventory, Records on; Maintenance with Readiness Pro. |
| Dispatch settings | Default statuses dispatched → Responding, released → Available (units already back in service or out of service keep their status); rest period 10 min; unit status timers 2 min (dispatched without en route) and 20 min (at hospital). Turn on Close call when last unit clears if crews report every status through to available, so a call closes when its last ambulance clears (details). |
2 — Types
| Type | Values |
|---|---|
| Unit types | ALS ambulance, BLS ambulance, Supervisor, Wheelchair van, Bariatric, Community paramedic. |
| Call types | By nature: Cardiac, Respiratory, Trauma, Stroke, OB, Behavioral, Overdose, Fall, Sick person, Interfacility transfer, Standby / event, Mutual aid. |
| Call priorities | If you use MPDS: Echo, Delta, Charlie, Bravo, Alpha, Omega (Echo/Delta = Emergency sound). Otherwise Emergency, Urgent, Routine, Scheduled. |
| Certification types | EMR, EMT, AEMT, Paramedic, CPR/BLS, ACLS, PALS, PHTLS, Driver (EVOC). |
| Note categories | Hospital diversion, Protocol updates, Drug shortages. |
3 — Groups, roles, statuses
- Stations: one per base/post with address and geofence (used for closest-unit selection).
- Roles: EMT, AEMT, Paramedic, Supervisor, Dispatcher, Driver.
- Custom statuses (EMS template): units — Available · Responding · On scene · Transporting · At hospital · Returning · Out of service · Posting; personnel — On duty · Off duty · Responding · On scene. Add an At station unit status with base type In Quarters so closest-unit selection measures those units from their base, and keep a status for units available on the road (base type Available, not Returning). Give Out of service the base type Unavailable or Maintenance so closing a call never puts it back in service, and give the transport statuses Transporting and At Hospital (base types and call automation).
4 — Units and crews
Create each ambulance with roles Driver/EMT and Attendant/Paramedic (both required). Use Unit staffing at the start of every shift (or from the Unit app) so the crew is known — checklists, chat DMs to the unit and accountability rely on it. Add hardware GPS tracking bindings if the ambulances have trackers.
5 — Dispatch
- Calls from your CAD by email import; or dispatchers use the Dispatch app.
- Run cards: ALS emergency (Echo/Delta): ALS ambulance ×1 + Paramedic role ×1; BLS: BLS ambulance ×1; MCI alarm level 2 adds ALS ×2 + Supervisor ×1. Closest-unit mode, Order by driving ETA on, minimum staffing Fully staffed, auto-dispatch on with a 10-minute rest period. Set In-quarters turnout and Mobile turnout (for example 120 s and 30 s) so a crew already on the road can outrank a nearer crew that still has to leave the station.
- Adding resources to a call already out (the Dispatch app's Dispatch additional resources, or Update on the website) shows what the run card still needs after the units already on the call. A unit's status in the Dispatch app starts on the call the unit is working, so dispatchers don't pick the incident for each status.
- Destinations: create hospital and ED POIs under Mapping so crews pick a destination on the call.
- Protocols: pre-arrival instruction protocols by chief complaint if you dispatch in-house.
6 — Shifts
Assigned 12-hour or 24-hour shifts per station; supervisors approve trades. Turn on Use shift for group dispatch so a station page goes to the on-duty crew only. Create matching workshifts so checklists can run each shift.
7 — Checklists
| Checklist | Target | Schedule | Notes |
|---|---|---|---|
| Ambulance start-of-shift | Unit | Each shift | Critical: drug box seals, O2 level, stretcher lock, monitor self-test. |
| Controlled substance count | Unit | Each shift | Witness required, photo on failure, Create work order on failure off. |
| Monitor / defib daily | Serialized equipment | Daily | Pads and battery expiry. |
| Station restock weekly | Group | Weekly |
8 — Inventory
- Items with lot tracking + expiration: medications, IV fluids, airway supplies; set minimum and reorder point; run the expiration alert weekly.
- Controlled substances: flag the items; every movement needs a witness; print the controlled-substance log monthly.
- Serialized assets: monitors, ventilators, stretchers, radios, tablets.
- Kits: jump bags per unit; issue to the unit at shift start.
- Purchasing: suppliers from Contacts; receive against purchase orders.
9 — Records and QA
- Activate Records with the Review required preset; use Run records for response documentation that does not belong in the ePCR, Unit activity per unit per call.
- Quality review: a rubric Run report QA (times complete, narrative matches interventions, protocol cited) sampling 10 per month.
- Restrict narrative and participant fields; enrol in ADP; set the disclosure statutory clock to your state's value.
- Analytics: response performance by call type; turnout target 60 s, travel target per your contract.
10 — Communication
- Messages with responses for shift coverage.
- Notifications: ALS unit available < 1 → supervisor; inventory alerts → logistics.
- Workflows: Call created → API call to billing/ePCR; Checklist failed (narcotics) → email medical director; Record finalized → export template to the medical director weekly.
- Chat: incident channels for handoffs; images off in general channels unless ADP is on.
11 — Workforce & Business Ops
- Certifications (free): NREMT EMT/AEMT/Paramedic and state licences as separate types (both mandatory on the Paramedic role), BLS/ACLS/PALS, annual MVR review; units: state ambulance permit, DOT inspection, registration, insurance. Enforce with a 0-day grace on licences — an expired licence must not run calls.
- Invoicing (Business Ops): rate card BLS transport, ALS transport (flat per call), Loaded mileage, Standby — event (hourly unit); billing profiles per facility and event organizer (net 30, PO number noted, tax exempt where applicable); online payments through the company Stripe account; workflow Invoice Overdue → billing manager.
- Deployment Finance / bids (Business Ops): event medical standby as a bid (ALS unit crew line × hours × days) → wizard → deployment; crews file time in the Responder app; generate the invoice after the event.
- Workforce & pay data (Business Ops + ADP): employer, establishments and job assignments for California agencies with 100+ employees; run the CRD report each spring.
See the Workforce & Business Ops overview for what is free and what needs the add-on.
First-week checklist
- Every ambulance created with two required roles and a Unit tablet
- Crews set unit staffing at shift start
- Hospital destination POIs created
- Every unit status has a base type (out of service → Unavailable or Maintenance; available → Available or In Quarters)
- Narcotics checklist with witness runs each shift
- Medication lots with expiry entered; expiration alert reviewed
- ADP decision made and, if enrolled, verification prompt tested on the Dispatch console
- Paramedic and EMT licence types enforced on the roles
- Rate card and one billing profile created; a test invoice sent to yourself