RALEIGH — Regina Godette-Crawford had a newly minted business degree when she got a job inspecting ambulances in 1985.
She didnt expect to spend much time in the world of emergency medical services.
I thought of it as stepping stone, Godette-Crawford says. I told people, Im not going to stay here.
Three decades later, the Craven County native has risen through the ranks to the post of chief of the N.C. Office of Emergency Medical Services, overseeing nearly 40,000 men and women who respond to about 1 million medical emergencies across the state every year.
Godette-Crawford, 50, has aided the offices transformation from a loosely aligned collection of largely volunteer groups into a highly trained force of which roughly 70 percent are professionals.
And now, shes leading the states paramedics in another major movement, toward a focus on preventative care that will keep more patients out of emergency rooms, saving time and money at a time when many uninsured citizens rely on emergency care.
Its not the business career she imagined. But Godette-Crawford says shes been driven by a passion to see people get the best help they can at their most vulnerable moments and by a love for the dedicated paramedics across the state who share that passion.
EMS is like a brotherhood, she says. You dont do it for the salary. Its a job thats near and dear to your heart, that comes from the compassion to help people.
Those who know her say her leadership style combines a relentless focus on making EMS more effective and efficient with a deft understanding of how to work with a wide variety of people.
She has such a passion to give patients all the best possible care, says Kim Sides, a compliance officer with the state office, who has worked with Godette-Crawford for decades. If there were an ambulance that needed to be inspected today, or a phone that needs to be answered, she would do it.
Joseph Zalkin, chief of professional development with Wake County EMS, says Godette-Crawford has supported a variety of innovative practices, in particular the preventative approach to EMS that Wake County is currently using.
Since she has taken the office, she has been sensitive to gathering stakeholders and looking beyond the box at issues affecting EMS systems, says Zalkin.
Godette-Crawford grew up in the coastal town of Havelock, the youngest of four children. Her father worked at the Marine Corps Air Station Cherry Point base repairing planes while her mother cared for their children on a farm with pigs and chickens.
She was a first-generation college student, and initially attended Winston-Salem State University. But she was so homesick and taken aback by city life that she quickly transferred to East Carolina University.
While she didnt plan to devote her life to EMS, she now lives and breathes it. Any conversation seems to veer back to a mix of acronyms, state statutes and credentialing procedures.
Its a field that has long struggled for recognition. There is still no federal EMS office, and the pay remains low.
Yet its adherents are dedicated. Many families have responded to emergency calls for generations, and Godette-Crawford says the average paramedic has a career of 35 years.
Her own long career has included nearly every aspect of EMS other than actually responding to calls.
She started as a regional coordinator, and has spent entire weekends grading paramedics as they performed CPR and splinting. Shes conducted disaster response exercises and fielded calls from grieving parents.
Her field was transformed after the terrorist attacks of Sept. 11. The profile of paramedics was raised, and local offices were infused with grant money to boost their ability to respond to attacks.
In 2003, Godette-Crawford was tapped to lead the states effort to strengthen its emergency preparedness infrastructure using a $13 million federal grant, including the creation of a mobile disaster hospital.
It was fast-paced work, she says. And it helped broaden our scope. Weve always had a role in response and recovery, but this enhanced the profession and paved the way to introduce other things.
By 2005, she had come to the state office as assistant chief. She became interim chief in 2010 and chief in 2011.
The state doesnt dictate policy to local EMS offices, but creates standards and helps disseminate new ways of doing things.
In that sense, Godette-Crawfords job is a mix of helping local offices correct mistakes and urging them to adapt practices to be more efficient.
She says her job is all about maintaining relationships, not only with local EMS groups but also with hospitals, local governments, national groups, lawmakers and more.
Its about a good business plan and my love of people, she says.
Instituting better practices
Since taking over as chief, she has sought out new methods and ideas, from using vending machines to replace equipment quickly to creating local teams to evacuate hospitals in an emergency.
One ongoing initiative is a program to treat EMS workers with substance abuse problems an issue that often crops up when they become addicted to pain medication after work-related injuries.
It can happen to anybody, Godette-Crawford says. We saw this as an opportunity to return them to the workforce as quickly as possible.
This year, her main focus is preventative care, expanding the role of EMS units to care for patients on site or to connect them with resources other than hospitals often the most expensive treatment option.
The idea is to make ambulances more like traveling clinics than just transportation that has the equipment needed to get a patient to the hospital. Paramedics can also talk to patients about how to treat chronic conditions such as diabetes, and perform routine checks on blood sugar or blood pressure.
Some of these frequent flyers dont have the intention of abusing the system, but they need the care, she says. Part of health care reform is to make sure we educate people on whats available to them and how they can use other measures and not tax the system.
Wake County has diverted more than 200 patients from emergency rooms under its program, saving more than 3,000 emergency room bed hours. Godette-Crawford says some systems nationally have reduced call volume by as much as 30 percent.
In addition to saving money, she says, the change will forge a crucial role for EMS in a health-care landscape that is rapidly changing as the Affordable Health Care Act is implemented. She unveiled the program to local agencies at a meeting in February.
An evolution is happening to be more proactive than reactive, Godette-Crawford says. Some people saw the health care act as a monster or something you need to be threatened by. I say, Why not identify the gaps and use that as an opportunity to expand our role?