Research Citation:
National EMS Museum People Files. NEMSM-0003. Jack Stout Collection
Copyright:
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Jack Stout
(1944-2020)
Jack L. Stout is known in the EMS industry as the Father of High Performance EMS and System Status Management. Jack’s concepts were developed in the 1980’s as an answer to fix failing EMS systems that were expensive, unreliable and didn’t meet EMS’s prime directive of:
“Provide each critical patient the best possible chance of survival without disability or medical complication, given the current state-of-the-art of prehospital care technology”
An economist by trade, Jack found that applying the science, concepts, economics and techniques used in manufacturing to a service industry produced an unprecedented ability to provide high quality, highly reliable EMS systems that could also afford to provide the best prehospital medicine available.
Frequently controversial, Jack’s approach also maintains that free market competition in the EMS environment is dangerous as Jack recognized that demand for EMS services is not effected by the normal market forces of supply, price and quality, but rather is based purely on mostly uncontrollable factors like population age, socioeconomics, health, education, culture, location etc. Given this, free market competition actually hurts patients as competing EMS agencies (that are typically geographically constrained to a certain service area) share a fixed demand for these services and therefore also share a fixed reimbursement pool that can not expand based on the supply of EMS resources. This, plus the fact that open market competition drives down prices, creates an environment of uncoordinated care, loses economies of scale, can not provide reliable and consistent service and is unable to provide the best clinical sophistication due to the economic conditions that occurs in these environments.
Jack’s solution to this problem was the development of the Public Utility Model (PUM) and Failsafe Franchise EMS System Designs. These approaches to service delivery provide a mechanism for cities and counties to eliminate the issues that multiple competing EMS service providers bring while preserving free market enterprise to allow to compete with each other through a competitive bid process.
Information above provided by JackStout.com
Jack Stout made his first mark on EMS with a series of writings in the Journal of Emergency Medical Services (JEMS) entitled The Public Utility Model in which he laid out his observations of a new concept in pre-hospital care system management. The Public Utility Model was conceived through a theoretical analysis of the system of pre-hospital care delivery by a team at the University of Oklahoma under the leadership of Stout. This study and the resulting reports would shape Stout’s career and ultimately help guide system development across the county. But it was, and continues to be, radical thinking, and as we move towards community centric care, Jack’s vision for EMS systems are an ever guiding light for industry leaders today.
The Public Utility Model Report and Observations were printed in three parts in JEMS in 1980, with a retrospective printed in 1985. The articles can be read here:
The Public Utility Model Part 1: Measuring Your System. 1980, May (22-25) JEMS
The Public Utility Model Part II: The Principal Elements. 1980 June (35-41) JEMS
The Public Utility Model Part III: The Major Constraints. 1980 July (35-37) JEMS
Public Utility Model Revisited: Part 1 , Origins. 1985, February (55-58, 62-63) JEMS
Public Utility Model Revisited Part 2: 10 Essential Features. 1985, March (71-74) JEMS
Tulsa, Public Utility Model Revisited: Part 3. 1985, May (58-64) JEMS
Additional publications can be found in the collection listed below.
National EMS Museum Resources
Watch Todd Stout’s Coffee with Doc session to hear about Jack’s work during his lifetime and the legacy he left behind:
In 2014 Jack Stout was honored by Jay Fitch at the Pinnacle Leadership Conference. Here is Jay Fitch presenting Stout with his Lifetime Achievement Award and highlighting many of the great projects Stout was involved in. In 2022, Pinnacle is again recognizing Jack Stout’s contribution through a special look at the Stout legacy throughout the conference.
Jack Stout Collection is being digitized by the National EMS Museum with special funding from FirstWatch & Academy of International Mobile Healthcare Integration (AIMHI).
Thank you FirstWatch, AIMHI, and the Stout Family for ensuring these important papers are preserved for generations to come!
More information about FirstWatch can be found here: https://firstwatch.net/
Additional information about AIMHI can be found here: http://aimhi.mobi/
Archival Arrangement
Below you will find a collection of Jack Stout’s published work organized by year. The month of the publication is followed by the title, page number and journal. Additional content notes are included in brackets.
To view any of the articles click on the link at the end of each line. If you are on a mobile devise you may need to download the articles to view them (click the link and select download on your devise). Should you experience any difficulty accessing or using the key word search please contact us at info@emsmuseum .org
Additional writings will be added to this list as they are digitized and indexed. Please submit written requests to copy to info@emsmuseum .org
1980
May, 1980. Public Utility Model (PUM) Part I: Measuring Your System. (22-25) JEMS Click Here to View Article
June, 1980. The Public Utility Model (PUM) Part II: The Principal Elements. (35-41) JEMS Click Here to View Article
July, 1980. The Public Utility Model (PUM) Part III: The Major Constraints. ( 35-37) JEMS Click Here to View Article
1981
September, 1981. Nightmare in Kansas City. (32-45) JEMS Click Here to View Article
1983
January, 1983. 10 Standards of Excellence: Measuring Your System. (84-91) JEMS Click Here to View Article
May, 1983. System Status Management: The Strategy of Ambulance Placement. ( 22-32) JEMS. Click Here to View Article
July, 1983. Public-Private Interface. (54-61) JEMS Click Here to View Article
August, 1983. Letters and Jack Stout reply. (11) JEMS Click Here to View Article
August, 1983. Showdown in Ft. Wayne, Indiana. (54-59) JEMS Click Here to View Article
September, 1983. Performance Security. (53-56) JEMS Click Here to View Article
October, 1983. Its Hard to be Afraid. (68-75) JEMS Click Here to View Article
December, 1983. Trauma Center ABC Style. (52-59) JEMS Click Here to View Article
1984
January, 1984. Giving the Best Edge. (103-107) JEMS Click Here to View Article
February, 1984. How Much is Too Much? (26-34) JEMS Click Here to View Article
March, 1984. State Regulations and ALS. (50-60) JEMS Click Here to View Article
May, 1984. Kansas City Revisited. (50-71) JEMS Click Here to View Article
May, 1984. Special Report: Priority Dispatching vs Call Screening. (34-39) JEMS Click Here to View Article
June, 1984. Letters: Rx for Medical Control by Jack Stout (6) JEMS Click Here to View Article
June, 1984. Fire Service EMS as Public Utility Model. (91-96) JEMS Click Here to View Article
July, 1984. Cutting the Fog in Santa Ana. (51-57) JEMS Click Here to View Article
August, 1984. Letters and Jack Stout reply. (8,11) JEMS Click Here to View Article
August, 1984. When to Say No: Eight Tips for Evaluating Ambulance Service Contracts. (46-52) JEMS Click Here to View Article
September, 1984. Contract Competition: Is Your Company Ready? (73-79) JEMS Click Here to View Article
October, 1984. Around the Nation by Dana Jarvis: Jack Stout update on Santa Ana. (28) JEMS Click Here to View Article
October, 1984. Federal Policies Promote Socialized Prehospital Care. (92-94, 99) JEMS Click Here to View Article
December, 1984. Socialized Prehospital Care, Part 2. (51-54) JEMS Click Here to View Article
1985
January, 1985. Ambulance Maintenance. (65-69) JEMS Click Here to View Article
January, 1985. 1985: A Turning Point. (105-108) JEMS Click Here to View Article
February, 1985. Public Utility Model Revisited: Part 1, Origins. (55-58, 62-63) JEMS Click Here to View Article
March, 1985. Public Utility Model (PUM) Revisited: Part 2, 10 Essential Features. (71-74) JEMS Click Here to View Article
May, 1985. Tulsa, Public Utility Model (PUM) Revisited: Part 3. (58-64) JEMS Click Here to View Article
July, 1985. Letters and Jack Stout reply. (9-10) JEMS Click Here to View Article
July, 1985. Comparing Ambulance Rates. (46-51, 54-57) JEMS Click Here to View Article
August, 1985. Please, Don’t Call it Competition. (38-43) JEMS Click Here to View Article
September, 1985. Forms of Competition. (66-71) JEMS Click Here to View Article
October, 1985. The Failsafe Franchise Model. JEMS Coming Soon
November, 1985. The Designer Dilemma. (6) JEMS Click Here to View Article
1986
January, 1986. Ambulance Systems Designs. (85-99) JEMS Click Here to View Article
February, 1986. Antitrust and You: An Overview of the Sherman Antitrust Laws, by George E. Leonard, additions by Jack Stout. (58-62) JEMS Click Here to View Article
March, 1986. Exemption from Antitrust: Limited Exemptions of the Sherman Antitrust Laws, by George E. Leonard in Jack Stout’s Interface column. (80-81) JEMS Click Here to View Article
April, 1986. Joint Ventures and Antitrust: Bringing together competitors for join ventures can be dangerous, by George E. Leonard. (66-70) JEMS Click Here to View Article
May, 1986. You Ain’t Seen Nothin Yet. (32-36) JEMS Click Here to View Article
May, 1986. What The Feds Should Know: An Open Letter to the Inspector General. (70-75) JEMS Click Here to View Article
July, 1986. No Hard Feelings. (99-100) JEMS Click Here to View Article
August, 1986. Letters: July Letters Revisited. (12) JEMS Click Here to View Article
August, 1986. Peas in a Pod. (63-64) JEMS Click Here to View Article
September, 1986. Strong Words Weak Arguments. JEMS Coming Soon
October, 1986. Why Subscription Programs. (71-75) JEMS Click Here to View Article
November, 1986. Our Elected Officials. (67-72) JEMS Click Here to View Article
December, 1986. Computer Aided What? (89-94) JEMS Click Here to View Article
January, 1987. Correction to December 1986: Computer Aided What? (11) JEMS Click Here to View Article
1987
January, 1987. Who’s Really the Primary Provider: Another View of the 150 City Survey. JEMS Click Here to View Article
May, 1987. Letters: Salary Controversies. (6 & 9) JEMS Click Here to View Article
May, 1987. Letters: The Great Debate. (13-14) JEMS Click Here to View Article
May, 1987. Was It Good For You: Ten Great Expectations for Management and Paramedics. (53-55) JEMS Click Here to View Article
June, 1987. Fire vs Private EMS. (84-86) JEMS Click Here to View Article
July, 1987. Privately Speaking About…The Battle of the Bids. JEMS Coming Soon
August, 1987. Contracting for Vehicle Maintenance. (81-85) JEMS Click Here to View Article
September, 1987. Measuring Response Time Reliability. (106-111) JEMS Click Here to View Article
October, 1987. Accreditation for What? (79-85) JEMS Click Here to View Article
November, 1987. Emergency Vehicle Driver Training : Two Schools of Thought. (80-83) JEMS Click Here to View Article
December, 1987. To Bid or Not to Bid. (65-67) JEMS Click Here to View Article
1988
January, 1988. The Inflation-Indexed Charge. (120-122) JEMS Click Here to View Article
February, 1988. Lets Dump the Prevailing Rate Approach. (63-68) JEMS Click Here to View Article
March, 1988. Organizing Quality Control in EMS. (67-74) JEMS Click Here to View Article
April, 1988. Corporate Image. (69-70) JEMS Click Here to View Article
May, 1988. Passing the Gear, by Jim Page. (5) [observation on Jack Stout system operations] JEMS Click Here to View Article
June, 1988. A Concept Worth Stealin’. JEMS Click Here to View Article
August, 1988. The EMS Subsidy: Price Tradeoff. JEMS Click Here to View Article
October, 1988. My Sector, Right or Wrong. (70-80) JEMS Click Here to View Article
October, 1988. The Black and White World of Private EMS, by Nancy Peterson. [Jack Stout quotes] JEMS Click Here to View Article
November, 1988. The Black and White World of Private EMS, by Nancy Peterson. [Jack Stout quotes] JEMS Click Here to View Article
1989
February, 1989. Letters: Jack Stout reply. JEMS Click Here to View Article
February, 1989. Controlling Emergency Fleet Operating Costs. (67-69) JEMS Click Here to View Article
April, 1989. System Status Management: The Fact Is, Its Everywhere. (65-71) JEMS Click Here to View Article
June, 1989. Wrestling with the Big Three Policy Issues. (79-81) JEMS Click Here to View Article
August, 1989. Peak-Load Staffing: What’s Fair for Personnel and Patients. JEMS Click Here to View Article
September, 1989. In the Industry: Jack Stout to USSR. JEMS Click Here to View Article
November, 1989. Charting the Path of Clinical Progress. (79-87) JEMS Click Here to View Article
December, 1989. EMS in the Soviet Union: The Granddaddy of Socialized Prehospital Care. (60-65) JEMS Click Here to View Article
1997
September, 1997. Capture the Competitive Edge, Part I. JEMS Coming Soon
October, 1997. Capture the Competitive Edge, Part II. JEMS Coming Soon
Additional Resources
A collection of Jack Stout’s writings can be found at: jackstout.com