Your critical care pathways are already failing. The question is: where and how badly?
We identify operational failure points in STEMI, stroke, sepsis, ICU, and EMS-to-ED workflows using in-situ simulation, KPI analytics, and system stress-testing — before they impact mortality, cost, and organizational risk.
MOST Clinical Consulting Group in the Field
MOST Clinical Consulting Group conducted an operational simulation and pathway analysis engagement with emergency medical leadership in Poland. This field work supports our mission to identify critical delays, escalation gaps, handoff failures, and implementation-readiness issues in high-acuity clinical pathways.
Where We Detect Operational Failure Points
We measure workflow degradation across clinical pathways and operational systems, identifying failure points before they impact mortality, costs, and organizational risk.
Clinical Pathways
STEMI & Cardiogenic Shock Escalation Failure
Identifying delays in recognition, PCI activation, and critical-care transfer coordination
Stroke & LVO Workflow Failure Points
Measuring thrombectomy routing delays, imaging bottlenecks, and transfer decision velocity
Sepsis Escalation Delays
Detecting recognition gaps, vasopressor initiation delays, and ICU access friction
Trauma & Massive Hemorrhage Operations
Testing bypass activation, blood product access, and trauma team readiness under pressure
Pediatric Emergency System Stress
Assessing transfer center routing, equipment readiness, and escalation hesitation in pediatric crisis
Operational Performance
EMS-to-ED Handoff Failure
Measuring notification timing, receiving preparation quality, and bed assignment friction
ICU Escalation & Bed Flow Logistics
Identifying ward-to-ICU transfer delays and escalation ownership gaps
MedTech Integration & Workflow Breakdown
Testing device adoption barriers, training-practice gaps, and workflow disruption under real conditions
Communication Failure Under Pressure
Detecting hierarchy hesitation, leadership clarity gaps, and escalation message breakdown
MCI & Disaster Readiness Stress-Testing
Validating surge capacity, command structure clarity, and inter-agency coordination reliability
What Traditional Training Never Detects
Most simulation programs evaluate clinical knowledge.
MOST evaluates system performance under pressure.
We Measure
- • Escalation delays — time from recognition to action
- • Handoff information loss — what critical data disappears during transitions
- • Decision overload — where teams freeze or hesitate under pressure
- • Communication failure points — where messages don't land or get misunderstood
- • Workflow degradation — how real protocols differ from daily practice
- • Operational readiness under stress — team and system resilience when it matters most
The Result
You leave with quantified operational intelligence, not opinions or recommendations. Your leadership team understands exactly where the system breaks, how often it breaks, and the clinical and financial impact of not fixing it.
This is how you make evidence-based decisions about operational change.
From Failure Detection to Operational Change
Every MOST engagement includes actionable intelligence for leadership decision-making.
Executive Report
Board-ready summary with findings, risk prioritization, and recommended actions
KPI Analysis
Quantified baseline metrics: escalation delays, handoff quality, decision velocity, protocol adherence
Failure Point Mapping
Visual bottleneck identification showing exactly where workflow breaks under pressure
Risk-Priority Matrix
What to fix first: clinical impact × operational feasibility
30/90-Day Operational Action Plan
Strategic roadmap: immediate operational fixes (30 days) → system-level optimization (90 days)
30 Days
Immediate Operational Fixes
- ✓ Quick protocol clarifications
- ✓ Escalation pathway adjustments
- ✓ Communication template fixes
- ✓ Leadership clarity actions
90 Days
System-Level Optimization
- ✓ Workflow redesign and testing
- ✓ Technology/tool integration
- ✓ Team coordination patterns
- ✓ Operational resilience validation
Diagnostic Leadership Built on Clinical Operational Expertise
Each engagement is directed by leaders with deep in-situ diagnostic experience and clinical operations background. Leadership focuses exclusively on operational diagnostics and measurement—not training, not consulting theater.
Robert Trzepizur, RN, BSN, FP-C, NRP
Critical Care Transport Nurse and Flight Paramedic with 20+ years of experience in high-acuity systems. Specializes in cardiogenic shock, advanced circulatory support (Impella, IABP, ECMO), and time-critical interfacility transport.
As Founder of MOST Clinical Consulting Group, he focuses on operational diagnostics of clinical pathways—identifying delays, escalation failures, and system-level bottlenecks across EMS, ED, and critical care. His work translates frontline performance into measurable, executive-level insights that drive faster decisions and better outcomes.
Dual U.S./EU citizen, fluent in English and Polish.
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Michael Czekajlo, MD, PhD, MSc
Michael Czekajlo, MD, PhD, MSc, is a board-certified critical care physician, Fulbright Scholar, and healthcare economist with over 25 years of experience in simulation, including in situ process improvement.
He has served as National Faculty for the U.S. Department of Veterans Affairs and is a Professor at Poznań University of Medical Sciences. A published researcher, he brings deep expertise in bridging U.S. and Polish medical education, clinical operations, and healthcare system design.
At MOST Clinical Consulting Group, he provides academic leadership, research alignment, and institutional access—ensuring that operational findings are clinically rigorous, evidence-based, and aligned with international standards.
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Scot Phelps, JD, MPH, NRP
Scot Phelps, JD, MPH, NRP, is a nationally recognized expert in EMS systems, crisis management, public health preparedness, and high-risk operational environments. His background includes service as New Jersey State EMS Director, Assistant Commissioner of Health for Emergency Management for the City of New York, and academic roles in public health, emergency medicine, public administration, and emergency management.
His work spans healthcare systems, government agencies, emergency response organizations, and paramedicine education, with a focus on decision-making under pressure, system resilience, and operational readiness.
At MOST Clinical Consulting Group, he provides strategic advisory on risk, policy, crisis operations, and system-level failure analysis—ensuring that operational findings translate into actionable leadership decisions at the executive level.
LinkedIn ProfileIf your pathway fails under pressure, you will not see it in a report. You will see it in outcomes.
MOST Assessment
Operational Pathway Risk Assessment
Which pathway or operational workflow would you like to assess?
Clinical Pathways
Operational Pathways
Note: Select a clinical or operational pathway to begin the assessment. Questions will adapt based on your selection. Estimated completion time: 5-7 minutes.
Current Implementation
MOST completed its first field pilot on May 6, 2026 with Pogotowie Ratunkowe in Sosnowiec, Poland. The pilot focused on high-acuity pathway performance under pressure, including escalation, handoff quality, decision ownership, and interfacility transfer readiness.
This was the first live deployment of the MOST operational diagnostic model in a real service environment. Final analysis and formal reporting are currently in progress.
What this demonstrates now
- • Real-world institutional deployment
- • Live operational observation in a functioning EMS environment
- • Structured data collection across critical pathway domains
- • Executive reporting process underway
Formal case findings and quantified results will be published after report completion and client approval.
Frequently Asked Questions
Get answers to common questions about the MOST Clinical Pathway Diagnostic Engagement and in-situ simulation methodology.
Book a 20-minute scoping call
Tell us the pathway, transfer problem, or implementation risk you want to assess. We will review your inquiry and respond within 2 business days.
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Ready to see where your pathway actually breaks?
Response time: We typically respond within 2 business days. If your situation is time-sensitive, please note that in your message.
What to expect: We'll review your inquiry, confirm fit, and schedule a 20-minute scoping call to understand your pathway, operational risks, and timeline.