The alarm bells have been sounded by a “Who’s Who” of EMS organizations. EMS uses lights and sirens much more than is safe or indicated. The National EMS Quality Alliance is leading a variety of associations and 50 EMS systems in the first nationwide performance improvement collaborative. The focus is on improving safety for patients, providers and the public in communities across the U.S. and Canada by reducing the percentage of 911 EMS responses and transports where lights and siren are used. A host of experts are involved in this initiative, including Joey Grover, MD, Jeff Jarvis, MD, Remle Crow, PhD, Rick Ferron, Bryan Wilson, MD, Jon Krohmer, MD, Jeff Clawson, MD, Doug Kupas, MD, Brooke Burton, Jeff Goodloe, MD, and Sheree Murphy, NEMSQA’s Executive Director. This update will include a discussion about why this initiative is needed and a progress report from the leadership team.