EMS Faces a Quality Conundrum

What providers can do to improve their service & care

 

 
 
 

William K. Atkinson, PhD, MPH, MPA, EMT-P | | Wednesday, September 21, 2011


Across all of healthcare, quality is a buzz word included in most seminars, operational meetings, and advertising campaigns. Some of the quality measures in use are meaningful and deserve a growing focus on our part. It is these measures that help us determine best practices and gold standard care to deliver the best possible outcome to every single patient regardless of circumstance, and it is these measures that can help consumers make informed decisions about their healthcare.

However, not all quality data is useful. Some quality information is based on shaky methodology and incomplete data that can confuse providers and consumers alike. Red flags to determine which organizations may be providing this misleading information are those that have a conflict of interest by also offering consulting services and those companies more focused on making a profit by requiring a substantial licensing fee for the use of their logo or name. You can imagine the results from these types of organizations; hire the consultant or pay the fee and mysteriously your scores improve.

This selling of scores vs. truly impacting quality in a positive way by educating consumers and compelling healthcare providers to do better pervades a Wall Street culture that allows healthcare ethics to dwell in the gutter.

Quality Improvement
The reality is America does have a quality issue across its healthcare system, primarily because of complacency and indifference. This is a sad phenomenon because we are blessed as a country to have more resources and more opportunity for choice in healthcare than almost any place on earth with few exceptions. With choice also comes opportunity for excuses, cutting corners or waiting for others to decide how we should behave or perform.

So what’s a provider to do? My advice to everyone who provides care is simply to remember that the vast majority of healthcare providers know the difference between right and wrong, including in the delivery of care. Professionalism and quality in the U.S. and across the globe for that matter must be in part defined by the individual’s commitment to understanding quality and working to ensure it is represented in 100 percent of the care provided for every person to whom we attend.

The drive for quality care in our nation may theoretically be fostered and measured by the government and private organizations, but the real driving force behind quality and safety is and always will be with the individual caregiver. If you are truly a professional and follow clinical literature routinely and attend in-services and continuing education – not because you have to but because you understand that professionals view education as a lifelong commitment—then you likely have a good feel for what is or is not right in patient care.

I know there are healthcare providers who do the right thing because of the fear that someone else is watching or recording their actions. It is true that everything we do in healthcare today has the potential to be caught on video and distributed on Twitter or Facebook in real time. What these individuals are overlooking is that the most important video camera they need consider is their internal recorder that is capturing actions and intentions. When played back for one shift, one day or one career this recording will hopefully show a compassionate person always striving to do the right things for the right reasons regardless of the circumstances encountered. We are all aware that in emergency services the environments we operate in don’t always allow for perfect care or the time or conditions needed to ensure that nothing goes wrong. However, the one thing we can take responsibility for is our own individual actions and the professionalism that comes from self awareness and a 24 hour a day, seven days a week and 365 day a year commitment to getting it right when it comes to quality, safety and service.

In America’s 9-1-1 environment, many millions of people every year call for assistance with the assumption that the people and equipment arriving at their aid will be competent, qualified, prepared and appropriately trained to meet their needs. Regulations do help, at least in theory, to ensure that this is true. But, as was true yesterday and will be true tomorrow, it is up to you and the caregivers around you to get it right. Remember that one of the key definitions of a real professional is striving to do things right each and every time. This includes when no one else is watching, because quality and safety do matter all the time whether it is recorded, reported or not.

Take It Upon Yourself
For healthcare providers to get it right, it requires a commitment and personal responsibility from you, the caregivers around you and your patients. If quality, safety and service are going to be important measures within the new healthcare order—as it should be—we shouldn’t wait for someone else to define how to get it right, whether that be through government regulations or quality indicators defined by independent organizations.

You don’t have to be in emergency services for long to realize that life is short. As a caregiver in emergency services, you have chosen to spend large portions of your time assisting others, helping to the best of your ability. There is a lot of power in your hands —the hands of a caregiver—and with power comes responsibility to try your best each and every time you are on a call to get it right the first time.




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Related Topics: Administration and Leadership, Leadership and Professionalism, William K. Atkinson, healthcare improvement, quality healthcare, quality information, EMS providers, EMS in healthcare

 
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William K. Atkinson, PhD, MPH, MPA, EMT-Pis the president and CEO of WakeMed Health & Hospitals and a JEMS editorial board member. He has devoted more than 30 years of his career to improving our nation’s emergency medical and prehospital care system.

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