Cardiac & Resuscitation, Equipment & Gear

Seven Golden Rules

The public really doesn’t expect much from us when you think about it. In fact, keeping the public happy is really all about the basics — things that have very little to do with technology or new and innovative procedures or drugs. It has more to do with good people skills and a positive attitude about our work.

Meeting the fundamental expectations of the public not only leads to a satisfied patient, it also makes us feel good about what we do and is a powerful means for avoiding litigation.

The public’s expectations of us won’t change, so we need to make sure our expectations meet theirs. Hiring people who truly want to meet these expectations of the public 100% of the time will make this goal achievable. To do this, we don’t need to focus as much on their technical skills. Instead, we should look for applicants with a positive attitude toward others, effective interpersonal skills and a caring, compassionate approach to patients. Spend time recruiting staff with the right attitude and outlook.

Once you’ve hired an applicant with these attributes, give them a well-defined orientation period with clearly communicated and reachable expectations. Then help them meet those expectations. If they don’t cut it after one-on-one coaching and the orientation period is over, maybe it’s time for them to consider other work. Don’t get caught wasting valuable time with people who aren’t willing to reconcile their own personal expectations to match the expectations of the public. They’ll become the weak link that will lead to complaints, lawsuits and harmed patients.

Probably 95% or more of the lawsuits we see in our national EMS practice come from failure to meet what we call the “Seven Expectations of the Public.” Let’s recommit ourselves to focusing on these basic expectations. Meeting these avoids litigation and leads to a satisfied patient and the good feeling we get of knowing that we served the public well.

1. We’ll respond promptly.This means “moving with a purpose,” and looking like you want to get to where you’re going. Drop what you’re doing when the tones go off. Get out of the recliner and promptly treat every call as if it’s the most important thing to you — that’s our duty.

2. We won’t get lost.Know your service area and travel to the scene in the most efficient and safe manner possible. Nothing is more embarrassing than going to the wrong address or getting delayed because you didn’t keep up with current street closings. You need to be able to find the location all the time, but especially in those few instances where minutes can make a difference in the patient’s outcome.

3. We’ll provide competent and compassionate care.This means we keep our skills sharp. It also means we never forget that people remember us not for the procedures we perform but for how we make them feel as a person. We need to always remember the “E” word — empathy — and put ourselves in their shoes. We demonstrate true empathy by treating the patient as we would want ourselves or our family to be treated and appreciating the patient’s perspective.

4. We’ll have working vehicles and equipment.Responding in an unsafe ambulance or showing up with equipment that is not properly functioning or is “missing” is the one of the most frustrating (and risky) things we can do. We have an obligation to thoroughly check the “tools” of our trade at the start of each shift. There’s no excuse for arriving at the scene with an empty D cylinder, a dead suction unit or, worse yet, a dead defibrillator. And many of those failures have become major lawsuits.

5. We won’t drop the patient. We must use good body mechanics and pay complete attention to all aspects of patient movement at all times. We’ve seen lawsuits where patients were dropped simply because a crew member was not paying attention and was treating the patient as a second priority — such as having one hand on the stretcher and the other hand holding a personal cell phone. Less than total attention to moving a patient gives the impression the patient is seen as nothing more than baggage to be moved from one place to the next.

6. We won’t have an accident in the ambulance.There’s no excuse for driving recklessly or causing an ambulance accident. Too many tragic ambulance accidents, which often are not really accidents at all, have happened. In northwest Ohio this past summer, five people on board an ambulance (including both patients) were killed after the ambulance allegedly went through a controlled intersection without stopping first. To avoid these senseless tragedies, we must drive defensively and with due regard for other vehicles, our patient and our partner. If we arrive 30 seconds late, no one will remember. But if we arrive 30 seconds early and kill someone in the process, no one will ever forget.

7. We won’t rip off the patient or those who pay us.Improper billing practices are more likely now in this environment of increasingly complex reimbursement. We have a duty to properly document the care we provide. This ensures the appropriate level of service will be billed to the patient or the insurer. And if we are part of a non-profit or municipal EMS agency, we are custodians of a sacred public trust and have an obligation to protect the assets of the organization. We need to have internal safeguards in place to avoid the risk of fraud and embezzlement.

Meeting these seven expectations really comes down to treating our patients and each other with respect and dignity. As the late Jim Page so aptly said, EMS is truly one of the most noble of all professions. We sometimes forget that. But where else can you find a job where you can have such an immediate and positive impact on human life? I know of no other. And if you’re having a bad day reconciling your expectations with the seven expectations of the public, consider the words of Sir Winston Churchill, “We make a living by what we get, but we make a life by what we give.” Let’s actively work to uphold the nobility of our profession by giving our patients what they deserve through meeting their needs and satisfying their expectations of us each and every time.

Steve Wirth, Esq., EMT-P, is a founding partner of Page, Wolfberg, & Wirth, LLC, the National EMS and Medical Transportation Law Firm and has been an EMS provider since age 16. He is also chair of the Panel of Commissioners of the Commission on Accreditation of Ambulance Services (CAAS). He remains in touch with field provider issues as an active member of the Hampden Twp. Volunteer Fire Co. in Mechanicsburg, Pa., where he serves as the incident safety officer and medical advisor. Steve can be reached at[email protected]