EMS Insider, Expert Advice

Is that a Fork in your Toaster?

Recently, there have been several news articles related to an interesting new public safety software designed for police agencies. This software disables all but the mapping and GPS functions of the mobile data computer (MDC) when an ambulance is operating over a certain speed. This has the potential to be a significant safety advance for those of us who drive emergency vehicles with computer screens that compete with trees and pedestrians for our attention.

One of the biggest challenges as a leader is determining the probability that the defenses we put in place (policies, protocols, safety guards, etc.) will prevent a bad outcome. While it’s possible to use fancy science like fault trees or Boolean algebra to predict how well something will work, for most of us who work with front line employees, intellectual honesty and understanding how conflicting values drive front line behavior will decrease the chance of harm.


Have you ever put a just a-bit-too-large bagel in a toaster? What did you do when the dinger went off and the pop up thingy popped, but no bagel came out? When a toaster manufacturer designs a product, they conduct a failure mode event analysis (FMEA) to determine how the equipment will eventually fail. This is a process that is conducted on nearly every product that makes it into the marketplace. However, the standard FMEA is associated with “work as planned,” in other words, people using the toaster as it was designed. What no one expects, or really plans for (except for the warning sticker on the bottom), is the customer sticking a fork in the toaster to remove their bagel. The expectation is that you will read the manual, heed the warning stickers and never stick a fork inside while it’s plugged in. Those of us in EMS know this unrealistic expectation as “job security.”


Reading the comments written by police officers on web articles about the software that makes their computer a “GPS map only” over, say, a speed of 10 mph, we learn that this obvious solution is not as simple as we might think. It would likely decrease inattentive driving and the risk of a crash. However, the officers see a different set of risks. Are there bad guys with guns running from the scene they are responding to, an ill-mannered dog that has not been fed for a week on a chain in the front yard, or someone with a bad cough and a recent diagnosis of TB in the house?


In your FMEA, is it possible to address multiple possible failures (crashes, getting shot, exposure to dogs or bacteria) simultaneously? What values are in play when making this decision? Is it possible to have a GPS map that helps makes a quick response possible, a method to keep responding officers informed in near-real-time of other dangers, and a system that keeps eyes primarily on the road to minimize the risk of crashes? Great question, but what I’d tell you is that the average street officer perceives the primary risks to be an informed arrival and getting to the scene in time for an effective intervention. Most officers will say that they already drive safely because they have not crashed. Managers will point to crash rates that are too high as evidence that there needs to be a change in the systems that provide safety.


We will become safer when we start actively looking for these value conflicts then addressing them head on. This needs to happen before investing in new technology or writing new policies that try to govern behavior on the front line. The next time someone presents a new idea or a new piece of technology, you might ask: What would happen if we stuck a fork in it?