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What If Amazon Ran EMS


In my opinion provides some of the best service of any company in business today.  It is rare that I have a problem with items that I have ordered from them, when they do occur; their customer service in correcting the problem has always been outstanding.  That got me to thinking…what if EMS was delivered via some of the same core principles that guide Amazon.  Here are just a few of their core principles as posted on their website.

Customer Obsession

Leaders start with the customer and work backwards. They work vigorously to earn and keep customer trust. Although leaders pay attention to competitors, they obsess over customers.

As prehospital medical care providers, we should always keep in mind that we exist, solely, because the patient needs us.  As in the above core principle, we should be working harder to be able to provide a better quality of service than we provided yesterday.  You may not feel that this is your job, but I would point you to hospitals that are making strides at making the “patient experience” a better one.  Maybe you don’t have any competition, so why would you need to put forth the extra effort?  The problem is, you do have competition as you are in a contest with every other department in your government hierarchy who is trying to get all of the dollars that they can.  I never hurts to have a patient speak to a local political leader on your behalf.  The customer (patient) isn’t always right…but they are ALWAYS the customer (patient). 

Invent and Simplify

Leaders expect and require innovation and invention from their teams and always find ways to simplify. They are externally aware, look for new ideas from everywhere, and are not limited by “not invented here". As we do new things, we accept that we may be misunderstood for long periods of time.

Why is it that we have a tendency to resist the future?  Slipping into a comfortable routine requires much less time and energy.  Looking at the problems that currently facing EMS and simply wringing our hands will lead to no solutions and a worsening of the problem.  We all have opinions and that is fine…as long as we remember that is just what they are…opinions.  We need leaders like those that broke the ground for our profession beginning in the 1960’s and 70’s.  It was they who came up with the crazy idea that the American public needed a new form of prehospital care…something much more than a fast ride in the back of a hearse.  We are the masters of thinking on the fly when comes to dealing with a difficult patient presentation.  We need to take that same kind of rational into the future of EMS.  

Insist on the Highest Standards

Leaders have relentlessly high standards - many people may think these standards are unreasonably high. Leaders are continually raising the bar and driving their teams to deliver high quality products, services and processes. Leaders ensure that defects do not get sent down the line and that problems are fixed so they stay fixed.

I used to wonder as to why agencies would do their own prehire testing of their paramedic applicants.  Once I got into management, I quickly learned why! Simply because a paramedic or EMT has a card does not meant that he or she is a competent provider.  In day time in which it is becoming increasingly more difficult to find paramedics for ambulances, it is certainly understandable as to the temptation to reduce standard so as to have a “butt in a truck”. As a former EMS manager, who is much more effective as an educator than a manager, I can certainly understand the pressure and temptation that this places on leaders.  However, these same leaders much keep in mind that they are going to have to manage these same, sub-par responders bring along all of the problems that they always do. 

In conclusion, my colleague and fellow faculty member in the Eastern Kentucky Department of Paramedicine, David Fifer, is one of the most intelligent people I know.  In a recent social media posting, he wrote, “This sometimes gives my faculty colleagues a bit of heartburn, but I'm actually very forthcoming in saying that you should not attend our program if your desire is simply to complete a good Paramedic program: we're too expensive, too lengthy, and quite frankly there are probably better Paramedic programs out there...I cannot honestly say that there aren't programs with higher first time pass rates.

You should only attend our program if you're looking for a good Paramedic program AND the experience of having your beliefs challenged, your values examined, your ideas tested, your communication skills developed, your research abilities honed....the things that differentiate a "Paramedic program" (found all over the place) from a bachelor's degree in EMS (found very few places). It's that second thing that I think we truly do better than just about anyone.

You can go lots of places and learn how to intubate and interpret EKGs and start IVs and select the right med for the right condition. I know lots of Paramedics who can do those things very well. I know very few Paramedics who can also analyze a study, write a grant, speak well to the media or the city council, or build a program from scratch. With one or two exceptions, those people have all graduated from college.”  Within our paramedic degree program, we seek to bring responders to the next level.  This should not be relegated to only university programs…any paramedic program should be able to do the same thing.  The good ole days are gone and if we were really honest with ourselves, they really weren’t that good.  We cannot use the same thinking that got us into this problem to get us out of it.  Don’t think outside the box…throw away the box!

About the author:

Dr. Bill Young began his EMS career in 1975 with a small fire department near Williamsburg, KY. They began running first responder calls long before the phrase ever existed. In addition to Kentucky, his career has taken him to Tennessee, Colorado, Georgia, and Kansas. He has served as a street medic, training officer, supervisor, state regulator, and educator. Currently, he is an Associate Professor and the Director of the Department of Paramedicine at Eastern Kentucky University.

Published on November 06, 2017

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