EMS: It's About Customer Service

By Warren J. Porter

When many of us entered EMS, we had the lofty goal of "helping people." We may have had no idea how we would accomplish this, but we knew that we would make a true and beneficial difference in the lives of our patients. Looking back, we can honestly say that we didn't think of our patients as customers, but, after a few years and a new perspective, we now realize that our patients are not only patients-they are indeed customers. Not only are our patients customers-everyone we work with and for are our customers.

Goal of EMS
To understand how our patients and others are our customers, let's examine the general goals of EMS. The first goal is to provide quality prehospital treatment and transport your patient to an appropriate facility. Embedded in that first goal is the second goal of EMS, which is to care about the patient. We "care" when we administer medications or apply traction to alleviate pain, or when we ask if the patient is comfortable during transport to the hospital. In EMS, we care for our patients/customers every day, regardless of whether the service we work for is 9-1-1 or nonemergent transport.

Who Are Our Customers?
In addition to patients, who are our customers? I would submit that they are everyone we interact with during our daily duties, beginning with patients and their families. When we care for patients, we often have to provide some type of emotional care, at a minimum, for the family. We comfort them, ask if we can call someone for them, and often have to explain to both the family and patient what treatment we are giving. Patients and their families are obviously linked, but who are the other customers?

How about the community as a whole? We may not transport everyone in the community, but, by the nature of our business, we provide a service to the entire community by being ready, able and willing to answer their calls for help. In many instances, we also conduct public education/ prevention programs for community groups; provide coverage for sporting events, fairs and festivals; and sometimes do blood pressure checks or other simple medical functions at various venues. Our communities count on us to be there. To me, that makes them our customers.

An often-overlooked customer is the government. The government, whether it is local, municipal or state, counts on us to be a resource for the greater good of the communities we serve. We have become an even greater asset to local government planners with the threats of terrorism, weapons of mass destruction and disaster planning. Mayors, county executives and governors are all affected by what we do, how we do it and if we don't do it. If we refused to care for a person having a heart attack, our inaction would reach from the patient and his family through whatever chain we have in our individual agencies, and would eventually end at a political office. Public officials are affected both negatively and positively by what we do.

Talking about overlooked customers, I would add other public safety agencies like the police and fire departments, even if we are not part of them. When we operate at emergency scenes with other agencies, we work together. If the police and .re departments were on location with us when we refused to provide care to a heart attack victim, they could be affected by our inaction, not only legally, but they could be at risk from angry bystanders or family members.

Another consideration when working alongside other public safety agencies is how we operate within our standard operating procedures/guidelines. When we decide to alter our operational techniques, it is important that we communicate that to other agencies operating with us, so everyone will work more effectively and safely together.

In that same vein, our coworkers and supervisors are also our customers, all working as part of a team. No one wants to be associated with haphazard medics, so we depend upon each other to maintain high standards of conduct and patient care, if not for the patient's sake, for our own.

A final group I would count as our customer is the hospital and its subunits: emergency department, ICU and maternity department. They are our customers in the same sense that other public safety agencies are our customers. They are affected by how well we perform our specific tasks and patient treatments. We are the entry mechanism for patients entering their hospital, and our actions may have a profound effect on patient outcome.

All of these groups are customers who count on us to varying degrees. We deliver service to all of them.

Service Equals Care
What do we mean when we say we provide service for our customers? We show that we "care" about them by being customer-centered, accountable, reactive to customers' needs and empathetic.

Customer-centered means basing our decisions and our actions with the best interest of the customer in mind. Do we make a conscious effort to be the best and do our best for the customer? Do our actions minimize discomfort, show respect and make our customers No. 1 in all of our interactions with them? If not, we are not truly customer-centered.

Are we accountable to our customers for our actions? Are we willing to take criticism with the same openness that we are willing to take praise? When we make a mistake, do we own up to it, or do we pass it along to someone else? We need to be accountable with our actions, comments, billing procedures and daily operations.

For the most part, we are a reactive business. We do a great job responding to calls for help, yet we need to ensure that we are responsive in other business practices as well. Do we meet the needs of injury prevention for children or billing assistance for the elderly or non-English-language patients? Do we conduct research for the betterment of the profession? Do we transport to a more appropriate facility that is 10 miles farther away because the patient would be better served at the more distant hospital?

The final aspect of care is empathy- applying the most human and heartfelt effort into our interactions with people. Empathy is the tie that binds us to each other on a human level. For many, it links to our primary goal of entering EMS in the first place: helping people. Empathy for people plus technical ability make for a complete package of medic/EMT.

How Do We Provide Customer Service?
Have you ever noticed how many people can't describe what customer service is, but they know when they don't receive the level of service they expect? Whether it's cold food at a restaurant or having the cashier go on break just as we get to the head of the line, we know it when we don't see it.

Whether we are private, fire-based or third service, our sole purpose is to provide quality service to our customers.

There are several ways to improve customer service, one being getting good training in the areas where we are weak. If you are weak in pediatrics or geriatrics, look for realistic training that addresses those areas. Training allows us to expand our abilities, see something from a different perspective and provide the quality service that we want to provide. One aspect of training is knowing how to work effectively with all of the equipment on your ambulance. This could be expanded to include equipment that you may not carry on your unit, but routinely come in contact with, like rescue and cutting tools. By knowing about these tools and general operating techniques, we can provide a higher, more complete level of patient care/service. These are the "tools of our trade," and we should have at 1east a basic understanding of their use.

Linked with these things is technical ability. When we have exceptional technical ability to assess and treat patients, safely drive the ambulance, write reports and handle every other facet of our position, we increase our level of customer service.

Another area is communication. We have all heard about "communication" in our paramedic or EMT classes, but many of us don't put much effort into it. If we are concerned with customer service, we need to expand our communication toolbox and put those extra tools to work. This might include calling older patients by their name, rather than "sweetie"; explaining to a patient about the side effects of a medication; or waiting for the patient's slower, disabled family member to reach your unit. We need to look at how we do things from the customer's point of view.

Putting It All Together
We work and interact with dozens of people every day, from patients to supervisors to our communities. When we view them all as our customers and work to meet their needs, we succeed. We meet customers' needs by being technically competent and empathetic, writing accurate reports, driving safely and communicating. There are many ways to CARE about our customers and practical ways to provide customer service by being customer-centered, accountable, responsive to customers' needs and empathetic.

We all want to excel in our careers and with the people we encounter on a daily basis. Embracing customer service allows us to do that. Customer service equals excellence in all aspects of your job, including technical abilities and administrative duties. The spirit of excellence will have a positive outcome for you, your organization and patients-your primary customers. Our customers deserve our best: quality customer care!