Original Contribution

Quality Corner--Part 12: Acknowledging the Good

12/11/2011

While the primary objective of quality improvement is to identify and correct problems in the pursuit of improved patient care, it is important that any quality program not be all negative. On any given day, there are many more things going right in EMS than wrong. The good should be emphasized at every opportunity and in every way so your quality improvement program is as encouraging as it is educational. A good quality coordinator not only identifies and corrects problems, but also looks for opportunities to acknowledge excellence. Here are some ways to do that.

Awards: Every time I walk into the Bucks County Rescue Squad, I pass a trophy case full of awards that go back to 1932. Over the years, as volunteer rescue squads and ambulance corps in Pennsylvania gave way to the paid EMS agencies of today, annual banquets and awards dinners have fallen by the wayside. That’s unfortunate, because anyone who didn’t know better, seeing all those awards from yesteryear and nothing from today, might wonder, What’s wrong with these underachievers today? Since we’re doing more and better things than ever in EMS, why shouldn’t we acknowledge that in ways that positively reinforce the kind of behavior we’re seeking, as well as showcase those achievements on behalf of the agency?

As a result of this awareness, we commissioned three awards: the Code Buster Award, the Stork Club and the Top Gun Award. The Code Buster Award is a plaque that acknowledges successful resuscitations. The Stork Club is for baby deliveries in the field. Top Gun is for excellence in call management. Just like in the eponymous movie, the Top Gun Award is not an individual award, but rather for an EMS crew or team, which further encourages the team concept.

Within the first six months of commissioning those plaques, our people delivered three babies and had five successful resuscitations. This was a surprising number of achievements to everyone, but underscored the fact that you don’t realize how much good you’re doing in EMS until you take a step back and look. Although it was not our original intent, these awards helped us do that.

Initially I envisioned Top Gun being a monthly award. However, our medical director, Dr. David Jaslow, who is both our greatest champion and our toughest critic, insisted upon maintaining only the highest standards for the Top Gun Award. Consequently we ended up with just seven Top Gun recipients in the first 12 months. Surprisingly, it ended up being a much-sought-after award for which our providers were very competitive.

All three of these awards are represented on large plaques that hang on the wall opposite the main entrance to our building, so they are the first thing anyone sees upon entering.

Citations and commendations: Compliments are the gold medal of quality improvement. (One day perhaps we’ll have a real gold medal to give, but for right now compliments will have to do.) When a provider has, in the opinion of the medical director, done an exceptionally good job or handled a difficult call well, they should be recognized, and a letter of commendation is an easy and affordable way of doing so. The original commendation should be given to the provider, and a copy should be placed in their file.

Many municipalities present commendations for exemplary service to public servants and community members. If, in the opinion of your quality coordinator, medical director or chief, you have providers who have performed exceptionally well, consider approaching your mayor or council person with your recommendations. Likewise, some state representatives like awarding citations for achievements, exemplary service and anniversaries. Don’t hesitate to contact these people and recommend your personnel for these awards. Many other people receive these types of awards for doing a lot less than EMS does. It’s time for us to become a little more politically savvy and public-relations smart.

Medals, ribbons and commendation bars: Currently there are no national standards for uniform decorations in EMS. But some large EMS systems and a couple of states have developed awards programs that include medals, ribbons and commendation bars similar to those of the military and many police departments. There are several manufacturers that market these type of awards to EMS. A few I found via a quick Google search are:

All of these companies offer medals for things like valor, distinguished service and line-of-duty deaths, as well as a variety of other purposes that can be designated by your agency. If your organization should decide to create a uniform decoration program, you should consider what the qualifications should be for any awards and how and when they should be displayed. Some types of awards might be for valor, exceptional service and professional achievement such as becoming an EMS instructor, tactical medic or honor guard member, as well as time in service (e.g., 10, 20, 30 years, etc.).

PR opportunity: With any award presentation, whether internal or external to your organization, there comes a public relations opportunity. I cannot stress this strongly enough: Do not allow these opportunities to be lost. Unlike fires, which are spectacular public events, or law enforcement operations, which for the most part are matters of public record, most of what we do in EMS must be kept from the public due to reasons of HIPAA and patient confidentiality. Consequently, public relations opportunities for EMS are few and far between. That so much of our work is out of sight and out of mind may well be why our recognition, public support and funding lag so far behind the importance of the service we provide. Issuing press releases or even holding an annual EMS awards day can help showcase the important and outstanding work done in EMS.

Joe Hayes, NREMT-P, is deputy chief of the Bucks County Rescue Squad in Bristol, PA, and a staff medic at Central Bucks Ambulance in Doylestown. He is the quality improvement coordinator for both of these midsize third-service agencies. He has 30 years’ experience in EMS. Contact Joe at jhayes763@yahoo.com.