How to Become Patient-Centric

I lead the team of a large EMS operation in the Midwest. Allina Health EMS serves 1 million people with emergent 9-1-1 service and other medical transportation services. We respond to more than 80,000 calls each year; 220 times each day.

We work hard to be sure the technical competency of our staff is up to par. In fact, like many EMS operations, that is the primary measure by which we have historically judged our value. However, I know at a visceral level there is more to being a great EMS service.

I have come to embrace the idea that the very best providers are not only technically competent, but they are good critical thinkers and have superior interpersonal skills. This idea, which I originally heard from RN leader and educator Dorothy del Bueno, is what we call the “Intersection of Excellence.” It’s something that separates the mediocre providers from the truly exceptional.

I tell my crews I can prove this concept is true. I ask them to think of someone they have worked with who is really good at clinically technical skills. Maybe that person can put an IV in an eyelash and intubate blindfolded, but they are a jerk. When I pose this question, people often smile knowingly, thinking about someone they’ve come into contact with during their career. That sort of EMT, paramedic or dispatcher has been seen in EMS operations far and wide across our country. In my view, our industry has been far too tolerant of behaviors that have not always put the patient first.

So I ask you, Mr. and Ms. EMS Leader: What are you doing to be sure your patients are having the best experience they can when they call your service for help? No matter the size of your organization, if you’re not bringing the voice of the patient to your staff in a real and meaningful way, you are not a patient-centered organization.

As a leader you are responsible for incorporating the patient’s perspective into the work you and your staff do. Your values, policies, management practices and, yes, even your budget must be aligned to be sure you are serving the needs of your patients.

Why does it matter if you are a patient-centered organization? I hope the answer is clear. It is central to the mission of each and every one of us, regardless of the tax status of our operation. It’s what we do: Serve patients! Plus, it’s becoming more closely linked to how we are paid. However, when I talk to EMS colleagues, it always amazes me how infrequently we actually talk directly to our patients to ask for their point of view.

I recognize that leaders face dozens of issues and decisions each and every day just to keep our operations afloat. Schedules, supplies, drug shortages and staffing issues can quickly fill a 24-hour day and cause us to feel like we’re stuck in a revolving door. Who has time to reach out to patients? Truth be told, even when we do reflect on our patients’ experience, it can feel like the “soft” stuff compared to the challenging task of making sure there is a crew in the rig, with the right training and the right tools to respond to the next call. It simply isn’t easy, and it often falls off the list.

I believe you need to hard-wire patient-centric thinking into the routine of your service. Until you do so, you run the risk that your patients might take a backseat to the other work of running an EMS operation.

Tips to Help You Become Patient-Centric

1. Get the patient’s perspective. Regularly invite patients into your leadership and staff meetings to discuss their thoughts about your services. It can be incredibly powerful to hear directly from a patient about how they would have appreciated an extra blanket, or to have them point out that the ceiling of the rig was dirty, or describe how their family member could have been better served if you’d done something just a little differently.
2. Ask patients to share their experiences. It’s surprising how often patients will leap at the chance to share their experience. So budget for that annual survivors’ dinner, and host reunions with crews and willing patients who want to meet their rescuers.
3. Don’t rule out surveys. Patient satisfaction surveys can be helpful and definitely have a place in providing directional data.
4. Consider using a measurement tool. Our hospital colleagues are currently immersed in a process of measuring the patient experience using a standardized tool called HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems).
5. Keep it personal. I’ve rarely met an EMS provider who did not have a personal story about why and how they became interested in EMS. Engage your patients in the same way and seek out their stories.

Brian LaCroix is president of Allina Health–Emergency Medical Services in St. Paul, MN. He currently serves on the boards of the North Central EMS Institute and the National EMS Management Association.