How to Chart a Course for Survival

If you’re a smart EMS leader, you’ve thought a lot about the future lately. You know times are tough and unprecedented changes are afoot, and you likely wonder how to navigate such perilous passages without running your whole ship aground.

Here’s the rote line that acknowledges no answers are easy and no two systems are the same and nothing we can tell you serves everyone. Now let’s get down to what you should do.

For one, you should take advantage of resources the EMS industry offers to help forward-thinking leaders puzzle these things out. One is the yearly Pinnacle EMS Leadership & Management Conference, held most recently in Colorado Springs this past July.

Orchestrated by prominent EMS consultants Fitch & Associates, Pinnacle brings together thought leaders and industry movers to help steer systems through the complex issues of the day. The concepts covered in this article are drawn from this year’s show.

The issues are more complex and imposing than ever.

“No matter what happens with the election and the move toward healthcare reform, the U.S. healthcare system is simply not sustainable in its current form,” says Joseph J. Fitch, PhD, founding partner of the firm that bears his name. “If you study world economics and how healthcare is provided, that’s abundantly clear whether you’re a Republican or Democrat. So it may change and morph along the way, but I think we’re going to see reform continue to move forward.

“But it’s not just that we have federal policy issues and reimbursement changing. We also have changing expectations from customers. In my entire career, I never thought I’d see police officers and firefighters laid off. We’re seeing that, we’re seeing benefits cut, we’re seeing cities go bankrupt. At first people in the rest of the country may have thought, OK, that’s California. But when it’s coming to places like Scranton, PA, people have to wake up and realize, Yeah, this is serious.”

You can’t much control how politicians spend money. But you’ll want to secure your place as budgets are twisted and squeezed. The way to do that is by providing value for your customers. And while patients may be the most important of those, there are others to concern you too—including those lawmakers and regulators, as well as other health and emergency system players. Value is the watchword of the day; figure out how to provide it, and you’ll better position your organization to withstand the inevitable buffeting that, while it may have already begun, seems likely to get worse.

Listen and Understand

The best caregivers are gifted listeners. They can synthesize what a patient says, how they say it, and other clues and contexts into an assessment and direction for action. Organizations require similar skills in discerning the needs and expectations of their communities and determining how to effectively meet them amid prevailing currents and conditions to come.

“Listening means different things for different communities,” says Mike Taigman, general manager at AMR Ventura County/Gold Coast Ambulance in California and a longtime EMS educator and consultant. “I think we’re pretty good at listening to our regulator community. In the fire and private ambulance communities, we’re pretty good at listening to each other. But if you look at a community as all the people who live in a service area and need healthcare and other services, I think historically we’ve not been nearly as good at listening to that community. We’re not as good at listening to our patients within that group as we could be.”

What you’re listening for, in girding for the future, is unmet needs. They’re not hard to find. You can hear them from your patients, in their express words and between the lines. You can hear them from your data, in patterns and clusters and anomalies. You can hear them from hospitals and other colleagues in healthcare and public health and public safety. The system is rife with gaps through which people slip, and that EMS—to the extent it’s not overwhelmed just answering 9-1-1 calls, and to be sure many are—is positioned to help reduce. We’re community-based, mobile, on duty all the time and approach care in a directed, algorithmic manner. That’s a recipe for producing value.