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Leading at the Speed of Trust

Providing first-rate patient care is a prerequisite for any EMS agency that strives to have a first-rate reputation in its community. Yet patients can’t always tell if the providers caring for them are following the latest protocols or using the most up-to-date technology.

So aside from skill, the question is: Are there other factors that go into creating that sense of confidence and trust? And are there reasons beyond the obvious why EMS leaders should care how they are perceived? The answer is yes, says Janna Binder, director of marketing and public relations for Professional Research Consultants, an Omaha, Neb.-based survey and market research company that specializes in health care-related clients, including EMS.

When it comes to creating positive perceptions, the effort starts with the way in which providers treat those who use their services. Research shows there’s a strong emotional component to the experience, including such things as responders’ ability to calm frightened patients by explaining procedures in a way the patients understand.

In other businesses, positive feelings foster loyalty, which means repeat customers. For EMS, loyalty more often takes the form of community financial support, even in the face of fiscal pressure. “What’s different with EMS vs. other clients is that patients don’t always have a choice,” Binder says. “But where the loyalty and the high positive word of mouth can come into play is during budget crunches or fundraising efforts. If the population loves the EMS system, they are going to stand up and make sure it gets the funding that’s needed.”

Building confidence and trust in EMS doesn’t end with patients. Agencies that are highly valued and respected have also found ways to establish good communication and strong ties with local government officials, as well as business and community leaders. Through community outreach, those EMS agencies show even those who have never had to call 911 that they’re partners in improving the overall health, safety and well-being of residents.

Best Practices spoke with three leaders of EMS agencies known for having excellent reputations within their communities about the recipe for creating and maintaining that sense of goodwill —and the rewards that come from doing that successfully.

Edina (Minn.) Fire Department
When a call comes into the Edina Fire Department, staff members are taught to do their utmost to help—even if it’s answering a question about garbage pickup or hazardous waste disposal. Firefighter/paramedics regularly visit homes to change batteries in fire alarms and check on carbon monoxide detectors. Every week, dozens of residents stop by to have their blood pressure checked. Firefighters have even been known to change a tire in the dead of Minnesota winters. And recently, when a woman called wanting to know how to properly dispose of a fluorescent light bulb, firefighters stopped by her house and took care of it for her.

“We empower our people to deal with the problems at hand, no matter what issue it is,” says Chief Marty Scheerer, who is also president of the Minnesota State Fire Chiefs Association. “We either take care of it ourselves or make sure they get to the right person who can help.”

To spread the word that they’re there to help, Scheerer and his staff speak to civic groups, women’s clubs, senior organizations and schoolchildren. The department helps organize holiday toy drives and year-round food drives. Scheerer also strives for transparency in how taxpayer money is spent, and he conducts surveys to measure how residents see his department’s performance. “The citizens have to feel they are getting a good value for their money,” he says. “They have to feel it’s well managed and we are not wasting money.”

A commitment to serving the community of nearly 50,000 is the primary reason he expects his staff to pitch in on requests outside of their job description, Scheerer says. But he and his team are also keenly aware of the importance of making sure the community knows firefighters are there to help; doing so ensures that residents and the city council continue to support the department’s $4.5 million annual budget. “We do a lot of things we don’t have to do,” Scheerer says. “The more you help people and the more you do, the more good things happen to you. If you go beyond, people appreciate it and trust you.”

West Des Moines (Iowa) EMS
Fiscal responsibility and operational efficiency are what Jeff Dumermuth, chief of West Des Moines EMS, believes has helped set his agency apart. A third service agency run by the city, West Des Moines serves a suburban area with about 55,000 residents.

About eight years ago, Dumermuth’s agency entered into an agreement with the county to share high-level administration, billing and other administrative office staff, resulting in substantial cost savings. More recently, Iowa Health Des Moines, a four-hospital system, was looking to change ambulance service providers and began working with West Des Moines EMS on specialty team transports. Dumermuth believes being the only agency in central Iowa currently accredited by the Commission on Accreditation of Ambulance Services helped them get their foot in the door with the hospital system. After doing so, West Des Moines was quickly able to show hospital administrators they were a well-run, high-quality service.

In July 2008, West Des Moines EMS began providing all ambulance service for the hospital system. Calling their arrangement the Iowa Health Alliance, the hospital system agreed to cover 30 percent of administrative costs for West Des Moines EMS, to hire eight new full-time paramedics and EMTs and purchase three ambulances. “Some of our best opportunities have come in trying to not only be an excellent service provider for our community, but to do our best to be fiscally responsible and to look for opportunities to increase efficiencies,” Dumermuth says.

The agreement with the hospital saved West Des Moines taxpayers $200,000 in administrative costs in 2009 out of a total annual EMS budget of $3.7 million. West Des Moines EMS now has additional vehicles that can be used as back-up if not being used by the hospital. Paramedics and EMTs also have more experience in transporting neonatal and pediatric patients, a patient group they would not normally encounter often.

The combination has helped them build on their reputation for being a well-run, quality service that is watching out for not just the physical, but the fiscal, health of the community. “It’s been a great partnership for the city fiscally,” Dumermuth says. “Not only does it free up those general fund dollars for the community, but the opportunities for our staff to expand their knowledge is critical as well.”

New Britain (Conn.) EMS
Fourteen years ago, New Britain EMS, a nonprofit ambulance company that’s the exclusive provider of emergency transport for the city of about 70,000, was in crisis. The city’s common council had lost faith in the organization, says Bruce Baxter, the agency’s current CEO, and withdrew some $500,000 a year in funding.

Baxter was brought in shortly thereafter to help improve the company’s financial management, enter into new strategic partnerships and rebuild its reputation. “Your reputation is everything in your community,” Baxter says. “If your community doesn’t believe in you, they are not going to support you.” Though New Britain EMS receives no direct tax support, the city provides its building, equipment and vehicles.

Transparency in their finances was one means of rebuilding trust. But Baxter and his team went a step further and reached out to address the needs of the community, which suffers from among the highest unemployment rates in the state.

Paramedics and EMTs provide a host of injury-prevention and emergency preparedness education, including free child safety seat installations and inspections and serving as an American Heart Association Community Training Center for CPR. New Britain EMS has also partnered with the local high school to offer emergency medical responder training programs to high school students, and it has joined forces with a local social services agency to offer summer internships through a federal grant. Both programs are designed to teach disadvantaged kids life skills and work habits to help them succeed after graduating.

“It’s helping communities to break the cycle of poverty and get today’s generation of currently unemployed back in the workforce,” Baxter says.

In January, New Britain EMS opened the New Britain Emergency Medical Services Community Education Center at Central Connecticut State University’s Institute of Technology and Business Development. The center is a professional training academy, offering new certifications for responders and desperately needed job training. The training center will offer American Heart Association courses and initial and recertification training including first responder, EMT-basic, EMT-intermediate and paramedic-level courses. Any profits will go back into supporting the city’s emergency medical services.

Efforts to establish a training program started about a decade ago. In recent years, New Britain EMS was training about 150 EMTs a year using their own facilities. The new center will enable them to accommodate 3,000 students a year.

“It’s more than just 911 response,” Baxter says. “We are beginning to bind ourselves with the population itself so that we’re viewed as a key collaborator focused not only on the health, but the wellness of the community.”

Many of New Britain’s outreach programs are run by Dave Koscuk, captain of support services. Those efforts include speaking at community meetings about proper and improper use of 911, a big issue in New Britain due to many residents’ lack of access to primary care. New Britain EMS also provides special operations assistance at all large community events such as 5Ks or the more than 100 New Britain Rock Cats AA baseball games played at the New Britain Stadium.

But rather than just sit in their vehicle, paramedics offer blood pressure screenings, File of Life materials that notify responders in case of emergency about what medications a person is taking, and other literature. “It’s a great opportunity for us to interface with thousands of people that we otherwise wouldn’t have the opportunity to do,” Koscuk says. “We maximize our time in the community.”

One of the agency’s more clever ways of developing ties to local movers and shakers is by hanging out at the municipal golf course. New Britain EMS owns a golf cart that it stores at the course; during special events, a paramedic rides around in the cart and hands out bandage dispensers, networking all the while. “The more opportunities to reach out in a non-traditional setting, the more visible we are and the more opportunities come across,” Koscuk says.

Their efforts are paying off. In January, the Lion’s Club of New Britain donated $30,000 to the agency to buy a community outreach vehicle, emblazoned with the New Britain EMS logo, to transport staff and equipment to community events. “We’re looking at it like a rolling billboard that will increase awareness of the work we do in the community,” Koscuk says.

Produced in partnership with NEMSMA, Paramedic Chief: Best Practices for the Progressive EMS Leader provides the latest research and most relevant leadership advice to EMS managers and executives. From emerging trends to analysis and insight, practical case studies to leadership development advice, Paramedic Chief is packed with useful, valuable ideas you simply can’t get anywhere else.
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