How an ambulance crash defined an EMS agency’s care
Allina Health's management of a traumatic ambulance crash is a lesson in how to put core values first
When the leadership team of Minnesota-based Allina Health EMS was awakened in the early-morning hours of Jan. 18, with the news that one of their ambulances had been involved in a devastating head-on collision they knew how they would respond.
Their actions were guided by a deep understanding of what matters to them, a desire to show how they cared in a big way, and a determination to stay ahead of storytelling about the event.
Just after 1 a.m. the ambulance was transporting without lights and siren a stable medical patient on a rural, two-lane highway when it collided head-on with an SUV. The impact ripped apart the SUV and destroyed the ambulance.
The lone occupant of the SUV suffered multiple traumatic injuries. The attending paramedic was unresponsive with a severe head injury. The lower extremities of the EMT driving were crushed.
The only uninjured person — the medical patient on the stretcher — placed a desperate call for help with the injured paramedic's cell phone.
Other ambulances quickly responded. By the time the leadership team learned of the event, the driver of the SUV and ambulance crew were on their way to area hospitals.
'We'll show you how much we care'
Allina Health EMS is the medical transportation arm of a $3.4 billion not-for-profit hospital and clinical corporation headquartered in the Twin Cities. Allina's EMS operations serve more than 100 communities throughout Minnesota, with 570 employees responding to more than 90,000 calls per year.
Regional Director of Operations Kevin Miller received the initial call and immediately headed for the hospitals where the critical patients had been transported. On the way he contacted other team members.
Their top priorities were:
- Ensuring the injured were getting the best possible care and support.
- Notifying and informing families.
- Assuring the rest of the Allina staff were informed and enlisted to help as needed. Allina EMS President Brian LaCroix was in Arizona at the National Association of EMS Physicians’ conference and immediately prepared to return to Minnesota.
Miller started notifying families of the injured and convened a leadership team conference call to make certain that Allina's response was coordinated, honest, transparent, generous, and reflected how much the organization truly cares about its employees and its patients.
Five months earlier, during a two-day leadership retreat, the Allina EMS team had wrestled with what distinguishes their organization and them as leaders. In sorting through the usual litany of lofty corporate values, they had recognized that a deep sense of caring was really at the soul of their organization.
They noticed that the highest levels of inspiration, motivation, and satisfaction came when field staff and leaders had opportunity to demonstrate caring.
Their discussion at the retreat led them to talk about the myriad of uncontrollable factors in emergency medical work, including the nature of the call, the severity of a patient's clinical presentation, the location of a patient, the socio-economics and politics of health care, and the challenges facing their large hospital-oriented parent company.
The discussion also touched on how much Allina could control, such as how they treated employees, patients, families and communities. They wanted all their relationships to be characterized by an overt demonstration of caring.
Toward the end of the retreat, Twin Cities Operations Director Jeff Czyson summarized what mattered in a single declarative phrase, "We'll show you how much we care." The phrase stuck and as the retreat concluded, the team committed to living out that declaration in the coming year.
Whatever it takes
In the immediate aftermath of the crash, Allina's leadership team had ample opportunity to demonstrate caring in a big way. They ensured the injured were supported, providing practical support to families in terms of companionship, medical information, accident information, emotional support, transportation, food, lodging and simple errand-running.
"We decided to do whatever it took," LaCroix said. "We didn't know the details about what had caused the accident and that wasn't our first concern. We wanted everyone to know we were there to help. Cost wasn't a primary concern."
The team offered support and full information to the family of the SUV driver who was in critical condition and later died. The family of paramedic Brian Nagel, also in critical condition, needed to travel from another part of the country. Czyson, Miller and other Allina staff stayed with Nagel until family arrived.
In addition, Allina provided a uniformed EMS provider to stay at the hospital for as long as was needed to be available to support and assist the family in any way. Allina helped Nagel's family publicize a Caringbridge website that brought thousands of wishes of support and prayer from around the world.
EMT Tim Daly's lower extremity injuries were severe and would confine him to a wheelchair for months. In addition to supporting Daly and family during his hospital stay, Allina employees immediately began helping Daly's family prepare his home for a wheelchair. Ordinary tasks like transportation, medical equipment, meals and encouragement became an organization-wide project.
News of the crash was quickly reported by local media, but not before the leadership team helped to guide the story to be about the injured and their need for support.
Contrary to the common corporate practice of saying little about an event until all the facts are known and public relations and legal departments have been consulted, LaCroix took a risk and within hours of the accident began providing information about the event to his entire staff through public Facebook postings.
The initial posting spoke frankly about the crash. Nagel was unconscious and in intensive care and his prognosis uncertain. Nagel's family wanted people to know what was going on, that Nagel was in need of support and prayer, and they wanted LaCroix to get the word out.
Rather than wait for the usual corporate news release, he moved quickly and communicated from the heart through Facebook. When local media picked up the story, they quoted from LaCroix’s posts. The quotes helped focus the story on the care and support of those who were suffering, which Allina has continued throughout the year.
Neither of the crew members have returned to full duty. After five days in a coma Nagel woke up, and has continued to make progress in recovering from a severe TBI. Daly has had several surgeries and is regaining use of his legs and feet.
"This has been a team effort," LaCroix said "Everyone in our organization has stepped up. It's been amazing to see how much people really care."