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Eliminate EMS disconnects through patient, provider communication

Eight ways to shape caregiver communications with patients and 4 key considerations for leading millennials


In its most basic form, the EMS mission is to increase the number of lives saved, reduce the human and financial impacts of an unplanned health event, and to provide great value as defined by our customers.

Photo/University of San Francisco

By Jay Fitch, PhD

Whether it’s a leader providing unclear guidelines, a follower with unrealistic expectations about working in EMS or a customer that expects EMS personnel to walk on water – disconnects happen! The simple truth is that we work in highly charged emotional environments and those around us have little tolerance when expectations aren’t met.

Our task as leaders is to reduce the gap between those disconnects and to reconfigure and reconnect caregivers to the primary EMS mission. In its most basic form, the EMS mission is to increase the number of lives saved, reduce the human and financial impacts of an unplanned health event, and to provide great value as defined by our customers.

EMS disconnects begin with the process organizations use to recruit caregivers. Agencies desperate for people often recruit younger workers by stressing the excitement of blood, guts and gore, while the caregiver’s reality is cleaning the truck after grandma pukes on their shoes.

Caregivers expect to work in shiny new vehicles with the latest biomedical equipment and instead find themselves switching out mid-shift to a rattletrap reserve unit.

We expect caregivers to be expert communicators when Millennials and those from Generation Z may be more comfortable texting than communicating face to face. In each of these examples, there is a disconnect between the anticipated outcome and actual result.

Improve patient communication

Follow these eight essentials to improve caregiver communications with patients:

  1. Communication in a caring and empathetic manner. Caregivers should try to walk in patients’ shoes, even in a brief conversation, to better understand their needs. This can be a challenge for younger workers whose preferred method of communication is via text.
  2. Communication about their comfort. EMS patients want to stay as comfortable as possible during transport. Caregivers should offer them blankets, offer to adjust temperatures and provide an ear to hear their concerns.
  3. Communication about their situation. Caregivers can reassure patients by keeping them fully updated and by explaining what’s happening. We often transport an older patient from their home to a confusing, sometimes frenetic, hospital environment. Let them know what to anticipate and what’s going to be happening.
  4. Communication about treatment and medication. EMS staff should be clear about what treatment they are providing and any medication the patient is receiving and, if appropriate, why.
  5. Communication about next steps and delays. Caregivers should be aware that time passes slowly for EMS patients, particularly if you are dealing with an off-load delay at the hospital. It’s best to explain the delay without throwing the nursing staff under the bus. Introduce them by name to whoever will be providing the next stage of their care.
  6. Communication in layperson’s terms. Medical terminology can sound like a foreign language to patients. ALS, BLS, EKG and many other acronyms and terms may be extraordinarily confusing to your customer. Caregivers should take care to speak in terms that are easy to understand.
  7. Communication both verbal and nonverbal. Actions and words show patients that EMS personnel aim for a high standard of care. Caregiver social chatter, banter and unprofessional behavior adds to the patients’ stress.
  8. Communication that is kind and complete. Caregivers should ask patients if they have any questions about what they are doing for them. Another great question: “is there anything else I can do to make you more comfortable?”

What EMS providers want from leadership

Here are four key things younger workers want from leaders:

  1. Inclusive leadership. Authoritarian leadership is out, and inclusive leadership is in, according to an article in Forbes by Ashira Prossac. The days of a boss being disconnected from employees sitting in a corner office (even with an open-door policy) are gone. Younger workers place a high value on open workplaces with less emphasis on hierarchy. They expect to be able to communicate and connect with all levels of leaders within the organization.
  2. Transparency. Leaders have to show caregivers that their work matters and how their contribution fits into the bigger picture. Leaders should show solidarity and a genuine intent to make a difference, or risk losing credibility. They must walk the talk, as ultimately, employees will mirror managers and managers will mirror leaders.
  3. Flexibility and a living wage for full time work. Offering flexible schedules and paying an appropriate salary gives caregivers a sense of control, particularly around work-life balance issues. Younger workers need to have full time hours rather than be required to work for multiple employers to have a flexible schedule.
  4. Challenge. Give them the chance to lead. Start small, and if they prove they can handle the responsibility, give them more. Millennials may need more direction than previous generations but given the right support they can become the most valuable employees. When they feel trusted and know they have the support of the leadership team, they’ll often outperform expectations.

Encouraging positive caregiver communications strategies with patients and understanding what younger workers want from leaders will reduce the disconnects for EMS agencies.

About the author

Jay Fitch, Ph.D. is the founding partner and president of the EMS/public safety consulting firm Fitch & Associates. He also serves as a commissioner for the American College of Paramedic Executives. Contact him directly at

For more than three decades, the Fitch & Associates team of consultants has provided customized solutions to the complex challenges faced by public safety organizations of all types and sizes. From system design and competitive procurements to technology upgrades and comprehensive consulting services, Fitch & Associates helps communities ensure their emergency services are both effective and sustainable. For ideas to help your agency improve performance in the face of rising costs, call 888-431-2600 or visit