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How to prevent a crisis in EMS

Consider the choices we as leaders and providers make that create the very crisis we are trying to resolve

At the recent American Ambulance Association (AAA) meeting, I had the opportunity to hear the speech by keynote speaker, former Arkansas Governor Mike Huckabee.

His main topic of discussion was about the impact of "Obamacare."

He had many good points, one being we are not in a healthcare crisis in the United States — rather, we are in a health crisis.  About 85 percent of hospital admissions are diseases caused by lifestyle choices, like smoking and obesity.

These choices lead to increased rates of heart disease and stroke as well as cancer and diabetes. I remember learning a similar statistic in college more than 30 years ago.

I think this weighs into many of the challenges we face as EMS providers; challenges such as keeping people on the job, and keeping employees, patients and the general public safe from harm.

Several times a day at both the field level and in the ivory halls of management, we make choices that create our own internal crisis. 

Many in EMS, like the rest of the country, are inching toward obesity.  We work long hours, often when tired. We rush, sometimes out of real necessity, sometimes just to get available. We drive fast when the conditions don’t support the speed or the need.

Huckabee told how the state was the largest employer in Arkansas and that he faced many of the same challenges as other employers. He told the story of how the state's leadership gathered to figure out how to cut the cost of healthcare, not only to state workers but state Medicaid as well. 

One of the members suggested they eliminate eyeglasses from Medicaid. He argued that the lack of eyewear is not life threatening. He made a compelling argument but as they talked it through, the true impact of such a decision became clear.

The people most likely to be affected by this small savings would be the elderly, already with limited funds and often failing health. The team asked: What might be the impact of denying eyeglasses to this group? 

One scenario they thought of was this:  What if the elderly person, not seeing clearly, misjudged a stair landing and fell from the top? What would the resulting hip repair surgery, weeks of hospital and rehab cost in comparison to the cost of a pair of glasses be?

Another scenario: What if a vision impaired person, unable to clearly read a prescription, took the wrong medicine or the wrong dose? What might this cost compared to the cost of glasses? This working group came to understand the impact of seemingly small decisions.

Over the many years I have "sold'"safety. I have seen similar decisions; those that only see a near-term gain and not beyond that.

What is the cost of not doing training on proper lifting or driver refreshers? I knew a company that only ever did driver retraining after a collision. They never did any proactive prevention training. 

They had huge collision-related losses and could never seem to get a handle on the problem.

When we as an industry discuss and debate the best way to reduce intersection collisions, to reduce the number of lifting-related injuries, medication errors and esophageal intubations, consider the choices we make. 

Consider the choices we as leaders and providers make that create the very crisis we are trying to resolve.

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