A Call for Innovation in EMS

Would an ambulance with airbags in the patient compartment be a good idea?

EMS is a dynamic field fueled by a constant need to adapt to changing conditions and working with whatever resources are nearby. So, when was the last time your organization took a look at its standing operating procedures?

Innovation is not about creating something completely insane or out of the box. Innovation is simply looking at the way your organization does business and seeing how it can be done more efficiently, cost effectively or safely.

Innovation is a process and if done in a strategic way can greatly improve outcomes both fiscally and qualitatively. Will there be crazy ideas? Absolutely, but it’s a part of the process.

Research shows that companies that innovate, regardless of what sector they are in (including medical), have higher employee engagement, lower operating costs and better patient outcomes. The idea of the “time out” before surgery was an innovation that decreased the rate of death and complication by a third across all hospitals studied. Similarly, self-scheduling for nursing has shown to decrease turnover. Both processes were considered innovations in the beginning.

So how does an organization start an innovation program? First and foremost is to have a plan. This will include ways to receive ideas, like e-mails to a dedicated “innovations officer,” a manner to sort through them (usually a committee) and a way to do pilot projects or implement the ideas brought forth. This will cost money but it must be viewed as an investment; budgets for an innovation committee will vary depending on the organization’s size. Regardless of the amount of money available it must be a sustainable, reoccurring amount to foster confidence in the program.

The committee should be made up of individuals from all touch points of the business and it should be stressed that it only be made up of high performers. More importantly, the men and women closest to the work know where the improvements need to be made and where they make the biggest impact. Put paramedics, basics, mechanics, accountants and housekeepers on the committee. Administration and leadership should be represented on the committee but only for administrative oversight and project management skills. They also play a key role in getting buy-in at the top level. These individuals should have enough authority to act on an idea that has made it to the pilot project stage. The leadership person should not be in charge of the meeting, nor be so intimidating that it becomes only about their agenda.

Next, collect ideas from all aspects of the organization. At the innovation meetings allow for a free discussion of how the ideas would impact the organization, including cost benefit analysis, return on investment and personnel impact. Once ideas have been narrowed down to a final list of five or less, the organization may survey all their employees and check to see which pilot programs receive the most votes.

No idea is too crazy. This is important because the craziest ideas may lead to simple ways to improve processes. Think about the “power stretchers” and when they were first being visualized. What would have happened if the person who said “Wouldn’t it be great if we could just push a button and the stretcher would raise itself?” hadn’t spoken up?

Next, select the plan that will create the best impact—it doesn’t have to be the most difficult or complex idea on the table; start small with easy actionable changes. Doing this shows the organization’s commitment to the staff and enables more ideas to flow quickly and easily.

Finally, if the pilot is successful and implementation is warranted, follow through and gather feedback. Celebrate the person who put the idea forward and if it shows a savings consider offering a percentage of the cost savings as a bonus to the employee who came up with the idea, or use the savings in a way that celebrates the entire staff for implementing the idea successfully.

In this economy it is easy to dismiss new ideas or new processes because they are perceived as too expensive to implement or just plain crazy. But doing things “the way we’ve always done them” won’t bring EMS into the future. It is only through the process of conceiving bold ideas—and the courage of organizations to try new things—that EMS providers and the profession as a whole make progress.

Patrick Pianezza, MHA, NREMT-P, is a consultant experienced with Studer, HCAPS, Gallup and Press Ganey principles. Along with nearly a decade of experience in the prehospital arena, he has worked for Johns Hopkins Hospital and Studer Group. He is currently the manager of service excellence for San Joaquin Community Hospital in Bakersfield, CA. E-mail ppianezza@gmail.com.