Lessons EMS Can Take From the Titanic

Raphael Barishansky is a featured speaker at EMS World Expo, November 9-13 in Nashville, TN. Register today at EMSWorldExpo.com.

Recently I traveled on a long flight with minimal reading material. Thankfully the gentleman seated next to me was willing to converse. After a while speaking about our careers, we turned to the 100th anniversary of the Titanic disaster. As is my habit, and almost automatically, I began to make comparisons between the EMS agencies I’ve worked in and managed and the tragedy of the Titanic.

I dare say most people reading this piece would rather not compare their EMS agency to the Titanic; when most think of the Titanic, they think of colossal failures. But upon reading a TechRepublic article entitled “10 Project Management Lessons From the Titanic Disaster,” I thought to myself that some of the lessons of the tragedy have clear implications for EMS managers and their systems. I won’t go into detail with each of the lessons, but here are a few:

• Don’t assume—just don’t. A number of assumptions contributed to the Titanic tragedy. One was that the ship was unsinkable. This led to a deadly decision: The ship was equipped with lifeboats to hold only a third of its full passenger capacity. Undoubtedly more people would have survived if this important decision had not been based on an assumption. Another assumption was that the Titanic had received a message from other ships in the area warning of a large iceberg field—and that it was relayed to higher-ups who may have taken action. We now know this critical message wasn’t received.

How often have we seen things in our EMS agencies blow up in our faces because of assumptions? Maybe we assumed an employee was just complaining for the sake of complaining, or that our new CAD software would do what it was supposed to, or that our supplier received our order for more BVMs. Assumptions are important in EMS and also in managing people and systems, but if we proceed on the basis of them, we must make sure everyone is clear that there are assumptions being made.

• Keep everyone informed of decisions. One of the most compelling stories of the Titanic is that of the Allison family, who was on board with parents, children and even a nurse. This nurse took one of the children, Trevor, from the family’s stateroom to a lifeboat after the Titanic struck the iceberg. She neglected to tell anyone. The rest of the family perished as they spent precious time looking for Trevor, turning down chances to escape.

The various projects in which your EMS agency is involved—operational, financial, administrative or other—might not be as critical as a sinking ship. Still, keeping everyone involved—your board of directors, government officials, even just upper-level management—regularly updated as to the status and progress of your projects is of paramount importance.

• Proper training is critical. As the Titanic sank, crew members struggled to release the lifeboats. They had not been properly trained to use the lifeboats in an emergency. To compound this, the deployed lifeboats were improperly loaded with too many or too few passengers, and only one returned to attempt to recover more.

Effective leaders understand the importance of a proper orientation and training program as well as appropriate continuing education. This also includes training on all equipment on your trucks—you don’t want to be the EMS agency that makes a headline like EMT unable to use defibrillator (or some other piece of critical equipment). It also means stressing the importance of practice, drills, exercises and even the dreaded refresher trainings. These all build muscle memory, meaning you will remember what to do when it counts the most.

• One of the final lessons is specific to EMS supervisors, managers and executives: Pride comes before a fall. The time when the Titanic was built was a time of optimism, almost to the point of brashness—things were getting bigger, better and faster, the age more prosperous and opulent. Nothing showed this brashness more than the statements made about the ship being unsinkable. I’m sure many an EMS manager has used similar boasts to describe their agencies or systems: “No one could do what we do,” “We aren’t going anywhere,” “We are the best,” “We are irreplaceable.” Be wary of claims of invincibility. Things can and certainly will go wrong. A little humility, coupled with good analysis of our systems, a way to let the public know what we’re doing for the community, and some fiscal responsibility is central to establishing a solid EMS agency.

The final lesson is to never underestimate the value of conducting an after-action investigation. After an incident is over, conduct an immediate hot-wash will all applicable personnel to ascertain what you did right and wrong; then plan a course of action to correct deficiencies. The follow-up to the Titanic disaster resulted in major changes to maritime law that impact us all even today. Learn from your failures and correct them. Don’t let your EMS agency become a Titanic.

Raphael M. Barishansky, MPH, is director of EMS for the Connecticut Department of Public Health. A frequent contributor to and editorial advisory board member for EMS World, he can be reached at rbarishansky@gmail.com.