Customer Service in EMS: The Forgotten Art

“We’re going to have a conversation about how you and I can make EMS a better place and push forward,” said Lillian Bonsignore, EMT-P, CIC, Chief of EMS Operations of the FDNY, in her EMS Today session “Customer Service in EMS: The Forgotten Art” in Tampa, Fla., March 4. “If we just wanted to maintain EMS instead of being innovative and transform EMS, then we wouldn’t have a lot to talk about.”

Bonsignore discussed the lost art of customer service. In a society where communicating via social media has detracted from our ability to communicate effectively face-to-face, it’s increasingly important for the EMS community to retain and improve that skill when interacting with our patients, colleagues, superiors and employees. “We have chosen to make a career out of tragedy, illness, and injury. Dealing with someone else’s bad day while you’re having a bad day isn’t a good equation, so we have to figure out how to solve that.”

The FDNY is home to 4,100 EMTs and paramedics and 10,000 firefighters trained as EMRs or CFRs, all of whom who respond to a combined average of 4,000 calls per day. Serving a city of 8.5 million residents (17 million with visitors), Bonsignore finds good customer service to be critical.

Know Your Customers

The Oxford Dictionary defines customer service as “the assistance and advice provided by a company to those who buy or use its products or services.” The service provider must be capable of anticipating a customer’s needs and meeting them before they ask are asked to.

Our external patients involve patients, their families, bystanders, and hospital personnel. But internally, those who work for and with us are also customers, like other first responders, supervisors, support staff, managers and civilian staff. Bonsignore said our external customer service starts with our internal customer service, so focus your efforts on establishing good rapport from within your department.

“As a leader I have to recognize the leadership I provide is a service,” said Bonsignore. “I am there to serve them, their job is to serve the communities. They don’t work for me, I work for them. My job is to support the rescuers so they can go out and provide care. How we set them up for their day at work is going to have an impact on how they treat their patients.”

What Good Customer Service Looks Like

• Building trust and morale. Bonsignore and Alvin Suriel, the assistant chief of EMS, wanted to answer questions and hear the concerns of their department’s largest body of customers—their crew members. Calling it “field feedback,” the two visited multiple stations in each borough of New York City to cook BBQ food and engage with their members.
  • “Little events that don’t seem like a big deal to us are a big deal to them,” said Bonsignore, reflecting on the valuable connections that developed from these lunches. “If we can find time in a large agency that has 4,000 runs a day, then I would argue that there’s no other agency that can’t find the time to do better customer service for the people that work for them.”
     
• Reducing the likelihood of assaults and conflict. If we treat our own with a higher level of respect and dignity, that will translate through to our patient care and interactions with community members.
   
  • Teaching de-escalation techniques. These are critical to discuss and practice, said Bonsignore. Scene size-up 101: Remove yourself from the threat—there is no need to engage in a negative or dangerous interaction. “Good customer service from leadership can set crew members on a path that is much more respectful and professional,” so if they ever find themselves in a threatening environment, “they can make a decision to retreat and protect themselves.”
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• Maintaining positive body language.
   
  • Get on eye-level with your patients (but maybe not within punching distance). Standing over someone is too authoritative. Maintain good eye contact and smile a little—they want to know you’re actively listening and you’re here to take care of their emergency.
     
  • Keep your hands out of your pockets and don’t cross your arms. It indicates that their emergency isn’t important to you; plus, it’s safer in the event you have to defend yourself if a situation escalates.
     
• Being mindful of tone and communication. Different inflections can insinuate entirely different meanings. Be aware of how you speak. “Positive body language, eye contact, the words you choose, and the inflections and tone are all working together to say to that patient, ‘I am here and I’m going to take care of you.’”
   
• Developing empathy. “It’s important how you make someone feel. Everything else is secondary,” said Bonsignore. “When you see a negative interaction between colleagues and patients, it is our responsibility to interject positivity and say, ‘That cannot happen again and I will never tolerate that. Are we clear?’” Talking about them behind their backs isn’t productive—confront them directly. If they’re not on the hook for it, they’re not going to change, she said.
   
• Providing support. We’re great at supporting our patients but not so much with supporting each other. No matter where you stand in the ranks, make an effort to check in on your colleagues. Ask your managers about their lives, like how their families are doing. “We’re people of service but we’re also very emotional as a group. That doesn’t go away when you become an EMS leader,” said Bonsignore. “Leaders in the department need good customer service as well.”
   
• Spending time wisely. When it comes to disciplinary action, Bonsignore said that we often spend 90% of our time on 10% of our people. Instead, spend 90% of your time on the 90% of people who do a good job. Educate and discipline the 10% who don’t do a good job. Avoid saying things that point blame on the individual, like “You messed this up.” Do point out their specific actions: “The behavior you exhibited is not acceptable.”

“All the things we want for our external factors are as important for our internal factors,” said Bonsignore. “We can keep doing what we’re doing, or be brave and bold and try something different, but that’s a choice we have to make. That’s going to take work.”

The customers of EMS—our patients—who utilize our critical service expect a certain level of professionalism and competence. But sometimes these qualities are impacted when we mix up our mission and politics, said Bonsignore.

“We are people of service, compassion, and kindness. Prehospital medical care is our mission,” Bonsignore said. The political mission involves aspects of the job itself, like our pay and benefits and the color of our uniforms. “These two missions often clash.”

“Each day you will become part of someone’s story. You change lives forever,” said Bonsignore. “That is an incredible thing to be proud of. Never mix up that mission with politics. What kind of story do you want to live?”

Valerie Amato, NREMT is assistant editor of EMS World. Reach Val at vamato@emsworld.com.