The delivery ‘good’services from fire, rescue and EMS personnel just do not cut it. This is especially true when a successful mission is frequently measured in terms of life and death. Sure, the majority of calls we run are not life and death situations; yet life and death are two of our outcome measures.
Fighting fire is by far the most dangerous activity we engage in. Even though working fires are only about one to two percent of what we do, the art and science of fire fighting consumes the majority of our training time. This is because fire fighting is the most dangerous item on our service menu and we must be competent in the skills and abilities that it requires as our lives, the lives of those we work with, and those we serve depends on our personal and team competence.
Those serving on the line do not have a problem going above and beyond the call of duty on responses that are life and death. We have a long and proud history of brave service and enjoy a great deal of public support because we are willing to go that extra mile. What if we measured each and every customer, patient and victim encounter as though it were a life and death scenario? If we were to take this approach would our actions and efforts be any different when the call is simply mundane?
Encounters with citizens, other than life and death situations constitute the overwhelming majority of what we do and are a critical component of our total service delivery. With that in mind, should we not prepare and train? The answer is, of course, yes. It is extremely important to us locally, statewide and nationally to provide the best possible customer service possible. This requires a conscious effort to prepare and learn the discipline and humanity of treating those we serve with respect and dignity.
This is not an indictment of fire service customer service. In my opinion, we collectively do a great job. However, it is important that we constantly and consistently monitor our actions. During my lengthy travels I have yet to encounter any unfriendly or unwilling firefighters, EMTs, or paramedics. The goal of this article is to assist in evaluating your organization’s and your personal customer service competency. Are you part of the crowd or are you competent?
Competent customer service starts at the top. Review the following questions to determine if the management/administration of your organization utilizes what are to be considered ‘best practices’ in customer service:
- Does everyone in the organization understand the importance of excellent customer service?
- Does the organization gather customer satisfaction data on all types of encounters?
- If so, is the data available to all levels of the organization?
- Is customer service training and evaluation an ongoing activity?
- Are your organization’s SOP’s customer service friendly? Translated: Do your SOP’s allow the latitude that enables crews and individual members to solve problems?
- Are those providing excellent customer service acknowledged formally and informally?
- Do the ‘higher-ups’ ever respond to non-emergent calls to observe customer service in action?
- Does the leadership encourage a sense of responsibility for group performance?
Do all personnel understand how their performance affects others?
If an organization is to develop, maintain and grow a culture of customer service excellence, those leading the agency must be fully committed to providing the motivation, training, and tools that are required. Is your organization competent of just part of the crowd?
While the organization can certainly set the tone, it is up to you and your crew to deliver the service. It is the responsibility and duty of each team member to commit to excellent service. This is much more than being competent in the job skills required to meet the demands of the task. We know you have the aptitude but do you have the attitude?
- I am always polite and considerate.
- I have empathy for those we run on whether I perceive it to be an emergency or not.
- I actively listen to the patient.
- I try not to judge those I am helping.
- I demonstrate a positive attitude whether its two p.m. or two a.m.
- I seek to solve problems not just pass them along.
- I help my crew members when they may not be at their best.
- I am competent in my skills and possess the knowledge to perform my tasks well.
Around the station
- We answer the phone as soon as possible and in a courteous manner.
- We respond quickly but safely.
- We welcome all walk-ins.
- Our station is clean and well organized.
- Our equipment is well maintained and always at the ready.
- We take care of each other.
Treating others the way we would like to be treated and in the manner in which we would like to have those we care about treated is really about attitude and awareness. Placing the needs of others before your personal needs is one of the key elements of what is described as humanity. Is it easy to ‘stub your toe’ along the way? Of course it is.
Experience is the best
I am a walking testament to the fact that we all have lapses; times when our true self and our values are not demonstrated. These are not examples that we are proud of, but they are examples that we can learn from. Do we all have times when we ‘fall’ and have difficulty ‘getting-up’ ? Absolutely. I’m going to share a story in which I was the key player. I am the captain in this scenario and although it is not a time in my career that I am proud of, it is an example that I am compelled to share in the hopes that others will learn from it.
The story is drawn from a soon to be released book that I have co-authored titled: “Case Studies for Emergency Responders: The Psychosocial, Ethical and Leadership Dimensions,” to be released in early 2010 and available at most bookstores and online book distributors.
The perfect storm
The sunny spring day was off to an excellent start. The rig had been washed, the quarters cleaned and the all important menu had been planned. The four person paramedic engine company jumped on big red and was heading to the grocery store.
“Channel 6-EMS assignment. Difficulty breathing.” The address followed and the company immediately identified it as their first due.
“Engine 4 responding,” responded the captain/EMT on the rig radio. It was at this point that the clouds started to gather and, unbeknownst to them, the company was rapidly racing into the perfect storm. The chatter started almost immediately.
“I can’t believe anyone could have difficulty breathing on a beautiful clear day like today.I just wish that one time we could shop for chow without somebody needing us.”
“Why can’t they just leave us alone?”
Upon arrival, the EMS equipment was retrieved from the compartments and the two EMTs and two paramedics made their way up the driveway. While knocking on the carport door and trying the knob the paramedic barked, “Fire department!” Once inside it was evident as to why someone might be experiencing difficulty breathing. A cloud of cigarette smoke puffed out the door and inside the smoke was visible and looked to be from ceiling to floor. The paramedic made entry first followed closely by the captain/EMT.
“Don’t you know that smoking can kill you?” the paramedic asked. He followed with, “We’ re going to have to move you outside. It’s too smoky for us to work in here.”
In a gravelly voice the elderly woman sitting at the kitchen table replied, “I’m not going outside where all the neighbors can see me!”
To this the captain replied, “It okay Ma’ am, it’s beautiful and clear out. Your carport is covered and I’ll even set a chair out there for you.”
“I’m not going outside!” was her only reply.
“If you won’t come outside, we are not going to treat you!” added the paramedic.
With a bit of firm but considerate assistance the patient was finally moved to the carport. Her vitals were fine, she was speaking in full sentences and the primary and secondary medical surveys indicated that there was nothing life threatening about her condition.
“Ma’ am, we can’t find anything wrong with you. Do you want to go to the hospital?” the captain queried.
“Yes, I want to go to the hospital. I’m not breathing right!”
“Well if you didn’t smoke three packs a day you’ d probably be able to breathe,” the second paramedic chimed in. The scene continued to deteriorate and the fourth member of the crew, a probationary firefighter/EMT, slowly retreated to the fire truck.
The rest of the story
At this point, the captain made a critical judgment. “Ma’ am, we can’t find anything wrong with you and I can’t justify tying up an emergency transport. I can get you a general transport non-emergency ride but you’ ll have to wait at least 30 minutes. Or, you can ask your neighbor for a ride.”
“That’s unacceptable” the patient retorted, raising her voice.
“Ma’ am, the ambulance that is here is for those who really need it. You are not the only person in this area. What if Tommy was drowning down the street? How would you feel if you took his ambulance?”
The war of wills was now in full force. Gail force wails of discontent filled the air. A neighbor intervened and was quickly dismissed to the sidelines. The captain offered to call his boss, stubbornly sticking to his decision. The patient was finally taken away by the ambulance on the scene and everyone involved in the altercation was very frustrated.
Subsequently, the patient called fire department headquarters to complain about how she was treated. A full investigation of the captain and crew’s conduct was undertaken. After an investigation, spanning several months, including the consideration of a suspension, this case was settled. The captain and a battalion chief went to the patient’s home and the captain apologized for how he and his crew treated the patient.
In admitting just how poorly the incident was handled, and regretting the breakdown, the captain had this to say; “I don’t mind apologizing to anyone when I am wrong. My only regret is that the department took six months to arrive at a simple apology. We didn’t need six months to determine what a successful conclusion would be. We should’ ve been able to draw this conclusion in about six seconds.
During the apology the captain found out that the elderly woman’s husband had died a few months prior to her 9-1-1 call. It became obvious that she was still grieving over her loss and really wasn’t prepared to deal with the challenges that the crew’s behavior elicited.
The less then desirable outcome of this call was determined at the time it was dispatched. The crew members set the tone through their expression of their collective frustration with being interrupted during grocery shopping. Attitude is everything. The time spent during response should be utilized to check everyone’s attitude and focus on the mission. This attitude check is the responsibility of the captain. The company officer sets the tone, not only on the scene but in route to a scene and during preparation for response. In this case the company officer did not serve as the solution; he became part of the problem. He hopefully knew better yet still chose to enter into the fray.
EMS and fire/EMS crews respond as a team. Each member has a personal responsibility to present a positive and professional attitude. Further, each team member also has a responsibility to the team. When things are not going well and the interpersonal exchange becomes unprofessional, team members should intervene in the interest of the individual and the patient.
Individual behavioral breakdowns are not excusable but are understandable. When the total team’s professional behavior breaks down it is often caused by a number of variables. The crew may have been working together too long and adopted a negative team persona. Perhaps the team was collectively burned out. Primarily, team behavior breaks down because none of the members are monitoring attitudes. When time allows, team members should check in with each other at shift change in an effort to see how everyone is doing —did they get enough rest, is everything going alright at home? If a crew member is experiencing a rough time it is very easy to pass this along to the citizens and patients. All crew members, including probationary members, should feel empowered to intervene when attitude is concerned.
In situations that may be progressing poorly it is always advisable to request the presence of a supervisor. Often the presence of a supervisor will provide the catalyst that will turn a call around. Further, the presence of a supervisor can validate the possibility that the customer is not always right or that the EMS provider is not providing adequate customer service.
Finally, disciplinary action is more than likely appropriate in this case. Discipline would best be served if the company officer was called to task. His personal actions were unacceptable and appropriate steps must be taken to prohibit any further recurrence. The company officer or crew supervisor sets the tone and must be held accountable for the crew’s attitudes and actions. As the company officer sets a positive and professional tone through his or her actions an environment of acceptable behavior is established and therefore all others present can be held accountable to that standard.
It is often a challenge to provide excellent customer service at all times. We are human, getting tired, getting burned out and even suffering from what is characterized as compassion fatigue. However, we must always keep in mind that those we serve have called us for a variety of reasons. These reasons are not always clear and we must be able to anticipate that while the caller’s emergency may not be an emergency in our minds, it is in theirs. Those we serve have an expectation regarding the level of service we provide. We must always be prepared to go above and beyond the call of duty; as though lives are always on the line. We must be competent; individually and as a team. We cannot allow ourselves to simply be part of the crowd. We must understand that ‘good’ customer service is just not good enough.