In the back of an ambulance, we are masters of clinical assessment. We can walk into a dark room, look at a patient’s skin signs and the way they’re using their accessory muscles, and know within three seconds if they are “sick or not sick.” We don’t guess; we verify. We slap on the monitor, grab a cuff, and let the data tell us the story of what’s happening under the surface.
But when it comes to the organizations that put those ambulances on the street, we’re usually flying blind. We manage by “vibes” or just by reacting to the most recent crisis, failing to realize that the agency itself is a patient—and it’s currently tachycardic.
The Organizational Anatomy
EMS agencies are actually a lot like EMS patients: they run because of a few important, interconnected systems. When one system stops working, the other systems are impacted. Both organisms and organizations have a limited capacity to compensate, and then they crash. There are plenty of indicators that a patient is heading in that direction, as long as there is someone to notice the signs.
Luckily, we have EMTs and Paramedics who are trained to look for the external manifestations of those subtle internal processes, like vital signs. By continually checking a few data points like blood pressure, pulse, and respiratory rate, EMS providers are able to understand a weirdly wide range of fundamental physical processes. By tracking changes and trends, we can tell if our patient is getting better or worse, and whether our treatments are working.
This is what data-guided management and informed decision-making looks like. We’re actually pretty good at it when it comes to patient care. We know this approach works, because we’ve all had patients we would have walked to the ambulance—until we saw the hummingbird pulse rate. Then things got real serious. The data doesn’t lie. Not like that sneaky hemodynamic compensation.
Just like injured patients, struggling EMS agencies are telling us exactly what’s going on internally through data that’s visible externally. All of the tasks involved in EMS management generate data, and each of those little numbers tells us something about how things are going. It’s not until we combine the datasets from different parts of the service’s operations that we really start to get the diagnostic view.
Moving Toward Advanced Assessment
Treatment Starts with Assessment
We wouldn’t give a patient a strong medication without checking (at least) a blood pressure first. Why would we make major operational changes—like changing shift schedules or adjusting our deployment model—without checking our agency’s vitals? It’s the only way we’ll know if the med, or the operational adjustment, is actually working.
The “EMS Sustainability Crisis” isn’t a mystery; it’s a clinical condition. The data is there, blinking on the monitor screen, waiting for us to interpret it. If we want our agencies to survive the many challenges of the post-pandemic healthcare hellscape, we have to stop managing by intuition and start managing by strong assessment. We can help you listen to what your agency’s vital signs can tell you. Because in EMS, the data doesn’t lie—it just waits for someone to listen.
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