Rules are no substitute for training

Rules are no substitute for training

Alan Perry

September 29, 2013

Rules are no substitute for training. Having been responsible for monitoring and correcting performance issues in field EMS I can tell you that it is always better to recognize the true source of the problem. It has been my experience and expectation that my providers want to do the best they can for our patients, they recognize when they need to brush up on a skill and come forward either requesting additional training or offering to conduct it themselves. In those rare circumstances when a problem develops that is evident through the QA process my first approach is always to examine the training. If it is an isolated event or a recurring problem with a single provider counseling is warranted which may include some one-on-one training. If it is presenting as a more widespread problem then clearly it is more of a training failure, either communication of the protocol or procedure, or the expectations. In either case merely writing a new policy to enforce an existing standard of care is not effective.

Performance gaps will present themselves in the dynamic environment that is modern EMS, the challenge for supervisors and system managers is to not add to the complexity, which is already growing, by supporting the on-going training needs of our providers. I know money and resources are tight but the potential liability to you, your providers and your organization could be much more costly. If you look at it from a risk avoidance standpoint it makes economic sense. Healthcare is becoming more performance & outcome oriented, our customers are more aware of the standard of care, your providers do what they do because they want our patients to have the best outcomes, from a moral & ethical standpoint a quality training program makes sense.

A quality training program should include periodic review, training & testing on all protocols, procedures & operations, this should be coupled with competency verification of essential & basic skills conducted at least twice a year if not quarterly. Such a program assures and verifies competency of these low frequency/high risk skills, giving them confidence in the face of their most difficult calls and improving the overall performance of your service. Don’t forget to add a personal touch, your providers need to know your expectations, the OMD’s expectations, and those of your supervisors, they should all have face time in the training process. Do you and your OMD know all of your providers by name? They will be more likely to respond positively to a request from you, or your agency’s OMD if they know you personally. They just want to know you value them and the work they do.