Because it's the way it's always been done.

[tcripp]

Taking this from another thread so that that one doesn't get hijacked...and thanks to flamingemt2011 for the segway.

I am what the corporate industry would call a type a personality. After spending nearly 30 years in the corporate world, I am of the mindset that there are always better ways to do things, sharing of best practices is a good thing, and the only thing constant is change. I then enter the world of EMS.

As a new hire (cadet) last year, I found myself always questioning why things were being done a particular way and making recommendations on how to change it to possibly make it better. LOL, this also included typos in our documentation, both internal and external. What I didn't know is that, as a cadet, my comments/suggestions would not only be met with deaf ears but much resistance.

How does your service handle suggestions for improvement or questions of "why" without saying, "it's the way we've always done it."?

Toni

[Kiwiology]

It depends what you want done.

If it is clinical it goes to the Regional Clinical Support Team Leader or you can go directly to your Regional Medical Adviser but it now must be approved by the Ambulance National Clinical Working Group since we now issue national Clinical Practice Guidelines. When either St John or WFA takes over Wairarapa DHB next year it'll make things much easier lol. *secretly hopes to see yellow vans in Masterton ... it also helps that Dr Tony Smith (the St John Medical Director) is chair of the National Clinical Working Group mwahahaha

If its an operational (non clinical) thing it goes to your Operations Team Leader or Team Manager depending on which your station has ie each station an OTM but some stations have OTLs for each watch if they are large enough.

Such suggestions are usually taken fairly seriously; we have a formal process and should the Operations Management Group want to trial it, we also have a formal pilot project process

<pedestal> We didn't get the best scope of practice and education standards in the world by sitting on our bum and standing still </pedestal>

Edited October 28, 2011 by kiwimedic

[hatelilpeepees]

kiwi, thats not the way it works here in the US. A couple of insites and suggestions tcripp:

1. It sounds like they are not very proactive, so you will have an uphill fight, but what I would suggest is to pick the most "wrong thing" that you can find, find a solution to it, then present the solution as a project you want to work on or just fix it and show what you did. For instance, you talked about typos. I assume that your policy & procedure manual is filled with typos too, so take a copy home and retype it, throw in some graphics, make it snazzy. Then present them with the new manual that they can copy. I am not saying this about you, but generically speaking, medics are real good at pointing out what is wrong, but they rarely volunteer to be part of the solution. When you bring the solution, or are willing to work on it by yourself or with a group of employees, managers are typically more willing to listen.

2. Visit a neighboring service to see how they do it. I have seen the most common things done so many different ways, like truck inventory for instance. I know systems that use sealed tubs in the cabinets, I know systems that use sealed cabinets, I know systems where everything is just out in the open in the cabinets. Some systems pay a person to restock and wash trucks (private, all at one station), as it is cheaper to pay one person $10.00/hour to do it, versus two people on overtime. There is always a better way. Visit the largest 911 provider near you, and the smallest nasty service too you, you will learn something from both.

3. Do you have a QI/QA or CQI committee to join ? If not, create one with likeminded medics, and start solving problems.

4. Create the "Board Meeting". Invest in a large dry-erase board, during the day/week, write down the problems that occured. Then once per day/week get all managers to meet at the "BOARD" and assign each problem to a manager/employee, and assign a deadline time for fixing it. At the next BOARD Meeting, review if the problem has been fixed, and if not, why not. Your owner will love this idea, managers will hate it, until they see the productivity and ACCOUNTABILITY it creates.

[medicgirl05]

I completely understand your position of newbie. I have been here 6 years now and from the beginning I noticed things that could be improved on or fixed. While others here recognize that problems exist they resent the idea of a new person trying to fix it.

HLPP suggested you just change it then present it to management, while that may work in some places it did not work for me. I was met with much resistance and rather than changing anything I spent lots of work on nothing.

Good luck to you. Don't get so centered on what you could do to better things that it causes you to burn out.

Just my 2 cents.

[tcripp]

For the record...I've figured out how my system works. Hoping that maybe we, collectively, might be able to change how new cadets are viewed.

[DFIB]

I know that my third world situation is vastly different from any of yours. More than a serious contribution this is going to be a little rant.

My service is led by an absent leadership and run by a bunch of small minded people that could screw up a wet dream. Med direction is a joke that spends his time sharking the service to line his practice with patients. No online directives. Horrible supply replacement. Very little accountability. A good worker is someone who doesn't steal stuff, shag a coworker while on duty or show up with ETOH on his/her breath and there aren't very many of them. When I pull call I show up with my entire crew because none of the other people are trustworthy. I love EMS but hate my service administrators. What can I do? They are the only show in town.

That said I have several very significant structural changes in mind that would be very productive and revenue producing. They would also cost a lot of folks their job. I am waiting for the annual leadership changes before I even bring up the ideas for change. If I can get onto the board I will be set for some really good things. Attempting change in my current set up is a waste of time.

So no matter how difficult your situation seems, it can always be worse.

Edited for spelling

As soon as I posted the above a lady called that said she was a "friend" of the service president to "buy" a CPR card for her husband without taking the class.

Yea, your situation could definitely be worse.

Edited October 28, 2011 by DFIB