Use Difficult Conversations to Provide Better Healthcare
Pretend you are a dust bunny behind the couch. Your life has meaning there, and you find happiness even though this is not what you expected. Times have been better, but things could be worse after all. The default in this world though is to be the fur on the back of a cat, not just some collection of fur, dust and house plant debris. Today, you have a problem and you need help. You aren’t exactly clear on what you want to happen, you just know that you need help. What arrives to your plea is a broom and a dustpan. The broom does not ask many questions – it just sees you as a dust bunny. Unfortunately, EMS agencies are like a broom that sweeps people toward the dustpan of interventions and life-prolonging treatment. Like a dustpan and broom, we are called to do a job: we sweep, scoop, toss and get ready for the next mess. EMS providers seldom take the time to ask that dust bunny with COPD what he or she truly wants, based on the facts. Why is this so? The most obvious reason is due to the way most EMS agencies can bill for service. We must take the patient somewhere (hospital, rehab center, helipad) in order to be reimbursed, so it makes sense that emphasis is placed on getting going. Also, there are times, of course, when speed is needed due to truly life-threatening emergencies, but these occur for the minority of EMS calls. Related Quality in EMS: Past, Present and FutureImproving Systems of Care in Time-Sensitive Emergencies Another rea...
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