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Going the Extra Mile: How to Get Medics to Bring More Patients to Your Hospital

By Shane Elmore, RN


Recently in my travels I heard something that really stuck with me: “When a hospital goes the extra mile, patients will do the same.”

Think about that for a minute. Is your hospital one that truly goes the extra mile? What does that entail?

The best person to ask this question of is a Paramedic who services your hospital. There are several things that determine where a medic takes a patient who has trusted them with their lives:

  • Destination Protocols -- This is where the paramedic takes a patient to a particular hospital base off of a protocol that has been approved by a Medical Director.
  • Closest Hospital -- Many EMS agencies provide 911 coverage and they may choose the closest hospital to prevent going out of the coverage area
  • Closest Appropriate Hospital -- This may not be the closest hospital but they are a hospital that provides a level of care that is superior to the absolute nearest facility.
  • Insurance or payer -- Some patients have insurance that determines where they need to go for medical care.
  • Patient Request -- A patient has the right to request who they want to provide their medical care.

There is one more, but I saved it because want to expand upon it. This is the question that every medic who has worked more than one shift has been asked. If hospitals had a clue how often this question was asked, it would forever change the way they saw EMS as a customer. The question goes a little something like this:

You arrive to a home of a 56 year old male patient who is having the signs and symptoms of a stroke. As you assess the patient and prepare for transport, you look to the wife who has the proverbial “deer in the headlights look” and ask her where she would like you to take her husband. She asks “Where would you take him if he were your family member?” The medic, if given a choice, will always choose the hospital that “goes the extra mile” even if that literally means driving extra miles to get there. 

So what does “going the extra mile” look like in the eyes of a medic?

1. First responders look for a hospital that practices what they preach -- most hospitals will do all that they can to protect their public image, but medics are able to gain rare insight into what things look like behind the curtain. So how can you increase their access to this valuable information and make sure medics know how well you perform with STEMI & stroke patients? You have to include EMS when you provide performance feedback. Otherwise, they can't know that you really are the best facility for their patient's needs. 

2. Medics also look for a hospital that listens to them and treats them as a part of the team -- I remember when I delivered a STEMI patient to a Texas hospital; we dropped the patient in the ED and I told them in report that the patient was a STEMI and they needed to activate the Cath Lab. I was told that they would “let the ED Doc know.” We dropped him off and went to grab lunch in the hospital cafeteria. When I exited through the ED, the patient was still laying on the gurney in room 4 like he had a laceration on their hand or something equally minor. You might be thinking "Shane that isn’t fair … maybe you were wrong in your diagnosis." This is possible, but if that were the case, I should have received that feedback. Because they did not provide that to me, and because the hospital acted so nonchalant about this patient I believed was experiencing a time-sensitive emergency, I never took another patient there unless I was forced to. Oh ... and it WAS a STEMI!

3. What does your hospital's communication look like? Abbot & Costello’s “Who’s on First” skit is hilarious, but not when it’s being done at the cost of a stroke patient who is losing 2 million brain cells every minute. EMS notifies you that they're coming for a reason. If you are a hospital who takes that call seriously, you will accurately and quickly share that information with your team. If you establish a reputation of smooth and effective communication, then EMS will go the extra mile to get their patient the care they need at your facility.

It really is true that if the hospital goes the extra mile, patients will also travel the extra mile to get to you. If you follow the above advice, I promise you EMS will travel further to get patients to you any time it's at all feasible. Know that simply putting words on a billboard will not do the trick with us … but do know that we are watching. We are a very pragmatic profession. If you go the extra mile, you won’t have to announce it to us.  


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Shane Elmore, RN

Shane Elmore, RN

Shane is Pulsara's Vice President of Clinical Innovation, and is certified in CCRN, CEN, and CFRN. Shane is a former Chest Pain Coordinator at Trinity Mother Frances Health System.

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