At 6 a.m. each morning, paramedic Keri Cook arrives at the offices of Pro EMS and collects the latest reports detailing the emergency calls recently handled by her colleagues.
“I review every single patient care report, whether it was a transport or cancelled,” said Cook, who serves as Pro EMS’s Director of Continuous Quality Improvement (CQI).
It adds up to more than 20,000 cases a year. But for Cook the process allows her to collect and analyze clinical data – and gives her the ability to directly impact the quality of the services provided by Pro EMS.
As Director of CQI, Cook spearheads one of the biggest initiatives at Pro EMS: To increase the clinical sophistication of every member of the Pro EMS team, and in doing so, improve the quality of patient care.
The CQI process that Cook helps to implement involves a continuous loop of analyzing data from emergency calls; providing consistent feedback to field members; enhancing skills through training; and implementing the latest technologies in order to advance care.
Importantly, Pro EMS also incorporates customer satisfaction surveys in its review process so that the patients themselves have a voice in the quality of the care they have received.
“Our job is to make them better EMTs,” Cook says. “People who join Pro EMS are drilled from the moment they’re interviewed. The training never ends.”
A Resource, Not a Reprimand
A paramedic for 15 years, Cook draws on her field experience as she reviews cases and provides feedback.
Whether praising situations that were handled particularly well, or pointing out when protocols were not followed, Cook stresses the educational aspect of this process. Her goal is to frame the feedback as a learning experience.
Cook’s firm, yet fair, guidance has encouraged EMTs and paramedics to approach her as a resource, instead of seeing her reviews as punitive.
EMTs and paramedics anticipate Cook’s feedback, and routinely seek out her advice. Many days, arriving for her daily shift, Cook finds messages waiting in her inbox that begin, “I did a call last night and wanted to run it by you…”
Cook’s experiences as a paramedic, and as a manager, also expanded her perspective on what it means to “make a difference” – a big reason many individuals say they want to get into EMS as a career.
Twenty years ago, as a new EMT working at Pro EMS, Cook eagerly anticipated the “blood and guts” calls and their accompanying adrenalin rush.
Over time, Cook learned, calls are often less exciting: the 80-year-old woman who is lonely and not feeling good in the middle of the night, or the intoxicated homeless man who routinely requires transportation to the hospital.
While treating a gunshot or stabbing victim can be overtly lifesaving, Cook has come to realize that even on seemingly mundane calls, she and her colleagues can positively impact a patient’s life.
“Most people [in EMS] want to make a difference and are in it to help others,” Cook states, “It’s not for the financial gain.”
In fact, dedication and commitment are qualities Cook and her colleague Rachid Sbay, Director of Operations at Pro EMS, seek when initially interviewing potential employees.
“We interview by committee…and tell people that [at Pro EMS] we want to make them the best EMT or medic they can possibly be.”
Adding Technology to the Field
In addition to acting as an educational resource, Cook and some of her colleagues are charged with the task of finding cutting-edge technologies and new protocols for patient care.
Over the past few years, a group of top managers from Pro EMS attended the annual “Gathering of Eagles” Conference that’s held in Texas and hosted by the U.S. Metropolitan Municipalities EMS Medical Directors Consortium (known as the “Eagles” Coalition). Attended by the 30 largest EMS systems in the country, this conference discusses the newest advances in pre-hospital patient care.
“We find that we stack up well with the rest of the country, but we always bring one or two things back,” Cook says.
Constant attention to new, evidenced based treatment modalities and equipment has allowed the Cambridge EMS system to be early adopters of the EZ-IO (intraosseous) drill; myriad advanced airway procedures; continuous positive airway pressure (CPAP); and the implementation of a therapeutic hypothermia after cardiac arrest protocol.
Cook always knew that she wanted to work in the medical field. After graduating from high school in 1987 in Cambridge, MA, she first considered a career in nursing.
“I didn’t want to stay inside all the time,” she says.
She became an EMT in 1989 and started working at Pro EMS. Cook recalls being terrified on her first calls.
“It took about six to seven months to get used to the job,” she said.
After a year on the road, Cook began working in dispatch. In 1993, to further her education, she enrolled in a paramedic training program in Hyannis, MA, and graduated a year later.
She’s since served in various roles, including Operations Supervisor and Field Training Officer. But it’s her current role that really makes Cook feel that she has a personal stake in the success of Pro EMS and the people who work there.
Speaking with potential employees, she and Sbay describe the unique culture of the company.
“We weed out a lot of people. We are looking for people who want to do the job and be great,” she says.
A resident of Tewksbury, MA, Cook is married and has an 11-year-old daughter.