By Glenn Gaines
Medic 44 arrives on the scene of an anaphylactic shock patient who was stung several times by hornets. The two medics have discussed what they will do on the way to the incident.
Upon arrival, the paramedic riding the aide position immediately leaves the vehicle, grabs the aide bag, the meds kit and heads out to the rear of the home where the patient is on the ground with impaired breathing.
The medic positions the head properly and listens for improved air exchange. He hears what he hoped for and begins to focus on administering epinephrine.
The proper dose of the medication is administered after a brief cell phone conversation with the emergency department doctor. Before the patient is fully loaded, his breathing has begun to improve.
Another perfectly performed routine operation as expected.
There are literally thousands of combinations of operations and tasks firefighters and paramedics are expected to perform perfectly every time out. The questions for fire chiefs and senior officers are, should they expect perfection from humans or is excellence good enough?
What is perfection?
Merriam Webster defines perfection as: "Being entirely without fault or defect, flawless, satisfying all requirements, accurate, absolute or unequivocal."
Merriam Webster defines excellence as: "Better than all others, the state, quality, or condition of excelling; superiority."
In 1711, Alexander Pope published the poem "An Essay on Criticism, Part II" where he coined the popular phrase: "To err is human." What followed was, "to forgive, divine."
It appears the author is resigned to the fact that humans cannot be expected to be perfect, so be prepared to forgive deviations from perfection.
If we believe the preceding, then we must surmise that to expect perfection from humans is a delusion, for they are indeed imperfect. However, most high-performing organizations establish their goals toward perfection.
Regarding the pursuit of perfection, noted Green Bay Packers Head Coach Vince Lombardi is quoted as saying, "Perfection is not attainable, but if we chase perfection we can catch excellence."
Failure as the exception
If we are to establish zero-error margins in fire and EMS organizations, how might we select which operations, tasks or behaviors as potential candidates? Here's a list of consequences that require zero-error margins.
Failure to attain perfection will cause:
- the loss of life;
- harm or human suffering;
- loss or damage to property;
- the organization to suffer significant civil or criminal penalties; or
- the loss of the credibility and public trust of the organization.
There may be other high-impact results from failure to achieve perfection, however, the preceding is a sound base.
High-performing fire and EMS organizations establish and will not deviate from high standards of performance, ethical behavior and moral conduct. These high-performing organizations know that occasionally there will be challenges to these extraordinary expectations, yet they stand fast.
They stand fast regardless outside and internal pressures to relax their standards. What these extraordinary organizations also know is they cannot accomplish the big things, the great things, if their members cannot perform the little things, the core things perfectly every time.
Investors, constituents, people with power will not invest in an organization that routinely fails to perform the basics like respond quickly, efficiently, effectively, respectfully and safely to requests for help.
So here is how it will play out if we cannot perform the little things right. Late in the evening, after a city council meeting, one of the city council members will be heard saying to another member of council, "So Henry, we need a USAR team in this region, but, can you believe the fire chief came to us tonight wanting more funds to create an urban search and rescue team when one of the chief's teams got lost responding to my neighbor's heart attack and last week failed to get water on that church fire because they couldn't find a fire hydrant fast enough? I don't know about you but, they don't get my vote."
The important message here is if we are to lead and be a part of a top-performing organization, we are charged with ensuring our members are motivated, equipped, trained and continually encouraged to behave, perform and produce impeccable service to those they are sworn to protect every day.
Finally, continually strive for perfection and expect nothing less than excellence.
About the author
Glenn A. Gaines was the Federal Emergency Management Agency's deputy U.S. Fire Administrator for the United States Fire Administration. He began his tenure in March 2009 and was responsible for managing USFA programs and training activities conducted at the National Emergency Training Center. Chief Gaines began his fire service career as a member of the Fairfax County (Va.) Fire and Rescue Department. He served in numerous capacities, including fire marshal, chief training officer, and chief of operations, culminating in his appointment as fire chief from August 1991 until December 1998. He was in charge of the nationally recognized Fairfax County Fire and Rescue urban search and rescue team that frequently deployed throughout the United States as well as internationally. Chief Gaines earned a degree in fire administration and has authored a fire service text, contributed to several other texts, and written numerous articles for several trade publications. He has served as a faculty member at the USFA's National Fire Academy, and was actively involved with organizations related to the professional development of the fire and emergency services.