The American engineer, statistician, professor, author, lecturer, and management consultant, William Edwards Demming, answered that question by quipping, “Without data you’re just another person with an opinion.”
While that might sound like a witty response for use during a county budget hearing, he was painfully correct. There are varied reasons why having the data is necessary. Some pragmatic reasons we need the data include: as humans we are notoriously poor at estimating and forecasting, data creates an objective standard, analysis avoids blind assumptions about performance, and most importantly, the nature of EMS demands realistic self-critique and accountability. Data is a powerful part of the array of patient satisfaction tools that help EMS providers elevate their standard of care.
Data helps decision making
We are human and it is well documented that humans are exceedingly poor at making objective decisions. We interpret statistical correlation as implying cause, extrapolate trends, ignore or do not correctly use probabilities when making choices, draw inferences from samples that are too small or unrepresentative, make overly optimistic and unjustified forecasts, routinely overestimate our abilities, and underestimate the time and effort required to complete difficult tasks. And that’s just for starters. These phenomena are robustly supported by, well…data. In the words of Ron Burgundy, “It’s science.”
Data is objective
Data provides an objective standard for performance assessment. Think of performance as a physical object, for example, a car. The data describes the car. The data tells you the make, model, color, size, age, gas mileage, and any other descriptors that help you create a picture of the car in your mind or the minds of others. Doing so allows you to decide if that is the kind of car you want to be or ought to be driving given your goals.
Using this analogy makes it easier to see the value and power of patient satisfaction data to help guide the direction of an EMS organization. A Ferrari is an awesome car, but that does not mean it’s the right car for everyone.
By and large, the delivery of emergency medical services is an operational problem, not a clinical one. Operational demands dictate clinical capabilities. The data provides objective patient satisfaction information that measures performance so a better assessment can be made of the need and way to modify or reinforce the behaviors that constitute excellence.
Data provides logical explanations & objective standards
Given the moral dimension of EMS it is responsible and professional to have an accurate picture of performance. Having the data quickly and easily available avoids reductionist or lazy explanations for both high level and unacceptable performance. It is tempting to avoid the mental and physical work of analysis in favor of blame.
There is seldom, if ever, a single contributing factor for success or failure. Rather than operating on perception and incomplete information, the data allows for a more complete and accurate model of contributing factors.
The limitations of our brains, the need for an objective standard plus professional and moral standards, and the need for realistic assessment of performance demand gathering of and attention to the data. Horribly paraphrasing Socrates, the unexamined EMS service is not worth working for. My suspicion is that your data will surprise you.
But what do I know? I don’t have your data, so I’m just another person with an opinion.
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Chris Postiglione, MSN, MPH, RN, NREMT-P is a critical care nurse and paramedic with experience in pre-hospital emergency transport medicine, hospital critical care, clinical research and drug development. During his career he has worked with data to measure and improve performance and to support clinical and operational guidelines. He resides in Austin, Texas.
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Further Reading
Kruger, Justin; Dunning, David. (1999). Unskilled and unaware of it: How difficulties in recognizing one’s own incompetence lead to inflated self-assessments. Journal of Personality and Social Psychology, Vol. 77(6),1121-1134.
The Monty Hall Problem: https://www.youtube.com/watch?v=mhlc7peGlGg
PsychologyToday.com: Why Are People Bad at Evaluating Risks? https://www.psychologytoday.com/blog/the-inertia-trap/201303/why-are-people-bad-evaluating-risks
Errors and Bias in Judgment: http://www.prioritysystem.com/reasons1.html