The Ultimate EMS Protocol
I don’t handle the card much anymore. It stays inside a plastic sleeve in my planner. The edges are worn and the words are faded. It wasn’t printed on kind of paper that travels well in a wallet for twenty plus years. But it’s been worth carrying. It is, quite simply, the ultimate EMS protocol.
I don’t read it often. I’ve read it enough times over the past two decades to have it pretty well memorized.
It’s my STAR CARE card.
I got it back when I was a paramedic student at Baystar Ambulance in San Mateo California. It was 1992. I always believed the original author was none-other-than EMS guru Mike Taigman. Mike had signed on to be the quality care guy at the fledgling service and I knew the cards had originated in his office.
The idea was simple. We can’t write a policy for eveything you may encounter in the field. Instead, use this guideline. If the decision you’re about to make passes these eight tests, we support you. NO matter what. Come hell or high water … we have your back.
It’s brilliant really. It’s the policy to end all policies. It’s the grand daddy algorithm. It’s the ultimate protocol.
Fast forward a decade or so. I had been working at a new start-up service in Colorado called Pridemark for afew years and I found myself in the CEO’s office discussing field care and policies. Jeff was a fairly progressive boss and it suddenly struck me that he had never seen my old STAR CARE card.
I said, “Hey check this out.” and I pulled the worn card out of my wallet. He studied it briefly, then smiled. He opened his wallet and pulled out an identical card. Jeff was an old friend of Mike’s since their days together back at Denver General. He’d received his card about the same time I had gotten mine and had also carried it ever since.
Five years and a hundred STAR CARE conversations later I sat in the office of Thom Dick. Thom seemed like he would love the STAR CARE guidelines. They were so in tune to everything he taught as an EMS administrator. I pulled out the card and asked, “Have you ever seen this?” Thom smiled his humble smile and admired my well worn card.
“Yeah”, he replied. “I remember Mike calling me while they were trying to get Baystar up and running. He said he didn’t have time to write a policy manual and wasn’t sure what to do. I scratched this out that night and sent it to him the next morning.”
At long last, the original author of the STAR CARE protocol had been revealed. Thom beamed when he saw his idea still alive and well after so many years. And now it lives on here. The next step in the journey of a brilliant idea.
So you want to know what’s on the card right? OK, here it is … word for word.
STAR CARE Checklist:
The following is a checklist you can use to analyze almost any patient care issue you might encounter. Go through the list in order from top to bottom, and ask yourself if your care meets each criterion. If it does, chances are that you can defend your actions in almost any forum.
Safe
Were my actions safe for me, for my colleagues, for other professionals and for the public?
Team-based
Were my actions taken with due regard for the opinions and feelings of my co-workers, even those from other agencies?
Attentive to human needs
Did I treat my patient as a person? Did I keep him or her warm? Was I gentle? Did I use his or her name throughout the call? Did I tell him or her what to expect in advance? Did I treat his or er family and / or relatives with respect?
Respectful
Did I act toward my patient, my colleagues, my first responders, the hospital staff and the public with the kind of respect that I would have wanted to receive myself?
Customer accountable
If I were face-to-face right now with the customers I dealt with on this response, could I look them in the eye and say, “I did my very best for you.”
Appropriate
Was my care appropriate - medically, professionally, legally and practically, considering the circumstances I faced?
Reasonable
Did my actions make sense? Would a reasonable colleague of my experience have acted similarly under the same circumstances?
Ethical
Were my actions fair and honest in every way? Are my answers to these questions?
Almost two decades later, the principals of STAR CARE still ring true. If you want to know if you’re about to do the right thing, look no further. In just about any organization on earth, the principals of this simple acronym will be all you need to defend yourself.
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Tags: accountability, liability, patient advocate, patient care, patient comfort, protocols, responder safety, scene management, scene safety, star care, team, teamwork
The STARCARE concept was rolled out at my agency a little more than a year ago, but did not really receive acceptance. I think a large part of it was the way that it was explained, and this is a really different perspective of looking at it which makes it much clearer and simpler.
Thanks for the providing the opportunity to comprehend it!
You’re welcome Dave. I’m sure how it is presented and adopted is going to be critical for its success. I was fortunate to have a leadership team that embraced the idea as more than just a motivational tool. They embodied the idea. And they had great buy-in from the employee group.