Adrian Diogo is Director of the Mayors Wellness Campaign at the Quality Institute.
You work in health care policy. Why did you decide to train to become an Emergency Medical Technician and to now volunteer as an EMT?
I thought that being on the front lines of health care and actually providing care would inform my work in policy. So much of our policy work focuses on the experience of practitioners and I wanted to understand that perspective in a more personal way.
You were required to spend 15 hours in a hospital as part of your training. What did you learn?
Students support emergency department and triage staff with vital signs and patient transport. I gained some understanding of the emergency department. The reports I read and the statistics I see are just not the same as being there and seeing the challenges faced by emergency departments — from hospital utilization to the opioid epidemic. For instance, in my short time in the ER I saw five or six people come to the emergency department to refill prescriptions, even though the hospital has a clinic a few blocks away.
How has being an EMT informed your thoughts on the opioid epidemic?
Seeing a person who overdosed when I am out in the field or in the ER really personalized this crisis and took the issue beyond the statistics. I also spoke to the ER nurses. They give people information to follow up but many of the nurses said we need better ways to connect patients to the services that are out there. There are not enough services, and connecting patients to the services we do have can be a challenge. The nurses said there is not enough follow up after a person is treated for drug overdose in the ER. This is an example of how being an EMT can inform my health care policy work.
What are the other ways your experiences as an EMT will translate to your work at the Quality Institute?
I have worked on CPR calls, car accidents … helped people with difficulty breathing. At the Quality Institute, I work on the Conversation of Your Life program to encourage people to write down their advance directives. But as an EMT I see that if you have a cardiac arrest and we arrive we are required to perform CPR unless the document is available. So I see the complexity of the real world. Another instance are the calls from nursing homes for very minor problems that a nurse or physician on call could handle. But the nursing home calls 911. This adds distress to patients and adds to the cost of health care. I also understand what it’s like to help people when they need you most. There is a lot of critical thinking that takes place as you are transporting people to the hospital. Then later I can consider what is going on at the policy level and connect my experiences to my work at the Quality Institute.
Are there ways you see the work of the Quality Institute play out in health care?
Yes. Here’s one example. In the field, I have seen the results of health care quality measures like the Leapfrog Hospital Safety Grade. (The New Jersey Health Care Quality Institute serves as the Regional Leader for Leapfrog in New Jersey.) Depending on the severity of injury or illness, patients can request to be taken to the hospital of their choice. More often than not, patient hospital choices directly reflect the Hospital Safety Grades. There’s a positive correlation among Hospital Safety Grades and able-patient hospital transportation requests.