By J. N. HALM
There are two components to providing service to customers: the service itself and the individual providing the service.
It is true that in service, it is not easy to differentiate between the one providing the service and the service itself. This is what is referred to as the Inseparability characteristic of service. The human factor in service provision can, therefore, never be overemphasised.
One area where the human factor affects the quality of customer service and customer experience is worker fatigue. The truth is that people are not robots. They do get tired after a while. Such is life. And when they do, the quality of service to offer to customers is affected.
On many occasions, the customer service professional will just work through the tiredness without any problem. However, when the customer happens to be a patient whose life hangs in the balance, then the importance of fatigue becomes even more critical.
There is a common saying among emergency responders that “seconds save lives.” Indeed, in emergency medical services, every second counts. The difference between life and death can be determined by how quickly paramedics arrive at a scene and how fast they can get a patient to the hospital. However, a factor that is often overlooked in this time-sensitive equation is the impact of fatigue on these brave men and women who work tirelessly to save lives.
Anyone who has ever worked a long shift would attest to the fact that fatigue is real. The longer one works, the more tired one becomes. This is just human nature at play. However, in some professions, the effects of fatigue can have far more devastating consequences than in others. Emergency medical services is one such profession where the effects of fatigue can mean the difference between life and death.
A groundbreaking study published a couple of years ago brings to light some fascinating insights about how fatigue affects the performance of frontline workers, in this case, paramedics. The title of the study was “The Distributional Impact of Fatigue on Performance” and the results were published in the January 2021 edition of the SSRN Electronic Journal. The study, conducted by researchers from the Wisconsin School of Business and MIT Sloan School of Management, analyzed an impressive dataset of 368,634 paramedic teams from the London Ambulance Service over a decade-long period. The findings of this study should make every healthcare administrator sit up and take notice.
The most striking finding from the study was that as paramedics progress through their shifts, the average time it takes to get patients to hospitals increases by 5%. At first glance, this might not seem like much. However, when one considers that in emergency medical situations, every minute—indeed, every second—counts, a 5% increase in response time could have serious implications for patient outcomes. A 5% increase in response time could literally be the difference between life and death.
What makes this study particularly interesting is that it goes beyond just looking at average response times. The researchers delved deeper into how fatigue affects the consistency of paramedic performance. Their findings were quite alarming. The variance in service time—that is, how much the response times differed from one case to another—increased by a whopping 39% during a normal shift. In other words, as paramedics become more fatigued, their performance becomes significantly less predictable.
Think of it this way: Imagine you are playing darts. When you start, your throws are consistent, mostly hitting close to the bull’s-eye. However, as fatigue sets in, not only do your throws generally become less accurate, but they also become more erratic. Some throws might still be close to the target, while others might miss the board entirely. This is essentially what happens with paramedic response times as fatigue sets in.
The study’s findings become even more intriguing when one looks at the specific aspects of the paramedics’ work that are most affected by fatigue. The researchers found that the increase in response times was primarily driven by the performance of paramedics at the scene, rather than their driving to or from the incident. This suggests that it is the complex, decision-intensive aspects of paramedic work that suffer most from fatigue, rather than the more routine tasks like driving.
One might think that experienced paramedics would be better able to handle the effects of fatigue, or that having fewer calls during a shift would help mitigate these effects. However, the study found that neither experience nor reduced workload significantly reduced the impact of fatigue on performance. This is a sobering reminder that fatigue is a fundamental human condition that affects even the most seasoned professionals.
The implications of these findings are far-reaching. For healthcare administrators and emergency service managers, this study highlights the critical importance of managing shift lengths and workload distribution. It’s not just about ensuring that paramedics do not work too many hours; it is about understanding that the quality and consistency of their performance naturally deteriorate as their shift progresses.
For policymakers, these findings should inform discussions about healthcare resource allocation and emergency service staffing levels. Perhaps more importantly, it should prompt a serious review of current shift patterns and working hours in emergency services. The traditional approach of long shifts might need to be reconsidered in light of these findings.
The study also raises important questions about how we measure performance in emergency services. Traditionally, the focus has been on average response times. However, this research suggests that we should also be paying attention to the consistency of performance—the variance in response times—as this can be significantly affected by fatigue.
From a practical perspective, there are several steps that emergency service providers might consider taking in light of these findings. First, they might want to implement more sophisticated fatigue monitoring systems. Second, they could consider adjusting shift patterns to ensure that the most critical cases are handled by fresher crews. Third, they might want to build in more recovery time during shifts to help mitigate the effects of fatigue.
It’s worth noting that while this study focused on paramedics, its findings have implications for other high-stakes professions where fatigue can affect performance. Whether we’re talking about surgeons performing operations, air traffic controllers managing flight paths, or nuclear power plant operators monitoring reactors, the impact of fatigue on performance consistency is a crucial consideration.
The road ahead is clear. We need to move beyond simply acknowledging that fatigue affects performance and start implementing practical solutions to address this challenge. This might require significant changes to how emergency services are organized and resourced, but when we remember that seconds save lives, such changes become not just desirable but necessary.
After all, when it comes to emergency medical services, consistency can be just as important as speed. A system that is consistently good might be preferable to one that is sometimes excellent but increasingly erratic as fatigue sets in. In the end, it’s not just about getting to the patient quickly—it’s about ensuring that every patient, regardless of when they need help, receives the same high standard of care.
As said earlier, the impact of fatigue on the performance of employees cannot be solely reserved for individuals in high-stakes professions. Even those working in less critical jobs are not exempt from being affected by fatigue. The bank teller who is exhausted is also likely to make mistakes and even end up causing the business to lose money. The same goes for any other business professional whose job involves serving lots of customers over a long time.
Employee workload can be effectively managed through several interconnected strategies to prevent fatigue and maintain high performance. This begins with clear task prioritization and time blocking, where employees are helped to distinguish between urgent and important tasks while creating realistic schedules.
Regular workload assessment helps identify signs of overwork early, allowing for timely adjustments. Strategic break management, including techniques like Pomodoro (25 minutes work, 5 minutes break) and encouraging proper lunch breaks, helps maintain energy levels throughout the day.
Since work schedules as well as work situations differ, it is important that every organisation, department, unit or even individual find out what works best for its particular context and then implement the same. While we wait for robots to take over our jobs, we must value the human workers at the post. As discussed, fatigue cannot be ignored. It could be the difference between a live customer and a dead one.
