PRACTICAL LEADERSHIP CONCEPTS

Since the goal is to build a high performance EMS team, we first must describe what a generic high performing team resembles. Ken Blanchard, of the "One Minute Manager" fame, describes the elements of such teams with the acronym PERFORM (Purpose, Empowerment, Relationships and Communication, Flexibility, Optimal Productivity, Recognition and Appreciation, and Morale). How these elements can be applied to volunteer ambulance teams is what will be described in this chapter.

Purpose relates to whether all team members understand the clear, challenging and relevant goals and strategies of the organization. Volunteer work output in an ambulance service is tied directly to how much value the volunteer believes he or she is providing the organization. If the volunteer does not understand how his or her efforts fit into the organization, their output will drop. On the surface, this appears to be the simplest of the elements to introduce and accomplish. Yet the development of the organizational mission statement, goals and strategies should be done thoughtfully and, once prepared, communicated throughout the organization. Having all members "buy into" these beliefs can be challenging. Gaining consensus in any volunteer organization can be difficult.

Empowerment relates to whether team members feel a sense of personal and collective power in order to support the organizational objectives. Do members have access to the necessary skills and resources to be effective? This element of an effective team is not often seen in volunteer ambulance services. All too often, a handful of the civil or operations officers make many of the decisions that directly affect the members. This is particularly damaging to a volunteer member that has expertise in that subject area.

Building good relationships and communication is yet another aspect of building high performing teams. This aspect emphasizes the openness and understanding between members. Unfortunately, our experience leads me to believe that these attitudes do not flow through many volunteer services. As such, this aspect of building teams is one most services need to address. The member retention chapter of this text provides some ideas for enhancing the flow of communications through an organization. 

Flexibility is another important element of a high performance team and its members. EMS has been, and continues to be, a rapidly evolving discipline. Services and their members that understand that and are willing to embrace it are easily spotted. For example, some services in America remain staffed by medics with Advanced First Aid training, while others are utilizing Paramedics. Successful services are willing to challenge themselves, and their members, and react appropriately. Flexibility is key to a service evolving within its industry. 

Optimal Productivity is also integral to the performance of a team. As for volunteer ambulance members, optimal productivity is often not reached. This is due to the small number of calls most volunteer services respond to. Members typically never respond to enough calls to develop and maintain high productivity. This fact is discouraging to members who have high personal expectations of care. Those members, who believe they are not performing well, may leave because they feel they are of less value to the team. To combat this situation, services need to provide meaningful feedback to medics on their performance, good educational opportunities and, if possible, a chance to "ride along" with busier services. 

Recognition and appreciation is an important aspect of volunteer team building. Since a salary is not delivered, recognition and respect from peers, the community, and management is critical. The recipients must value Service Recognition awards, not necessarily that they are valued by management alone. The member retention chapter deals with recognizing members. 

Building and maintaining morale is impossible in a volunteer service with poor leadership. Members must feel good about their membership on the team. Leaders must create an environment where members have confidence in their medical skills and are proud of it. Again, members who believe they are making a significant contribution to the team usually continue to volunteer.

It is easy to envision how Blanchard's elements of high performing teams relate to volunteer ambulance services. Each element is easily connectable to these services. Service leaders need to explore these elements and learn how to implement them.

Common Leadership Practices

Our search for developing strong leadership in volunteer ambulance services takes us to the work of Kouzes and Posner. Through their work, the two described five leadership practices successful leaders have in common. The first of these practices is known as "challenging the process". This can be described by explaining that those who lead others to greatness seek challenge. They are pioneers, and are willing to take risks. They are "brave enough to fail" and willing to learn from their mistakes. This concept relates very well to volunteer services. As previously stated, EMS is an extremely dynamic discipline. Biotechnology is enabling us to do more in the pre-hospital setting. Leaders need to not only be receptive to new concepts; they must seek them out. They must be brave enough and smart enough to implement these concepts. To do this, leaders must be willing to seek out fresh ideas. These ideas may come from within the membership, other ambulance services, in journals and texts, the Internet computer system, even other industries! All too often, service leaders are so narrowly focused that the answers to their problems often lie undiscovered just outside their own personal experience. 

"You can't light a fire with a wet match" is an old Texan expression that is as descriptive in inspiring a shared vision as it is on the prairie. Good leaders choose to lead because they have a vision of how things should be. Since reaching this vision requires the work of the total organization, this vision needs to be effectively and enthusiastically communicated to the workers. Without effective communication, workers won't know why you are asking them to work so hard. The flames will not be lit in the hearts of the volunteers. We know they are not there for the money. They are there for the internal satisfaction and the rewards of helping others whom are in their greatest time of need. 

As previously stated, successful leaders realize that obtaining high performance requires the total team to be productive, not just themselves. Enabling others to act encompasses encouraging collaboration and developing a sense of ownership by all members. If all members feel this way, performance can reach new heights. 

Whether it is Blanchard saying, "walk your talk" or Kouzes and Posner saying "model the way," they should both mean the same to service leaders. The fact that a person holds the leadership position does not automatically translate into respect from the workers. Without respect, the leader's vision, no matter how laudable, is not likely to be implemented by the workers. The respect comes from workers who see their leaders living and working in the manner that is expected of them.

Blanchard, Kouzes and Posner share another common leadership element, celebration. Blanchard and his fellow company workers celebrate "every chance they get". Kouzes and Posner call this "encouraging the heart". Whatever it is called, it is used by leaders to deliver genuine acts of caring for their workers when an accomplishment has occurred. Celebration in volunteer ambulance services is usually limited to an annual recognition banquet typically held at the local banquet hall. Some members receive plaques or clocks to honor their service to the organization. This is followed by long speeches by persons the members do not know or respect and then they listen to a disc jockey spin top 40 music. Volunteer services need to discover or even invent interesting and meaningful ways to celebrate an organization's accomplishments in a timely manner. Celebrations need not be elaborate or expensive, but they must be in response to meaningful accomplishments. 

Successful leaders use these leadership practices. Volunteer service leaders need to first recognize these practices, learn them, internalize them, practice them and live them! These practices do not rely on huge budget outlays, but they do consume time, perhaps the most valuable asset of the volunteer. Volunteer workers deserve this leadership and the survival of many services depends on it. 

What Followers Expect and Admire

To continue our examination of leadership in volunteer ambulance services, we look next at the expectations that followers have of their leaders. In two extensive surveys done by Kouzes and Posner, they determined that the majority of us admire leaders who are honest, competent, forward-looking and inspiring. It comes as no surprise that some of the characteristics are similar to the practices employed by successful leaders, as described in the previous section. In these surveys honesty was the most often selected characteristic. What message does this send to a leader of a volunteer service? The message should indicate that his/her practice must match his/her preaching. Promises must be kept, and the leader must have the confidence to follow their beliefs. All too often, volunteer managers enter office with grandiose ideas, only to become overwhelmed by the work involved or get pressure from the family to spend more time at home. As a result, projects aren't completed and the workers feel "let down" by their leaders. Even with the best of intentions and integrity, the perception by the workers is that the leader never planned to make these changes. Related to this perception is that of competency, the second most selected characteristic in the survey. When projects are not completed, workers also question the leader's competency. Once this occurs, even when the leader remains competent at delivering medical care, workers will distinguish between the two different types of competency in their leaders.

The next most frequently selected characteristic of good leaders is that of being forward-looking. To be admired, the leader must know where the organization is headed. This is much like Blanchard's concept of "if you don't know where you are going, any road will get you there." Workers in any setting can quickly observe a leader that is not forward thinking. I have maintained for years that most volunteer service leaders are "too busy chasing the cows to fix the fence". For example, these service leaders will struggle with trying to recruit more new volunteers, while they disappoint the ones on board with the service. 

Fourth on the survey list was inspiration. As discussed, the leader's vision must be communicated throughout the organization. This communication must be not only informative but also inspirational. If I, as a leader of a volunteer service, am not enthusiastic about my visions, how can I expect others to be? If I am not excited about the potential success of resuscitation that a new defibrillator may bring to my service, why should my workers take the extra training required to use the device? All of these characteristics are ones that volunteers are seeking. When volunteers don't see them, they lose confidence in their leaders and the organizations, and ultimately themselves. This low confidence is very destructive to these organizations. It leads to members leaving, often taking friends with them. It also negatively impacts recruitment, because most recruitment occurs through existing members that are excited about being in the organization. 

While widely recognized as an important need, there exists little opportunity for learning leadership for volunteer ambulance personnel. On the job education does occur, but often at a significant cost to the organization. It has been a goal of mine to design and deliver an appropriate educational program in this area. This education could examine how successful leadership concepts can be applied to volunteer ambulance services. 

What is clear is that the leadership concepts discussed here are directly applicable to volunteer ambulance services. Leaders need to know the characteristics of high performance teams in order to know where to go. These same leaders need to learn how to get there. I am concerned that if these services do not invest in these efforts and the education is not made available to them, many services will continue to fall farther behind the standards and expectations of the public, the community and government.