About this series: Best Practices commissioned Jay Fitch to write a 12-part series on how EMS agencies and fire departments can adapt to the extreme pressures to operate more efficiently while exploring entirely new paradigms of how prehospital care can be delivered. He uses the concepts of organizational agility to provide a blueprint for the “strategic management of uncertainty.” The graphic above shows the four dimensions of organizational agility and the 11 factors impacting agility; each installment of this column will examine a different factor through the prisms of the four dimensions.
Fitch serves on the Best Practices editorial board of advisers and is a founding partner of Fitch & Associates, which has provided strategic and operational consulting services to EMS and the fire service for nearly three decades. To see the previous installments of this column, along with an agility self-assessment tool, visit
fitchassoc.com/agility. — Keith Griffiths, editor in chief I was catching up with a mid-level manager at this year’s Pinnacle conference and asked, “How are things going?”
“Huge changes,” he lamented. “We have lots of projects, goals and priorities. We’re constantly making lists and setting action plans. But we seldom see anything through to completion before some urgent new priority is pushed at us.”
To get another perspective, I sought out the manager’s director and asked her the same question. “Between dealing with the city manager and my staff, I sometimes feel like a kindergarten teacher,” she replied. “It’s like walking into a classroom where 25 to 30 children are pulling at your pant legs trying to get your full attention, each shouting your name a little louder. It simply becomes disorienting.”
Fragile organizations let changing priorities disorient, distract and be destructive. Agile organizations and leaders break through the cacophony, deal with the crush of activities and focus by prioritizing issues based on the organization’s mission, vision and values.
Now let’s take a look at managing changing priorities through the four dimensions of organizational agility.
Awareness and alertness
If people are directed to stop one project and start another, there’s a risk that nothing ever will be completed as tasks fall off the bottom of the triage list and into a black hole. Agile leaders are alert to changing priorities and how they impact the organization’s performance; fragile leaders are clueless to what is occurring until they hit the wall or the bottom of the hole.
Part of the underlying problem is that everything comes at us so quickly in times of rapid change. Everything is a priority. It’s like being in an unfamiliar city late at night at the end of a long trip: You’re tired and trying to follow ambiguous directions to your hotel. It’s raining and everyone is driving twice as fast as they should. You get distracted and miss the turn, becoming even more frustrated. You thought you were heading in the right direction, but now you are hopelessly lost.
Agile leaders understand that it’s best to pull over, take a deep breath and become more alert and focused rather than risk crashing while frustrated or distracted. Are you agile or fragile?
Leadership orientation
Do you suffer from “leadership fibrillation,” with lots of electrical activity but no meaningful throughput? Agile leaders send a focused signal that allows the appropriate nodes to act; fragile leaders send multiple electrical impulses, confusing the receptors and facilitating fibrillation.
Setting priorities and sending a clear message that doesn’t confuse is essential during periods of uncertainty. Staying in balance, triaging priorities and providing appropriate direction are mandatory if you want to be an agile leader.
In periods of high stress and change in the professional realm, we must remember that our lives are made up of seven vital areas: health, family, financial, intellectual, social, professional and spiritual. To be an agile leader, we can’t neglect any one area (never mind two or three) without affecting the others. Much like a table, if one leg is longer than the rest, it makes the entire table wobbly. Developing processes and structure can help us prioritize the priorities and be disciplined in our leadership.
High-value processes and structures
Fragile leaders get caught up in trying to hit a moving target rather than having a clear vision and making decisions about priorities that are consistent with that vision. Agile EMS leaders have to guard against constantly searching for the latest management fad and reconciling priorities and decisions to the prime directive, as defined by their mission, vision and values. (If you’ve forgotten the prime directive, here’s a hint: It’s not about you. It’s about the patient.)
Being a bit more pragmatic, agile leaders develop a work plan detailing critical priorities. Ideally they get plans signed off by the city/county manager or company owner, knowing that they may be tossed for new priorities at any time. If that does happen, they can at least go back through each of their previous plans and chronicle the results they achieved. What must not happen is for the chaos of changing priorities to obscure the ability to achieve results.
Having detailed work plans will also help manage your own equilibrium. For now, you may have to simply accept that you’re going to experience turbulence, but having a plan will at least put as much of the process as possible under your own control.
Finally, keep in mind the wisdom of Christine M. Riordan, the dean and a professor of management at Daniels College of Business. She wrote in a recent Forbes Magazine Leadership Forum that many change initiatives fail because leaders treat them as events rather than as processes.
Development of a performance-based culture
Fragile EMS organizations are often beehives of activity and hard work that generate little practical return. Fragile managers confuse “busy work” with results; agile leaders work to develop a culture throughout the organization where setting priorities to achieve results is part of the organization’s basic framework.
As an agile leader, with priorities in place, you can always ask questions that reframe the argument in any discussion. This can work regardless of your place on the team. When there is uncertainty or disagreement, reframe the discussion around the priorities using questions like these:
- What problem are we trying to solve?
- Does this problem relate to our top goals, or is it a distraction?
- Is this problem important enough to warrant changing our priorities?
- What is the simplest way to resolve this that will allow us to meet our goals?
- If we’re struggling to meet our goals, which goal can we drop down to priority #2?
There are examples throughout EMS of organizations that have developed a culture that allows leaders and followers to stay focused on the prime directive rather than on constantly changing priorities. That’s agility!
