This is article is the second in a series from the National EMS Management Association that explores how principles of size and scale can be applied to EMS while maintaining a strong community connection. The first article introduced economies of scale. This article describes how several large community-focused organizations leverage scale with volunteers. The third article will explore how several innovative rural and volunteer EMS services, both domestic and international, have used scale to their advantage.
By Sean Caffrey, NEMSMA
The American Red Cross (ARC) and the Boy Scouts of America (BSA) are two well-known organizations that are highly dependent on volunteers and operate in nearly every city, town and village in the U.S. Both organizations have taken advantage of economies of scale and may even be competing with emergency services for volunteers.
What can we learn from their approach and how can it be applied to volunteer EMS?
American Red Cross: 96 percent volunteer led and run
The ARC is perhaps the most well-known volunteer organization associated with disaster services and humanitarian relief. Although it has come under fire in recent years for various disaster response, governance and accountability concerns, it remains one of the largest volunteer organizations in the U.S. In 2014 the ARC had 900,000 volunteers and 30,000 paid employees making the ARC 96 percent volunteer staffed.
The ARC is organized into 600 local chapters with estimated revenues of $6 billion. The ARC supplies roughly 66 percent of the donated blood in the U.S. and responds to 70,000 small and large scale disasters annually. The organization is chartered by the U.S. Congress and represents the U.S. as the national affiliate of the International Federation of Red Cross and Red Crescent Societies.
The ARC believes strongly in community orientation and the utilization of volunteers for most operational roles within the organization. Volunteers are supported by a much smaller group of paid professionals. The professional staff are responsible for volunteer recruitment, orientation and ensuring that volunteers have the skills and tools needed to perform their duties well. Professional staff handle many administrative duties freeing up volunteers to perform the core work of the organization.
The ARC espouses a philosophy of allowing local needs to drive the organization. As such, the ARC provides services otherwise unavailable in a community while avoiding duplication. ARC chapters scale their efforts based on gaps. For example, the ARC does not duplicate blood services in a region if another organization is already providing that service. ARC chapters will also scale their efforts in disaster services or health and safety education based on what other providers operate within in the community.
ARC managers describe a core philosophy that qualified volunteers are welcome to perform any job in the organization. The philosophy adds that paid staff can always be reassigned to other areas more in need of paid staff support.
The ARC also invests heavily in standardized volunteer orientation, making sure that new members have a sense of the mission, history and culture of the organization. An extensive training infrastructure that includes both online and in-person elements ensures all volunteers have the tools and training to effectively perform their duties.
An internal social media platform, Volunteer Connection, is used to track, schedule and inform volunteer members. Managers are further held accountable to ensure volunteer utilization metrics are met throughout the organization and its programs.
Boy Scouts of America: Collective of locally chartered organizations
The Boy Scouts of America (BSA) was founded in 1910 and currently has 2.6 million participants ages 6 to 20. The BSA relies on 105,000 locally chartered units with 960,000 volunteer leaders to deliver the scouting program.
Local units, with a few exceptions, are required to have a sponsoring organization within the community. Sponsoring or chartered organizations are often local churches, parent teacher organizations or other community organizations such as the American Legion, Lions or Rotary clubs.
While the scouting program delivery is local, a large amount of support is provided by 276 councils across the U.S. Local councils employ paid professionals who specialize in administration, training and other support functions. Councils also own and operate uniform stores, summer camps and other shared facilities used by local units.
The national council of the BSA provides another level of support including the development of programs, training, uniforms, awards and publications used throughout the scouting movement. The national organization also owns and operates a number of adventure bases and organizes national events. Despite being a national and international movement, scouting is actually a collection of more than 100,000 local organizations that participate in the similar activities while wearing the same uniform.
5 lessons for EMS
The American Red Cross therefore represents a fairly centralized volunteer organization, while the Boy Scouts of America represents a more decentralized approach. The question, however, is: What can EMS organizations learn from these organizations?
1. Locally connected, driven and led
Despite being large international organizations, both organizations have mechanisms in place to ensure that local needs drive their activities. The BSA does so by requiring a connection to a local community organizations and requiring that units are governed and operated independently. The ARC, while more centralized, relies heavily on service delivery at the chapter level. ARC chapters are also governed by local advisory boards and executives.
The message for EMS is that it is possible to take advantage of scale, while operating independently at the local level. As a matter of fact, local independence is a core principal of both of these large scale organizations.
2. Leverage size for administration and training
The ARC and the BSA do, however, take significant advantage of economies of scope and scale, especially when it comes to administration and training activities. Most administrative activities, from human resources to marketing and fundraising, are handled by paid staff who serve a large number of volunteers. Expensive items such as information technology and facilities are purchased centrally and shared across the organization. In many cases, equipment and supplies are purchased in bulk at greatly reduced costs. .
3. Maximize volunteer resources
Both organizations also make a concerted effort to not burden volunteers with administrative duties. For example, leaders of local BSA units do not need to develop their own programs, publish handbooks, establish uniform policies or manage facilities. ARC volunteers do not have to perform human resources functions, wire computer networks or maintain fleet vehicles. An exception to this, however, is volunteers who may be specifically recruited or are interested in performing these tasks.
4. Standardize training on procedures and traditions
Both the ARC and the BSA have long and rich histories of service. New volunteers are provided with standardized training programs that have been refined over many decades to ensure volunteers have a firm understanding of organizational history, culture, rules and procedures. Once oriented volunteers participate in specialized training for their roles and have access to both paid and volunteer colleagues who can help them as they find their way in the organization.
5. Inform and engage members
The ARC and BSA put a strong emphasis on volunteer and member communications. The BSA publishes Scouting magazine specifically to keep volunteer leaders informed. It provides tips and tools for local unit programming. The ARC has a similar emphasis with the Volunteer Connection social media intranet. Both communication tools keep volunteers informed, educated and engaged. Channels also exist in both organizations to provide professionally developed “just in time” training as needed.
Best practices for EMS
What best practices can volunteer EMS organizations borrow from these organizations? Clearly autonomy, local control, training and finances are big issues for most EMS services. What aspects of EMS systems however, could be done more effectively if shared or consolidated? Add your thoughts in the comments.
