5 essential components for strategic change in EMS

EMS leaders should apply these steps to prepare for changes to CPR and cardiac care guidelines


When it comes to EMS leadership, there is a dirty little word that no one likes, but is essential to the success of any organization. That word is change. When change rears its head, people feel uncomfortable for all sorts of reasons. When your personnel have those negative feelings about change, they will normally resist, and oppose change.  

In the present day EMS is full of change, transformation, and uncertainty. As a leader it is paramount that we are able to move change, motivate change and minimize the negative impact to the organization. Change management is the cornerstone to ensuring your organization grows and continues on a path towards success.  

In October 2015, another change hits the streets; the new 2015 AHA Guidelines will be released. In an EMS1 interview, Dr. Michael Sayre talked about some of the changes in the 2015 AHA Guidelines.

Currently the AHA guidelines are published every five years, which really puts the EMS provider at a disadvantage as the science of resuscitation changes much faster. In the video Dr. Sayre states that the future AHA guidelines will be released every six to 12 months. This means an EMS provider will be able to take a CPR class with new information every time they recertify.

With the new standards due out in a few months, it is now time to prepare for this change and implementation.

Ineffective management forces change

Regardless of the organization, change is one of the words that brings a slew of emotions, feelings and uneasiness. One of the main reasons this occurs is the approach you and your organization takes to managing change. Instead of showing the ability to effectively sell change to the workforce, we usually just wrap it in a nice little bow and roll it out without input from field personnel. This is one of the most common ways to stoke the fire of resentment, and cause your workforce to hide from change rather than embrace it.

5 essential components for strategic change

Your organization is in a great position right now to prepare for the AHA changes. Do you have a plan?

You can prepare now, or get caught behind the 8-ball later. Being able to effectively sell change demands a strategy, let’s discuss five essential components to act as your foundation for a successful change progression:

1. Responsiveness to known and unknown

A component of being a great EMS leader is the ability to be responsive to the current changes in our career field. Being able to look into the future and predict what is coming is an essential skill for any successful leader. While working at MedStar, we were discussing the mobile integrated healthcare transformation. Matt Zavadsky said to me “we are standing on a hill with a pair of binoculars, what do you see?”

This was a great lesson, as it challenged me to look for what was coming. Knowing the AHA guidelines for CPR are going to change, have you prepared to address this change now? Waiting until the eleventh hour is never a way to lead. Be responsive to what the future is telling you and have a plan to address what’s to come.

2. Effective change equals effective timing

Now that we know change is coming, how do you effectively plan for this change to occur? If the AHA guidelines are released in October, as scheduled, you will need some time to learn the changes, determine how the guidelines will impact your protocols, rewrite the protocols, train personnel on the updated protocols, and finally implement the new protocols. Depending on your organization this could take weeks to months to achieve. You could wait until the last minute, or develop a schedule of implementation now.

3. Sell your ability and experience to manage change

There are many feelings and emotions that come from implementing something new; these may include:

  • Fear
  • Anxiety
  • Frustration
  • Anger
  • Sense of Uncertainty

Here is a secret to a successful change process: Being able to sell change really comes down to being able to sell your ability and experience to manage that change, more than the change itself. There are folks in your organizations that have a mentality of ‘if it’s not broken, don’t fix it.’ Being respected as a leader, and the workforce knowing you can manage this change, softens the blow that change is coming. Instill confidence in your workforce, and let them know you can navigate change with your ability and experience.

4. Create trust with the workforce

We trust our workforce to deliver the highest quality of patient care possible. We trust them to go into a dark house at three in the morning. Trust them to help them lead the organization!

Getting your workforce to that table and outlining the change you see coming is a win-win for all. From the very beginning, you are getting ideas, input, and buy-in because you are valuing their opinions and experience. Never implement change without input from your workforce.

There is an old saying, “Rules without relationships result in rebellion.”

Grow your trust in your workforce, ask for input, and develop relationships that get results.  

When I was in the U.S. Air Force a middle manager came to the workforce and said, “I developed this new process, I think it will work better for you, start using it right away.”

There was no forewarning, no opinions asked for, and no one was happy. This process did not make things better one bit. In fact it was more time consuming, cumbersome and not very practical. As a team, we complained to the chief who said, “come with me.”

We entered the middle manager's office and the chief told us to totally rearrange the office. When he finally came in, the chief told him “we thought this configuration would work better for you.”

Do not change a process just because you think it will work better. Get the feedback of the people who do the actual work.

5. Be dynamic and fluid

You have reached the point where change is outlined, you and your team have developed a great strategy, and the workforce is on board. The next important step to realize is that things will go wrong, not work as planned, and at times it will seem like you are traveling down the wrong road.

This is just a normal day in the dynamic and fluid process of everyday business. Since we do not have a crystal ball, when we begin the process of walking into the future we have no idea what is happening around each corner. Be prepared, accepting, and be fluid. Reconstruct, analyze and adapt your plan as necessary.Like water, move around the challenge.

Change is coming; are you ready?

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