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How to reduce your agency's 'suck factor'

Five questions every EMS leader should ask employees about their perceptions of the organization


In more than a decade of conducting organizational assessments, we have found that leaders are often out of touch with their organization’s “suck factor.” The suck factor is your frontline employees’ unvarnished opinion about what isn’t working and what needs to change.

'Suck' is hardly a precise quantitative term, but when a paramedic says, “This sucks,” it’s a window into your culture. Yes, it’s their opinion, thought or feeling, but organizational culture rides on perceptions, not facts.

For example, if medics perceive that the scheduling process sucks, even if they are wrong, have incomplete information or are simply being selfish — the perception is what you have to deal with. You can’t change their perceptions about scheduling by simply smothering them with facts and details.

Perceptions about what sucks need to be heard, understood and examined for what lies beneath. The most common “suck factor” issues are:

  • Employees not feeling appropriately valued (“my brother-in-law makes more installing window glass and doesn’t work nights or weekends”)  
  • Employees believing their opinions are not heard (“no one listens to us”)
  • A mismatch between how leaders describe organizational priorities and how frontline employees describe organizational priorities ("we’re focused on becoming a world-class clinical provider” vs. “all management talks about is money”)
  • The toleration of too much internal drama (“I won’t work with any of those new guys”)
  • Allowing poor performers to stay and impact the organization ("It is impossible to get fired")
  • Leaders keeping secrets ("We can’t tell the troops about our plan because they’ll be disappointed if it doesn’t work”) 

Don’t wait for a consultant to use a survey, interview, or focus group. Start assessing your "suck factor" using the following five questions.

1. How engaged are your employees?

Engagement is consultant lingo for an employee’s excitement, enthusiasm, dedication and loyalty. Engagement impacts everything in the organization. It’s about how employees think and feel about their jobs. It includes how they view their place in the organization, their value to leaders, their connection to others in the organization and how they view the meaningfulness of their work. Engagement is affected by structure, operational issues and rewards (pay).

Research is telling us more about engagement every year. When engagement is low, things suck for workers and, ultimately, for customers and organizational success. When people don’t look forward to coming to work and don’t feel connected, cared about or part of something big, they will only do what’s required (and often less). When engagement is low, absenteeism, safety breaches, turnover, customer complaints and internal conflict go up. When engagement is high, customer service, quality and productivity all go up.

Don’t assume you have high engagement. Engagement can change and needs to be continually assessed by talking with employees and using proxy questions and engagement surveys. We’re finding that the most useful tools for EMS are those that use common engagement questions that are adapted for the specific challenges and issues of EMS work.

2. Do managers and supervisors make time to listen to employees and value their input?

The people who know what sucks and how to fix it are the frontline staff. Many managers don’t believe this. Consequently, the most common complaint we hear from frontline employees is, “Management doesn’t listen to us.” That’s their perception. Even though managers and supervisors may frequently ask, “How’s it going?” or conduct rounding processes, employees do not perceive they are being heard. Token listening doesn’t work. 

There is a kind of listening that really makes a difference. It’s the kind of listening that emerges from a deep conviction that employees have valuable feedback, information, ideas and solutions that are critical to organizational success. So, the secondary question here is: Are managers and supervisors convinced employees have information you truly need to know? If so, they will keep asking and listening.  

3. Are you tolerating drama and allowing problem employees to stay?

While most leaders know about the 80/20 rule (80 percent of your time is spent on the bottom 20 percent of your employees) many fail to get rid of the problem employees. Developing a hard line against problem employees and the drama they bring is a powerful way to reduce the suck factor and honor your best-performing employees. 

Imagine what your organization would be without the problem people around. Make a commitment to get rid of those one or two problem people as soon as possible and then use your new found extra time to work on more positive issues.

4. Is there a common perception about organizational priorities and direction?

One of my favorite organizational assessment processes is to individually ask people throughout the organization to describe the organization’s top three priorities. Rarely do I find agreement on priorities and direction. When people don’t agree on what’s important, it’s nearly impossible to align behaviors and actions toward success.

Employees’ perceptions about priorities and direction are formed by observing the actions and behaviors of leaders and not from what is said. For example, a leader may say that quality patient care is a top priority, but in behavior and actions, the leader demonstrates that reducing overtime and expenses is the current top priority. 

Ensure that everyone understands the current priorities and direction. This is done by first, clarifying your direction and aligning your stories and actions and then, continually assessing the employees’ perceptions of what’s important and where you are headed. 

5. Do employees believe you keep secret information they would benefit from knowing?

A prime indicator of a great organizational culture is the absence of a perception that there are secrets. Secrets poison your culture. Trying to protect employees from unnecessary anxiety by keeping something secret only breeds resentment and the perception that leaders view employees as immature. Employees feel valued and trusted when leaders go out of their way to be open, even with difficult information. Ask employees if they believe there are unnecessary secrets in the organization, and then tell all.

Paying attention to your "suck factor" is a powerful way to strengthen your culture. What really sucks is when leaders are clueless about their own organization’s suck factor. 

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