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3 factors to change a stubborn EMS culture

Embrace change, empower leaders and remove cancer are three factors to evolve an EMS agency and avoid the pitfalls of stagnation

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This article originally appeared in the October 4, 2018 issue of the Paramedic Chief Leadership Briefing, Changing a stubborn EMS culture | Viral video tips | EMS Agenda 2050. Read the full briefing and add the Paramedic Chief eNewsletter to your subscriptions.

Is your EMS agency plagued by a culture of stubbornness and an attitude of “this is the way we’ve always done it”?

Culture change at any organization isn’t easy. It rarely is. At our agency, we have had our fair share of headaches and hurdles, but we are at the corner of a cultural breakthrough. Here are three factors that have helped our organization evolve:

1. Embrace change

To avoid the pitfalls of stagnation, embracing change is the most important factor in allowing your organization to grow. Members of the leadership team must be willing to embrace change. If you and your team are ready to lead an EMS agency on the “leading edge,” then you must have full and total buy in, starting from the top.

Embracing change isn’t easy. In fact, it can be dreadful and can create feelings of anxiety and frustration. As you move through this process, just remember, this culture of resistance or reluctance to change was not embedded overnight, it will not be resolved in that time either.

Patience and persistence are key components to embracing change. Don’t allow a small setback or bout of adversity to derail the momentum for cultural change.

2. Empower leaders

The next component to moving on from a stubborn culture is empowering leaders. At our organization, we are finding that today’s current and rising leaders are part of a “why” movement, in that they crave to know the rationale for change.

Give them what they want. Explain the need for the culture change and why this move will make your agency and their work life better. Explaining why could be one of the first actions to kick start a change.

After explaining why, we identified several newer employees that were excited about our mission who brought new and invigorating energy. We harnessed that energy by inviting them to the table for discussion, giving them projects, engaging their minds and asking their opinions. Their energy became infectious and we had a clear line of who was ready to move our organization forward, and those who were stagnant and unwilling to share our vision.

3. Remove the cancer

By far the most difficult step is removing cancer from the organization culture. The personnel who have the stubborn attitudes can be infectious and sprout a clique of opposition.

Once the staff who embrace the vision form a core group of leaders, it is time is to separate from those who remain actively resistant. From an HR perspective, this is challenging. However, thoroughly documenting constant communication and coaching helps.

Demoting or terminating an employee unwilling to change is an extreme step and the hope is that everyone will harmoniously buy in to our vision. But the reality is, there will always be at least one dissenter.

Do not allow a small amount of untreated cancer to ruin your organization. You will lose all the traction you gained to change that stubborn culture. Your staff, leadership and patients deserve the highest quality product and service.

Xavier A. De La Rosa is chief clinical officer for Harris County ESD 11 Mobile Healthcare. He has held multiple roles including for-profit EMS, 911 EMS, flight medicine and EMS-based fire service, and as a lieutenant in the Training Division of Fort Bend County EMS in Texas.

He has a degree in Emergency Health Sciences from the University of Texas Health Science Center San Antonio and a Master’s of Business Administration from Johns Hopkins with concentrations in Private and Public Sector Leadership; and Health Innovation, Technology and Management.

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