If there’s one thing the fire service has done well, it’s embracing a fire officer culture.
Departments, divisions, battalions, stations and crews are all driven around the ideals of accountability, supervision and structure. These are the basic foundations of crew resource management.
While fire-based EMS agencies have adapted to this culture well, EMS-based agencies seem to have difficulty with this concept. Part of this is due to an identity issue regarding the titles of staff members. Are they captains and lieutenants, or supervisors and crew leaders?
Regardless of the assigned title, any EMS agency can adopt an EMS company officer culture. Sticking to the concept of crew resource management and building a culture that believes in accountability, supervision and structure can help strengthen any EMS agency.
Accountability requires ownership as an EMS company officer
Accountability does not equate to micromanagement, nor does it equate to complete control. Instead, accountability should be seen as synonymous with responsibility.
Ambulance 1’s crew is responsible for their vehicle, their crew integrity and their supplies. Short-handing the next crew, arriving on scene without a proper stock and not reporting vehicle issues are all accountability issues that an individual crew can face.
At the next level, station-based items are the responsibility of a house captain, station supervisor or senior medic. The old adage that items should stay in-house should be true for minor items. In short, every decision should not need to be addressed by a manager or chief officer.
Accountability also equates to ownership. Quality care, personal readiness and company pride build the culture of ownership within both your own crew and your agency as a whole.
Supervision happens at all levels within EMS company officer culture
Even though we’re all adults here, some supervision is still required.
Supervision does not equate to micromanagement; it does, however, help tie accountability and responsibility closer together.
We see it all around us: tenured paramedics supervising newer paramedics, single paramedics supervising their EMT partner and regional directors or battalion chiefs supervising station leaders or house captains.
In each situation, supervision promotes individual and crew accountability through the reinforcement of responsibility. Each member knows that there’s a consequence for not acting or performing appropriately, in addition to an appropriate reward for succeeding.
Supervision is best facilitated, and promotes crew resource management, when there’s an established structure to follow.
Structure varies between agencies, but hierarchy yields results
As mentioned earlier, it seems that EMS’s identity when it comes to structure varies in geography, system design and overall agency culture.
Regardless of the collar brass you wear, building the culture of structure within your EMS agency is paramount. Simply relying on the highest ranking in your agency for everything will only lead to havoc. Reporting every complaint to the chief will only overwhelm him or her. And, making a decision that is well outside your scope or authority will only lead to consequences.
Hierarchy, chain of command and an incident command structure are all examples of how structure plays a critical role in both an organization and an individual incident. When the chain of command is followed, internal issues are more likely to be solved by the appropriate individual. When the incident command structure is followed, patients get transported to the right hospital and ambulances stage in the right location.
In addition, each of these components of crew resource management revolve around embracing a culture.
Promoting a positive EMS culture is paramount for crew resource management
Culture can be driven by individuals both at the top, as well as individuals at the bottom, and this driving force can be positive or negative.
Invoking buy-in, involvement and investment in any process can lead to a positive culture. Toxic attitudes, animosity and complacency can all lead to a negative culture.
As an EMS company officer, it’s your responsibility to build a positive culture within your agency, whether it’s fire-based, municipal-based or private. Promoting accountability, supervision and structure are all key elements toward building a positive culture of crew resource management.
No one likes getting called to the principal’s office for petty items, and if the issue is on a larger scale, it may be your responsibility to make individuals aware of some of the consequences for making waves and disrupting the agency’s culture.
An EMS company officer culture is about ownership and attitude
Embracing an EMS company officer culture is more than touting a title. Being an EMS company officer means believing in and representing your own accountability, leading as a supervisor and embracing your position in your agency’s structure. Being an EMS company officer is about embracing a positive and progressive culture.
It’s about ownership, both in and out of the ambulance.
