Circulation is the system in the body where the work gets done. If there are no clear lines of authority in your organization’s circulatory system, then you have a dysfunctional system and an increased chance of failure. Without clear lines of authority, people are not sure to whom to report, action items aren’t followed through, and no one is held accountable to an established standard. Mismanagement of an organization like this will eventually lead to disaster. Possible outcomes could include misallocation of money and mismanagement of personnel and/or resources. Figure 1 shows an optimum organizational system, where lines of authority are clearly delineated.
A Plan for Change
After careful assessment, the leadership of an organization may determine that in order to prosper, it needs to change. This process consists of many steps, which start with planning. This is also an excellent opportunity to retain a well-qualified and knowledgeable lawyer to assist.
Step 1: Schedule and hold open planning meetings.
One of the hardest barriers to overcome is the thought that this process is being managed without the help, assistance or input of the general members. Remember, members are the ultimate decision makers in most agencies, and they need to be included, not alienated.
Step 2: Set realistic goals and stick to a plan.
Goal setting is one of the more useful tools for an organization. Set short-term, realistic goals with the overall health of the organization in mind. Build milestones into the process that force the planning committee to stop and evaluate progress. Think about how frustrated and disappointed your committee and planners would be if you were three or four months into the process before realizing a mistake was made in the first month.
Step 3: Communicate.
Communication is essential in any process that yields change. Leaving stakeholders out of the loop on the progress or speed bumps is a sizable mistake. Leaving people in the dark suggests that the planning group or members implementing change are hiding something or building power holds within the company. This point should be the highest priority for not-for-profit EMS agencies, because most of these types of organizations enlist their membership as a voting authority. Hiding information from the voting authority may bring this process to a halt.
Step 4: Enlist additional support.
An organization fortunate enough to have retired or currently employed business executives among their membership or boards may only need to enlist minimal assistance from legal counsel or accountants. For organizations consisting primarily of volunteers from different career fields, this may be a new process. Requesting outside support from county or town managers, professional consultants or other agencies that have completed this process may increase efficiency. Don’t be afraid to ask for help.
Step 5: Manage governing documents.
A thorough review of the organization’s governing documents is mandatory when making changes. To change leadership or responsibility, an organization may need to change its governing documents. Furthermore, if the organization expands, it may need to change its corporate purpose as well. Utilize legal assistance when making changes to protect the corporation, thwart conflicts and ensure all necessary paperwork is filed appropriately.
Characteristics of Efficient Organizations
EMS agencies face myriad challenges, both short and long term, some of which have the potential to significantly impact their mission. These include funding/financial challenges, personnel and staffing issues, and compliance and regulatory realities, as well as others. An efficient organizational structure—one that includes an eye on these issues through development of short-, medium- and long-term plans, as well as careful financial management—will help deliver the tools necessary to appropriately manage call volume and other programs an organization decides to deliver. Well-planned organizations work efficiently because they have clear lines of communication and authority. Each position in the organization is responsible for a piece that fits into the larger puzzle. With a clear mission and vision from the board of directors, each subordinate office or person can complete the tasks at hand. Ensuring board members chair committees will assist those committees in completing requested tasks with the overall mission and focus in mind.