Similar to the incident command system, each level of management needs to determine its effective scope of leadership. That is, how many people can one line leader effectively manage? Many organizations grossly overestimate this figure. For example, putting one captain and one lieutenant in charge of 10 paramedics and 15 to 20 EMTs is unrealistic. The burden of training and record-keeping for up to 30 people would rest on the shoulders of just two people. If being a squad captain is not your full-time job, this responsibility could lead to mistakes, misjudgment or burnout. Becoming comfortable with the number of people being managed helps make an organization efficient.
Stay the Course to Ensure Success
During the change process there are many roadblocks and seemingly difficult tasks. However, staying the course ensures an EMS organization will not only meet the needs of its community, but be able to share its benefits with its members while increasing morale and developing systems that ensure survivability.
Take a minute and assess your organization the same way you would assess a patient. Have you stabilized the ABCs yet? If not, the organization cannot grow and will eventually be unable to maintain what it provides.
Finally, understand that effective organizational awareness and management starts at the very top and filters its way down. All levels of supervisory and management level personnel—on both sides of the operational/administrative divide—will undoubtedly benefit from a strategically thought out, well planned and properly managed organization.
Barishansky RM. Strategic planning for EMS agencies. EMS Magazine, April 2005, www.emsworld.com/print/EMS-World/Strategic-Planning-for-EMS-Agencies/1$1864.
National Highway Traffic Safety Administration. A Leadership Guide to Quality Improvement for Emergency Medical Services Systems, www.nhtsa.dot.gov/people/injury/ems/leaderguide/index.html.
Virginia Office of Emergency Medical Services. EMS Agency Management Series: EMS Strategic Planning, www.vdh.virginia.gov/OEMS/Files_page/OEMS_general/Stategic%20Planning.pdf.
Daniel E. Glick, BPS, NREMT-P, is an aeromedical evacuation operations officer for the 139th Aeromedical Evacuation Squadron, New York Air National Guard, and a practicing paramedic in upstate New York. Contact him at firstname.lastname@example.org.
Raphael M. Barishansky, MPH, is chief of public health emergency preparedness for the Prince George’s County (MD) Health Department and a member of EMS World’s editorial advisory board. Reach him at email@example.com.