EMS Leadership Part 8: Behavioral Leadership Considerations for EMS

Your behavior as a leader is very important in maintaining a successful organization


Ben had just been hired to take over as EMS director for Red Hawk County. Before assuming the position, he was told that the organization was receiving consistent complaints about response time, patient care and cooperation with other emergency response organizations. He spent the first three days watching what was going on and listening to EMS crews, as well as patients, aeromedical, fire department and emergency room staff. What he heard was not encouraging.

Ben spent the weekend revising policy and protocols with the county medical director. Monday morning he called a meeting and required all EMS staff to attend.

"Based on my observations last week, we are not working as teams, and definitely not being effective and efficient in our patient care and response environment," he told them. "This is going to change. Get ready to take notes, because we have a number of policy and protocol changes that you will adhere to in all emergency responses. There are significant changes in ambulance upkeep, ongoing training, relationships with patients and other emergency response teams. We are also going to reduce our current response times by half. We have the worst response times in this part of our community, and that will change immediately. I will be keeping a close eye on what is going on and will be involved in every aspect of this organization and its mission. If you cannot live up to these new policy changes, it's time to look for another job opportunity. For the next few months, we will definitely be task-oriented and get this organization back on track. Are we clear on our focus?"

A low but affirmative response came from the attending staff. Ben then spent the next two hours going over policy and protocol changes.

Ben remained very active in his involvement with the operational environment. In the first three days after the staff meeting, the response time was cut in half. Ben let two EMTs go because they refused to follow policy and protocol. While the first month was challenging for everyone, complaints were reduced by 85%. After the second month, only compliments were coming in from patients and other emergency response organizations. Ben was seeing a sense of pride in his ambulance crews and administrative support team. The operational environment was running much more smoothly, and individuals appeared to look forward to working with Red Hawk County EMS.

By the third month, Ben was changing his leadership approach to building positive and supportive relationships with his organizational staff. He was scheduling and attending birthday parties and promotions celebrations. While the monthly meetings and training environment were basically task-oriented, positive relationships were building between Ben and his staff, as well as within ambulance crews. EMS staff were offering proactive recommendations regarding response times, patient care and relationships with other emergency response organizations. Red Hawk County EMS was back on track, and a sense of pride was evident in all aspects of the organizational mission and operational environment.

The "Leadership Style" or "Behavioral" theories that were identified in the late 1950s and early to middle 1960s still apply today. The inability of researchers to define effective leadership based solely on personality traits led to looking at the behavior of leaders and how it might contribute to leadership success or failure.1 Northouse's theory was that leaders have an impact on followers through the tasks performed, as well as the relationships created. According to Northouse, leadership is composed of essentially two general kinds of behaviors. Task behavior relates to goal accomplishment; relationship behavior relates to helping subordinates feel comfortable with themselves no matter in what situation or operational environment they work.

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