Views From the Field

"The greatest revolution of our generation is the discovery that human beings, by changing the inner attitudes of their minds, can change the outer aspects of their lives." --William James

Although leadership is one of the most relevant aspects of the organizational context, defining it has always been challenging. Defining leadership in EMS is no different, especially at a time when we are seeing a national healthcare reform effort, increasing pressure on EMS systems to accomplish more with less, and lack of a united voice on issues of major significance. Strong leaders, including those who don't view things through "we-have-always-done-it-like-this" glasses, are needed more than ever. This year's Emerging EMS Leaders, who come from backgrounds in education, operations, consulting and special operations/homeland security, take on these and other relevant topics in the article below.

BRANDON W. GRAHAM, BS, EMT-P, ASSOCIATE DIRECTOR, OFFICE OF HOMELAND SECURITY, THE GEORGE WASHINGTON UNIVERSITY, WASHINGTON, DC

What is your philosophy on EMS leadership?

My leadership philosophy, which has always driven my command vision, is relatively simple: Lead by example, and lead in all directions. Modern EMS leaders must articulate a clear and concise vision that embodies the goals, expectations and consequences of the organization, and they must exemplify that vision at all times. As coaches, mentors and facilitators, I expect the leaders in my organization to not only be role models for team members who work to support them, but also for those who are higher in the traditional chain of command. Leadership is contagious in all directions, and I have found that by being competent, fair and ethical, while constantly identifying and removing obstacles that impede success, others in the organization will join you in its pursuit. Specific to EMS, the focus of leaders today should remain on valuing the mission, providing the necessary resources to safely accomplish the mission in a superior manner, and truly value the most critical component of all EMS operations…our people.

What qualities do you see as critical for EMS leaders?

The most important characteristics for EMS leaders are competence, strong business and organizational acumen, consistency and an unwavering ethical compass. Without these qualities, we cannot meet the expectations of ourselves or our organization when we choose to take on the roles of coach, teacher, mentor and incident commander. You must have a blended balance of the skills you would expect from each of these roles. Also of greater importance today is having the ability to maintain a broad perspective on the “big picture” and leverage technology that provides real-time feedback on group and system performance to provide optimal situational awareness. The consequences of the failure of our EMS systems are of life-and-death importance, so we must better align our management systems with those of higher-reliability organizations. We must be better managers of dynamically changing environments and be better skilled at identifying opportunities for small leverage points that can be exploited so that a small input of resources yields large, positive outcomes for the team and the organization. This is so important, because EMS as an industry continues to be asked to do more and do it with fewer resources.

Whom in your career do you consider a mentor, and how did they assist you?