Sweating the Small Stuff: Understanding How Corporate Culture Impacts Customer Services in EMS

March 20, 2004: Ben and Danielle arrive at work at All-City EMS, an ambulance facility providing both ALS and BLS services in Metropolitan City. As they enter the building, they are confronted by their supervisor, who proceeds to chew them out for leaving the truck a mess after their last shift. As Danielle starts to explain that they got held up for a late job, he cuts her off with an “I don’t care…this is your responsibility, so get it done.” A few minutes later, while checking the truck, Danielle relates how that late job caused her to miss her daughter’s piano recital. Ben responds, “Sorry to hear that. Remember how rude the dispatcher was when you mentioned that it would hold us over? Then that annoying old man took forever to get his things!”

July 1, 2004: James has been an administrator at All-City for two months. One day he arrives at work to find an irate voice mail message. The local ED nurse manager is angry over a complaint by a patient’s family member. He states that a BLS crew had manhandled the patient during a transport that occurred almost three months ago. Apparently angry over having been given a late assignment, the crew was rude and unnecessarily rough with the patient, causing him distress and exacerbating his chest pain. The anger and frustration in the manager’s voice is almost palpable as he relates that this is the fifth time he’s called and he has yet to receive a return call. He finishes with, “What kind of organization are you running over there? Doesn’t anyone return phone calls?”

A few days later, after reporting the call, James witnesses the director of operations yelling at the operations coordinator in front of some employees over this same incident. Later that afternoon, the operations coordinator tells James how much she hates working there, as do a number of the other coordinators. She complains that there never seems to be any support from the upper management. It appears that a few supervisors, along with some senior field personnel, may be actively looking for jobs elsewhere. James is stunned. When he interviewed for the job five months ago, the agency seemed like a team, a great place to work where everyone pulled their own weight. Now it seems that everyone from the line personnel to upper-level management wants to leave.

Corporate culture is defined as the environment—social, physical, political, emotional and economic—within which you work.1 More succinctly, it’s “how things are done around here.” If you have ever experienced a chain of events similar to those mentioned above, you understand the importance of a positive corporate culture. The lack of a strong, supportive corporate culture will erode even the most motivated employees over time. A good way to identify organizations suffering from this lack of “moral compass” is to look at their track record in regard to customer service. This involves examining not only how they treat external customers, such as patients, but also how they handle the most important internal customers—their employees. There are many aspects to establishing an EMS service that is attuned to providing good customer service on all fronts. This article will focus on customer service as it is affected by the corporate culture, and ultimately projects the mind-set of the entire organization.

Corporate Culture

The values, beliefs and practices of an organization’s work environment contain the power to directly influence economic performance and overall effectiveness. But what determines the structure of these building blocks? You, as the manager/administrator/supervisor/leader, have significant impact on establishing this foundation. Actively shaping corporate culture in your organization means being willing and able to effect change, determine what you are doing right and identify where you can improve. And there is no better place to start than the top. When the various levels of management aren’t getting along, the resulting cause-and-effect relationship can lead to an unhealthy corporate culture.