From the Officer’s Desk: Strategic Decision-Making

According to numerous recent studies, the most valued skill among businesspeople today is strategic thinking. It’s integral to success: If organizational leaders don’t have a set strategy to anticipate and manage day-to-day operational and administrative issues, they will find themselves falling short of their organization’s mission and vision.

Having a strategy is essential—it’s your plan to ensure your EMS organization or section meets its operational and administrative objectives. Tactics aid this strategy by accomplishing specific activities. Essentially, you think strategically and act tactically. Strategy and tactics must be complementary to achieve a desired outcome.

Strategic thinking is an integral first step of the strategic planning process; however, it must extend beyond the organization’s strategic plan and become a mind-set for leaders proposing new initiatives and managing day-to-day activities.

Outside the Box

Strategic thinking is not just coming up with a single idea, plan, or initiative. Rather, it is the ability to assess and analyze information in a way that allows the thinker to formulate a strategy that anticipates and prepares them to handle daily activities and new challenges. It entails thinking outside the box, making well-thought-out improvements, and accepting change to achieve quality outcomes.

Strategic thinking begins with the goal to be achieved, then develops a strategy that’s followed by a tactical approach to implement it. Strategic thinking will help the EMS officer become less reactive and more proactive not only in individual circumstances but in all day-to-day pursuits.

Without strategic thinking, reactive responses may not best serve patients. Take the example of a service that adds an EMS transport unit as a result of increasing response times. Strategic thinking would have established a system in advance to determine when a new EMS transport unit should be added. The goal of such a system would be to anticipate and detect increases in response times and system overload during specific times of the day, as well as monitor overall unit utilization and any variation from the organization’s expected service delivery. Then, based on the data, its officers could anticipate and begin to formulate a strategy as to when and where to place the next transport unit. Strategic thinking would help define a strategy that’s then executed by a tactical response.

Or consider implementing a new medical protocol. Strategic thinking beforehand should encompass ensuring the training of personnel before disseminating the change; handling questions once the change is disseminated; offering makeup dates for those who miss initial training; and the interval between training and making the new protocol effective.

So how does someone begin to think strategically? Part of it is anticipatory—forecasting changes, needs, and variables. It can help to frame specific questions in terms of fundamentals. Say an officer must determine if a change in unit staffing from two paramedics to one paramedic and one EMT will benefit the organization. As part of the strategic thinking process, the officer would develop some relevant questions:

• What is the objective of the change? Is there a need being addressed? Will the new staffing model add value to the organization? Does it align with the organization’s mission?
• Is the new model attainable? Are there constraints that could prevent it from being successful—for example, a lack of resources, time, cost, or a culture resistant to change? What are the risks and benefits?
• What are industry staffing trends? Is the proposed profile part of an emerging trend to improve outcomes or simply to cut cost? How will the new model impact EMS service delivery?
• What other information has been gathered pertaining to the proposed change? Is there enough data to make a strategic decision before acting?
• Are there other options available? What is the contingency plan if the new model fails?

Synthesizing all the needed information in a process like this can be overwhelming, but the EMS officer must be decisive. Once leaders make strategic thinking part of their everyday routine and encourage those around them to participate, making strategic decisions will become part of the organization’s culture.

Orlando J. Dominguez, Jr., MBA, RPM, is assistant chief of EMS for Brevard County Fire Rescue in Rockledge, Fla. He has more than 30 years of EMS experience.