Organizational Leadership – A Pragmatic Review

Nature holds plenty of leadership lessons. One of my favorites comes from an unassuming little bird called the common starling. On an individual basis they aren’t much to look at. Plain brownish and speckled, they are stocky little birds with triangular wings that you might never notice foraging across your lawn. But when they collect themselves in big flocks and fill the sky, they can become magical.

Murmurations of starlings is the term given to describe the beauty of hundreds, sometimes thousands of individual birds taking flight, swirling and darting in a mesmerizing flow. Their huge mass creates a mercury-like undulating aerial ballet. The flock is at once both liquid and solid, expanding and contracting, up and down, back and forth. Often triggered as a defense to fend off predators, when murmurations of starlings take flight they have been known to stop traffic and take your breath away.

It’s interesting to note that flocks of birds never have just one leader. The movement of the flock is governed collectively by all of the birds. In a fascinating paper published last year by the Public Library of Science (PLOS), it was reported that starlings are able to accomplish such close-quarter maneuvers by paying attention to the closest seven neighbors flying next to them. When one moves, the nearest other birds move too, and the maneuver is repeated in cyclical fashion across the flock.

I’m not suggesting for a moment that EMS leaders abdicate their responsibility to lead. But these starlings do offer some pragmatic food for thought, inasmuch as EMS operations are often a high-stakes mission, performed by independent practitioners, in a highly dynamic environment. Good EMS leaders create the atmosphere within which our caregivers can operate successfully on their own. Furthermore, in the best organizations caregivers are encouraged to not only perform well independently, but support and enhance the overall performance of the team around them.

By definition “organizational leadership” is the study of leadership within different types of organizations. Emergency medical services is arguably a unique environment within which to be a leader, but not necessarily unique in terms of the skills that all really good leaders should have. The recently released National EMS Officer Competencies from the National EMS Management Association, identifies six specific areas of focus when leading others. They are communications, interpersonal awareness, motivating others, developing others, influencing, and human resources management.

Management and leadership textbooks are filled with theories and techniques describing ways to put these competencies into practice. Here we will review three specific tactics that organizations of all stripes use to advance their own competency when leading others.

Rounding for Outcomes

Most employees don’t leave an organization because of pay or benefits. The number one reason they leave is because they have a poor relationship with their direct supervisor. It’s been well documented that what most employees want in a leader is approachability; to work shoulder to shoulder; tools and equipment to do their jobs well; appreciation; efficient systems; and opportunities for professional development.

This is what rounding for outcomes is all about—having deliberate conversations with every employee on a regular basis about the things that matter to them. It may sound simple, but it can be challenging to set aside deliberate time to just talk when the daily demands of EMS can keep you busy putting out fires in a revolving door.

Agencies that have done this have linked it to their success in improving employee satisfaction/engagement, loyalty, and ultimately attracting and retaining high performing employees. It’s a practice that helps caregivers feel they have purpose, are doing worthwhile work and making a difference.

One caution—employees need to understand this isn’t just an opportunity to back up the dump truck full of complaints. If that happens leaders will end up with a long list of to-do’s that will be impossible to accomplish, creating further frustration. Rounding needs to be specific, with regular follow-up. Importantly, leaders should spend just as much time explaining why something might not be able to be done, as meeting an employee’s request.

Situational Leadership

Situational leadership is a leadership style that has been developed and studied by Kenneth Blanchard and Paul Hersey. It refers to when a leader tries to meet the person where they are. It is the leader who changes his or her approach not expecting the follower to adapt to the leader’s style.

The Blanchard/Hersey model follows a construct that includes:

• Telling and Directing—step-by-step careful instruction to the beginner.
• Selling and Coaching—encouraging the novice and giving tips along the way for improvement.
• Participating and Supporting—allowing the competent person to begin standing on their own. While the leader still provides encouragement and direction, the decisions ultimately lie with the follower.
• Delegating—Delegating is where the leader is involved the least with the employee. These folks can stand on their own and often become the teacher.

For example, many years ago when I learned to drive a car my instructors were very prescriptive about what was expected of me—telling and directing me. I learned the fundamentals one step at a time.

Today, with many years of driving under my belt I might be considered an expert. I no longer need that kind of step-by-step instruction. In fact, I’ve actually became the teacher and I entered into the delegating phase when I helped my own children learn to drive.

In contrast, if today I wanted to learn how to play the piano—something I have never done before—I would need to go back to that telling and directing stage.

Situational leadership can be very effective, particularly when there is new material to learn or new people to integrate into an organization. However, there are limitations. Remember at its core situational leadership isn’t really leadership at all, but rather a management technique. And if the leaders aren’t careful it can be perceived a manipulative. So don’t let the technique become a replacement for your responsibility to have a genuine relationship with your staff.

Nine Block Matrix

The nine block grid or chart is a simple but effective tool, particularly for those who lead other leaders, for succession planning. It’s a simple grid with three squares up and three squares across, creating, as the name implies, nine blocks. Employees are ranked by their leader on the Y axis, based on their past performance—low, medium or high. Similarly, the x axis is used to rank their future potential. Rankings are typically reviewed by the senior leadership team to gain consensus.

High-performing individuals who also are perceived as having high potential land in the top right quadrant. They can be looked to for promotional opportunities. In contrast, those in the lower left quadrant (low performer, low potential) need to be managed up or out of the organization. The various blocks in between help identify where people land on the continuum of their own career development.

Often attributed to Jack Welch, former CEO of General Electric, the nine block can be a very effective tool. But it can also be seen as a harsh method by which to slash and burn low performers. Be transparent. Make sure your high performers know you think they are high performers, and re-recruit them before someone else does. As for any low performers, honest and direct communication can help people understand what is expected of them. It’s a whole lot more rewarding—and cost effective—to help low performers improve, rather than move them out. But in the end it’s really their choices that will determine their future.

These three tools are just a few of the many available to EMS leaders. Leadership matters and EMS organizations of all shapes, sizes and tax status can benefit by creating the environment where caregivers really love their jobs because they get to do meaningful work, and are part of a high performing team—a team as flexible, hard-working and awe-inspiring as the murmurations of starlings.

Brian LaCroix, BS, EMT-P, is president of Allina Health EMS in Minnesota and a board member of the National EMS Management Association.