Are You a Meeting ``Master``?

Management of today's EMS systems requires knowledge of both administrative and operational aspects of the delivery of prehospital medicine. The challenges inherent to satisfactorily choreographing these types of complex organizations can be as daunting as any seen in the business world and require a blend of formal education, experience and on-the-job training. Quality management, overall performance and human resources issues, as well as a host of other trials and tribulations, are all part of day-to-day operations for EMS managers.

The Corner Office is a bimonthly column sponsored by the National EMS Management Association (NEMSMA). While laying the foundation for more expansive thought on management concerns, the column will also prepare readers to analyze important public-policy issues that confront EMS systems, as well as combine theoretical and practical experience and a knowledge of the healthcare industry as it applies to EMS.

It has been the week from hell. The days pass in a blur, with no real sense that you have accomplished anything significant, but rather that time is being eaten by small "fires" that keep popping up. Just when it looks like making a small dent on your weekly to-do list may be possible, a text message appears announcing, "Per the director, all supervisors and managers must attend a mandatory meeting in the conference room at 14:00 hours." You roll your eyes at the ceiling as you recall the endless litany of meetings you have attended this month--the credentialing committee, the county disaster meeting, the physician oversight board, etc.--and how little any of them actually accomplished. Mentally giving up on other needed tasks, you resign yourself to an afternoon of completing a long agenda, hearing rambling reports and discussing start-up projects that will go nowhere.

Most of us in EMS are the victims of multiple meetings in our daily, if not weekly or monthly, schedules. There are some basic truths to meetings, whether you're in EMS or another field, but most people don't like them. They can be boring, go on too long or not go anywhere.

Robert's Rules of Order

Before proceeding any further, it's important to note that the vast majority of meetings follow the format laid out in Robert's Rules of Order, known widely as just "Robert's Rules." This guide is the bible of organization. It provides a simple introduction to parliamentary procedure (the cornerstone of meeting management) and is essential if you are running any meeting.

Tips

Whether you are running the meeting or are a participant, there are some excellent ground rules you can employ to keep the meeting schedule realistic and the meetings themselves on track and informative.

1. Make sure you need to have a meeting. Meetings are necessary when a group of people must be involved in an action or a decision. But unless you are a government entity or regulatory body required to do so, don't schedule a meeting just because it's time to have one. For instance, rather than ask all your system's on-line medical control physicians to get together just because it's "that time," meet when there is a new treatment modality or medication to be evaluated prior to inclusion in the protocols.

2. Make sure the right people are invited and in attendance. Holding a meeting when the principal stakeholders or decision-makers can't be present makes no sense. Also, there is a difference between inviting individuals who may be interested versus individuals who have a vested interest in the topic matter. This is an often overlooked but somewhat critical factor to the success of accomplishing the task at hand.

3. Set specific goals for the meeting and make sure all participants know them at the meeting's onset. Be very clear about why you're having the meeting and what needs to get done or be decided. Break that task into steps, or divide the discussion into sections as needed. This will become the basis for your meeting agenda. At the outset, state the goal of the meeting and make it clear that this is the only benchmark that will qualify the meeting as a success. At the end of the meeting, remind participants of your goal. This lets everyone leave feeling successful and more than willing to attend your next meeting.

4. Remember that the participants own the meeting. Let them set the agenda before the meeting, or at least add to it when you begin. If decisions need to be made about the process (whether to end a discussion that's going on too long, for example), ask the group. This overall point ties into another--make sure people participate. People tend to think a meeting is useful based on one simple thing: whether or not they contributed (i.e., talked). So everybody should have a chance to share their ideas, but within reason. It's OK to ask specific people what they think, but you should also be prepared to gently remind them when they're talking too much.

5. Paperwork can be your friend. Remember to generate an agenda in advance, have a sign-in sheet with attendees' names and affiliations, and distribute minutes after the meeting. A quick aside about meeting minutes: Minutes are a record of the meeting and must record the date, place and nature of the meeting. They start at the beginning of the meeting and finish when the meeting ends. They do not need to be a word-for-word account of everything that was said, but they must record the main points, decisions and motions (for example, "discussion regarding new state BLS protocols").

There are also various before-, after- and during-the-meeting tips that should be followed to ensure success. These include:

Before the meeting:

• Be clear on purpose and aims
• Create the agenda
• Schedule the meeting
• Ensure the agenda is posted and sent out
• Ensure that appropriate supporting information is circulated in time to be useful
• Ensure that room arrangements (including refreshments) are made
• Arrange for a recorder and any needed supplies (such as flip chart, markers, etc.).

During the meeting:

• Start meeting on time
• Ensure quorum (if required)
• Review agenda
• Keep discussion focused on agenda items
• Encourage full participation
• Help group reach decisions
• Summarize decisions
• Agree on action plan: point person and what needs to be done
• Draft agenda for next meeting(s)
• Evaluate meeting.

After the meeting:

• Ensure that minutes are produced and promptly distributed, including to guests
• Ensure that agenda, minutes and meeting and supporting documents are kept together and archived as required
• Check to ensure that action is taking place as agreed.

The Communications Conundrum

In order for meetings to be effective and flow smoothly, they need to be free of distraction. However, since they will often involve key members of the organization's management structure, they will need to "be in touch" and accessible. Thus, the conundrum is whether to allow cell phones, pagers, Blackberries and other communications equipment that may disrupt or distract attention in an important meeting. Providing a gentle reminder that such items should be on "silent" mode for the duration of the meeting, and that calls should be taken outside the meeting room, will be appreciated by all participants.

Conclusion

Meetings are important tools and can serve multiple purposes, including conveying important messages, getting everyone on the same page on critical issues and gaining consensus among key stakeholders. EMS managers need to be careful of "overmeeting." And don't forget, the benefits of a meeting are only realized when you remember the basics.