Ludwig on Leadership: How to Master Decision-Making

As an EMS leader you make countless decisions every day. Some are simple: Do I want another cup of coffee? Where am I going to lunch? Should I stop and get gas for my car? But there are tougher decisions that need to be made during your work day. Some may be related to budget cuts or, if you’re lucky, what to buy with all the money you have in your budget. The odds are, though, that most tough decisions deal with personnel problems or administrative issues that have a department-wide impact.

The question is, as an EMS leader in your organization, how do you go about making decisions and problem solving? And if you are dealing with multiple problems, how do you  prioritize which takes precedence?

Don’t Rush to Judgment

As EMTs and paramedics we are taught to make snap decisions multiple times a day. We’re presented with the facts right in front of us, and we use our knowledge, training and education to make an immediate decision.

Unfortunately, many leaders in EMS organizations take that same mind-set and transpose it to their administrative decision-making. Someone walks in their office with a problem expecting them to make an immediate decision and typically they do, since that was how they operated as a field provider.

I should know. I was guilty of this too. But I have come to realize that as a manager I am usually not on an emergency scene, and I do not have to make a decision right now. Someone may want an instant solution to a problem, but I have learned not to bend to that pressure. I tell other EMS leaders to take their time and gather all the facts before making any administrative decision. It is often wise to consult with your legal or human resource departments before making a call that may result in severe discipline or even termination of an employee.

Gather the Facts, Dispel the Fear

When you pause and take a breath, you allow yourself not to react instinctively to what you are hearing at that immediate moment. There is probably more information on the matter that you have not heard yet. Sometimes whoever wants a decision from you is only telling you a partial amount of the story that favors the decision they want you to make. Other times, they may not have the complete story or the accurate facts themselves. When they give you the information, they are unintentionally providing you with the wrong information to base your decision upon.

As the EMS leader of an organization you also cannot be afraid to make a decision. I have met passive leaders who are hindered by an inability to execute action. First they are afraid they are going to make the wrong decision and second, they are afraid staff will not like the decision and thus not like them.

Transparency Is Key

Any problem you solve or decision you make has to have some form of communication. Transparent communication is essential to making the right decision. This communication can be written or spoken. Either way it is necessary if you wish to make the right decision or solve the problem.

Only once all viewpoints have been heard can the EMS leader map out a path toward a viable and sustainable solution. In order to get all viewpoints and all the information necessary, you may have to break down silos. Unfortunately I have seen cliques develop in EMS organizations and, if there is a major issue of some type, people will align themselves with whatever group they associate with. These are nothing but barriers to creating a team concept where everyone works together.

Problem-solving and decision-making are skills EMS leaders must develop. They are not skills that can be acquired overnight, but rather something that comes with experience. If you remember some basic rules—including not to react emotionally to information that is brought to you—and if you hesitate before making an impromptu decision, you will typically find yourself in a better position at the end of the day and not have to change a decision you made even after additional information is received.

Gary Ludwig, MS, EMT-P, is chief of the Champaign (IL) Fire Department. He is a well-known author and lecturer who has successfully managed large, award-winning metropolitan fire-based EMS systems in St. Louis and Memphis. He has a total of 37 years of fire, rescue and EMS experience and has been a paramedic for over 35 years.