From the Officer’s Desk: Preparing for Transformative Initiatives

Introduction

EMS officers and other organizational leaders will routinely have to make decisions about implementing key organizational change to improve organization-wide business practices. Some change initiatives may be small in scale while other initiatives may be transformative having a direct impact on processes, systems, the organization’s culture, or other interdependent business activities across the organization. Implementing change or transforming a business practice is something that EMS officers and other organizational leaders will have to do as part of their assigned responsibilities and must be well versed as to how best to achieve the following initiatives. Although used interchangeably, transformation and change are not the same. Transformation is an action taken by organizational leaders to ensure the organization is making the necessary improvements to current business practices or introducing new ones. In addition, when organizational leaders move toward a business practice transformation it is forward-looking and is a deliberate shift as it pertains to improving, adjusting, or implementing a new initiative across the organization. It may be large in scale, overarching, typically proactive, and may require time to implement; for example, organizational transformation may consist of moving from an all-advanced Life Support (ALS) response agency to one incorporating Basic Life Support (BLS) units to the department's response model, developing a community paramedic program, transforming the organization’s culture or implementing an EMS officer training academy to name a few. Transformation is about reinventing the organization and how it does business. Whereas change is a response to a specific organization activity and can usually be made quickly; for example, having to change first-line medications due to the medication shortage, changing employee work schedules, changing a specific treatment intervention, or changing the number of units responding to non-emergent requests for service. There is no doubt that transformation activities will include change; nevertheless, they are still different. And so, EMS officers must be well versed as it pertains to successfully implementing transformational improvements, or adjustments that consist of introducing a new business activity across the organization being that transformation initiatives require resources, are larger in scale, and may require more time to complete. As it pertains to this article, the focus will be on preparing for transformative organizational initiatives. With that said, before crafting a transformational plan, the EMS Officer must be aware of misfires that lead to transformational failures. 

Why do Service Delivery Transformations Fail

According to the McKinsey & Company consulting group, 70% of organizational transformations fail. So, what is causing these transformational initiatives to fail at such a high percentage? There are a few reasons for the high failure rate that must be avoided to ensure successful implementation:

• Poorly articulated “non-specific” transformational plan

• Inexperienced leaders

• The transformation is too complex 

• Too many projects taking place at the same time

• Unrealistic initiative

• Lack of stakeholder buy-in 

• Employee resistance to the transformation

• Lack of support from senior leaders

• Stakeholders do not have the tools and training to accept the workforce transformation

• Scope creep

 When to Consider a Service Delivery Transformation

When considering a transformation initiative, the EMS officer and other organizational leaders may want to ask the following questions before taking any action:

• Is Transformation Necessary? Before committing to an organizational transformation, EMS officers as well as other members of the organization must ask themselves what is the purpose for the proposed transformation. Is there a system, service, or other business practice that needs improvement, adjustment, or not in place? Once the EMS Officer identifies the purpose of the proposed service delivery transformation, then it will be easier to articulate what will be included in the transformation plan and will be easier for others to follow.

• Why is this Service Delivery Transformation Important? The EMS Officer must ask him or herself, what are the consequences if the following transformation is not implemented.

• Does the Transformation Align with the Organization's Mission, Vision, and Values? The EMS officer must ensure that any transformation being considered must align and thereby support the organization’s mission, vision, and values. If the transformation is not aligned with the organization’s mission, vision, and values the actions may result in an unsuccessful implementation. 

• Has the Transformation Under Consideration Been Done in the Past? If a transformation is under consideration and has been attempted in the past, the EMS Officer must investigate the outcome before embarking on a similar initiative. Transformations require time commitment and resources; therefore, make sure that it is worth the investment.

• What does the data show? As an EMS Officer, you will have the opportunity to determine if a business practice transformation is warranted. With that said, organizational leaders must thoroughly evaluate as much data about transformation being considered. Transformational initiatives are often large in scale and will require time and unless there is enough data to conclusively support the commitment to move forward with any service delivery transformation, the EMS Officer must take a pause and determine if the change initiative is worth pursuing.

Crafting a Transformation Plan

When the EMS Officer concludes that a business practice transformation will be required, he or she must not lose focus as it pertains to the desired outcome and must consider the following as part of their transformation plan:

• Assembling a Team: Assembling the right personnel to work on the transformation team is critical. Team members must have a good understanding of the task at hand and what is required of them to achieve the transformation initiative. Having members on the team who do not have experience with the proposed transformation or are not interested in being part of the initiative will not only impede the transformation but may also lead to an ineffective transformational outcome.

• Making Time: One of the causes of transformational failures is working on too many projects at the same time. McKinsey & Company recommends allocating 70% of the organization’s resources to transformations that are critical to the organization’s success, 20% to those that “potentially” may have a benefit to the organization, and 10% of resources to transformations worth exploring but are not a priority.

• Use the SMART Acronym: It is critical that EMS officers clearly articulate and must be specific as it pertains to the transformation initiative. Before the start of any transformation, the EMS Officer, as well as other organizational leaders, leading the initiative must consider using the SMART acronym: Specific, Measurable, Attainable/Achievable, Realistic, and Time-Bound when setting the transformational objectives. This will assist in setting up guard rails to ensure the transformation plan is clearly defined.

• Clearly Articulate the Transformation Plan: The EMS Officer must continuously communicate not only to the transformation team but also to the organization of stakeholders, informing them of how the transformation is moving along and if there are any additions or changes to the plan. The lack of communication is another factor that will lead to workforce transformation failure.

• Seek Feedback and Input: The EMS Officer must routinely seek feedback and input from the transformation team and organizational stakeholders as well. It is extremely important to make sure that many of the concerns or issues are identified and addressed before implementation.

• Engage People: The EMS Officer must make every effort to engage not only his or her transformation team members but other stakeholders as well. Stakeholders need to understand why such transformation is needed and how it will impact them. When the organization has buy-in from its stakeholders, it will be much easier to achieve successful transformation.

• Saboteurs: The EMS Officer, as well as the workforce transformation project team members, must not get discouraged by individuals known as saboteurs. Saboteurs are stakeholders that will make every attempt to derail the transformation from taking place. EMS officers as well as other organizational leaders must not get discouraged and remain laser-focused in achieving the service delivery transformation. The EMS Officer must continue to promote the importance of the transformation and involve as many members of the organization as possible, even those who are trying to derail the project. Service delivery transformation is at times difficult to accept since it requires change and there might be fear of the unknown; therefore, being inclusive will go a long way in breaking down some of the resistance.

Implementation

Once the transformation plan has been crafted and approved, it is time for implementation. The EMS Officer will need to make sure the implementation plan is followed to avoid any mistakes that will derail the implementation. Once implementation occurs, the EMS Officer and/or a designated transformation team member must be assigned the responsibility to monitor the activities post-implementation to ensure the desired outcome is controlled and there is no deviation from the intended goal.

Conclusion

The EMS Officer must promote a culture of transforming business practices that will benefit patients, employees, and the organization itself. It will be up to EMS officers to monitor the organization’s business practices, regularly, and determine where transformative initiatives may be required.