Seven Components to Implement Change



Gary Ludwig, MS, EMT-P | From the August 2010 Issue | Wednesday, August 11, 2010

Have you ever noticed that some EMS organizations seem to click together just fine, but other organizations languish in constant turmoil, with one problem after another, invariable turnover and dysfunction? Why is that? It may be because there’s a gap between where they are and where they should be.

EMS organizations should routinely evaluate their performance and look for improvement opportunities. The problem most organizations encounter is deciding what to examine. Agencies can examine internal or external factors, but the best EMS organizations scrutinize both.

It seems effective organizational models come and go as routinely as visitors at a fast food restaurant. However, one that seems to have remained for a while and is frequently used is the McKinsey 7S model.

Identify Goals
The McKinsey 7S model was developed in the early 1980s by Tom Peters and Robert Waterman. This management theory identifies seven internal factors that should be in tune with each other for that organization to be effective. There are seven factors, which all begin with the letter “s:”
1. Strategy
2. Structure
3. Systems
4. Shared Values
5. Skills
6. Style
7. Staff

The model can be used by a team to improve performance or for a project the organization is trying to accomplish.

When applied to an EMS organization, the model’s basic premise is to align the seven elements to support each other. The model also works for successful agencies because it can be used to discover which elements need to be united to further improve performance or maintain alignment during change. Management style, department restructures, new projects or even agency mergers are all types of change for which use of this model could benefit the agency.

The first step to utilizing this model is to analyze your current situation. Then, set a goal for where you’d like to be. When you apply the seven components to the two situations, current and future, gaps and contradictions will emerge, indicating where changes should occur. To realize your goal, you’ll need to adjust one, some or all seven components.

If you were to apply this model to an EMS organization looking to improve its effectiveness, the application would look like this: Let’s say an agency is looking to put together a team to implement a public access defibrillation (PAD) program. Applying the McKinsey 7S model, key questions would be asked to address each of the seven components and determine the organization’s current situation and future intent for the PAD program.

Ask the Right Questions
The first question would be, “What’s our strategy?” Then, when you’ve developed a strategy, more questions, such as these, would follow:

  • How do we intend to achieve our objectives?
  • How are changing taxpayer demands addressed?
  • How is the strategy adjusted for financial or environmental issues?

When looking at the skills component, more key questions that can be asked to determine your current status and where you’d like to be in the future with the PAD program. Some of those questions include:

  • Who has the strongest skills within the EMS organization?
  • Are there any skills gaps?
  • Do any of the current employees have the ability to do the job?
  • How will the skills be monitored and assessed?

Moving on to the last “s,” for staff, you should try to decide if any specialization would be needed within the team carrying out your goals. This will tell you if any positions need to be filled or if there are any gaps in required competencies.

If something within your organization or team isn’t working, it’s likely discrepancies or inconsistencies exist between some of the elements identified by this standard model. The key to improvement is to identify these inconsistencies. Once identified, correct and align the elements to make sure they’re all contributing to the shared goals and values.

The heart of using the McKinsey 7S model is analyzing your agency’s current position in regard to all seven components. By taking your analysis to another level and determining the current state for each of the factors, you can move your EMS organization or team forward and make substantial progress. JEMS

This article originally appeared in July 2010 JEMS as “‘S’ is for … : Implement these seven ‘s’ components to transform your agency.”

Connect: Have a thought or feedback about this? Add your comment now
Related Topics: Administration and Leadership, Leadership and Professionalism, “McKinsey 7S model”, “Gary Ludwig”, “change”, Jems Leadership Sector

Author Thumb

Gary Ludwig, MS, EMT-P

is a deputy fire chief with the Memphis (TN) Fire Department. He has over 35 years of fire, EMS, and rescue experience. He is also the immediate past Chair of the EMS Section for the IAFC. He can be reached at


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