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Leadership Sector: What Did You Do Today?

In the early days of the 20th century, Charles Schwab, president of U.S. Steel, was visited by Ivy Lee, a pioneer in management consulting, who said he could help U.S. Steel become more effective. When Schwab expressed doubt, Lee said he would give him a single suggestion to put into effect for one month and that Schwab could pay whatever he thought the idea was worth. Schwab accepted the proposal, Lee described his suggestion, and they agreed to meet again at the end of the month.

Schwab implemented the suggestion as described, and when the two men met again, he handed Lee a check for $25,000, representing $1,000 per minute for their 25-minute conversation. Schwab said it was the best advice he had ever received. It worked so well for him that he passed it on to all of his subordinate managers.

What was Lee's advice? Something simple: Every morning when Schwab got to work, or every night before going to bed, he was to make a list of all the things he wanted to accomplish that day (or the next) in order of priority. He was to work on the first item until he had done all he could do. He would likely be interrupted while working on the items, but he was to handle the interruption and then return to the task. Lee postulated that when managers are interrupted, they often forget what they were doing and never get back to it.

This principle applies to EMS managers. At the end of the day, you probably won't have completed every item on your list, but the important tasks should be done. Take the remaining items on the list and integrate and prioritize them into a new list for the next day. At the end of the month, if the same items remain on the list as at the beginning of the month, chances are they weren't important enough to require your attention to begin with and could have been delegated to other staff.

EMS managers are continually faced with prioritizing short- and long-term projects. Many managers confuse what's urgent with what's important in the long run. Before deciding whether an issue requires immediate attention, you must distinguish between urgent and important tasks. Time-sensitive issues with deadlines ƒ a ringing phone, a person at your desk with a burning question ƒ are all urgent. Urgent matters must be attended to immediately or serious consequences might ensue.

Contrast this with important tasks ƒ projects that add value to people or to processes. They have an intrinsic value and are closely tied to long-term organizational success, such as evaluating new equipment, quality improvement programs, employee training and planning. What stops you from doing these time-consuming and complex tasks? All the "little things"„that seem to multiply incessantly.

Some managers color code their calendar or planning chart so they can tell the status of projects at a glance. For example, use red for high-priority items for that day, blue for project deadline reminders (two or three days before the actual deadline in red), green for following up on other people's work and black for prescheduled or recurring tasks. Also, PDAs, Blackberries and computer software make such organization even easier.

EMS management can often limit the establishment and completion of daily priorities. Emergencies can pull an EMS manager away from their office, especially when they play an active role in an incident command system. This conflict is especially evident in smaller systems, in which managers may have to jump on an ambulance during crew shortages or as a matter of routine in addition to being responsible for administration.

Therefore, EMS managers must learn to delegate. If your to-do list is long, chances are you'll find yourself putting in 12-hour days, seven days a week, with no end in sight. EMS managers should know the capabilities of each of their employees and know how to appropriately and confidently delegate tasks to competent staff.

For example, if you need a lecture prepared on a new prehospital drug, you could delegate the project to a training officer, senior paramedic or other staff person familiar with EMS education. If you want the lecture created with PowerPoint, select a person who is familiar with the program.

Productivity for the EMS manager is vital. Without planning, establishing priorities and possibly delegating tasks to other personnel, a prescription for disaster lies ahead.

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