A.J. Reports from the Pinnacle Conference – Day 3

Jay Fitch, PhD, president of the EMS consulting firm Fitch and Associates, presented a compelling keynote session at the Pinnacle EMS leadership conference in Florida on Thursday morning entitled “Becoming a 3D Leader.”

Fitch noted that W. Edward Deming, known as the “Father of Quality,” stressed that management should learn to align the beliefs of people in their system. He also stressed that “the tools we use today are anchored in research,” and that EMS leaders have to be ready to cope with the following in the changing healthcare environment:


Several of the EMS leadership tips and pearls presented by Fitch were:

  • Leaders must learn how to best balance cost, quality and service;
  • Leaders must learn how to eliminate waste;
  • Leaders must improve the value for the customer and your community;
  • Use a rational adoption of new devices;
  • We don’t know what quality is but our customers do;
  • You must measure and document your work flow;
  • Start from where you live to improve your value;
  • Focus on good operations deployment; how we use our people to meet our demand – are key;
  • Pay attention to retention and turnover;
  • Relationships are important;
  • Create value-conscious care givers;
  • Evaluate whether you really need to have an 8:39 minute response time in your system;
  • Look at whether you can–or shouldpull back on first response to ALPHA callsor should you start to hold back transport ambulances on some ALPHA call;
  • You don’t need to send the “Army” to all calls;
  • The roles between public and private sectors have to be better designed;
  • Remember that we are all care givers – including your management team;
  • We have to deliver high quality services;
  • There’s merit in cooperative purchasing;
  • Use competitive procurement;
  • Consider trimming down the demands and specificity of your equipment and vehicle specifications to cut costs;
  • To improve revenue, make sure your clinical documentation is solid;
  • To improve revenue, think about how you can expand services;
  • Know what your mission is;
  • Decrease lives lost, and reduce pain and suffering;
  • Teach your people to be safe;
  • You must “Grow your people”;
  • Today’s staff want opportunities for development;
  • Engage your staff, community and customers and complete the feedback loop;
  • In times of change and limited finances, you must think outside the box;
  • Align your mission and actions;
  • EMS organizations must be “hands on” to prevent negativity and encourage positive attitudes;
  • Our crews want leaders and want managers that care;
  • Terminations are usually a result of the person being unable or unwilling to do the job;
  • Don’t have any ambiguity in your organization–make sure your people clearly understand your reporting;
  • De-personalize errors and encourage your staff to report error and concerns;
  • Listen to your staff’s perspective and understand what’s going on;
  • Follow up on issues–make sure your staff knows they are not ignored or forgotten;
  • Selective perception is looking for “something right”;
  • Your staff wants systems that are reliable and work correctly;
  • You need to have a mentoring programs in place;
  • Recognize that there are different competency levels among your staff;
  • Internal training and annual skills competency are important;
  • Show people how to lead;
  • Pass on the leadership baton;
  • Identify future leaders and “nudge them into responsibility”;
  • Be knowledgeable and conscious of, and teach other managers and leaders about, power abuse and conflict management; 
  • Observe what is working well and what is not working well;
  • Observe and recognize who is doing a wonderful job in your organization;
  • Accept your limitations and come to grip with your limitations or weaknesses; and
  • Always be absolutely positive.

Fitch concluded his powerful presentation by emphasizing that “leadership footprints” are unique. These footprints are measured by the weight of your character, by your unique marks of accomplishment, by the shapes of your kindness, by the length of your stride and the depth of your compassion, and, by the width of your personal worth and generosity.

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