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Leading Change

Carmen D'Angelo

Change is inevitable.  Given that our environment is continuously in transformation, we either see the merits in leading the change, or find ourselves adapting to the change, or if blinded by the environment, being forced into the change. 

This new edition of Canadian Paramedicine is a prime example of change being led by Publisher Lyle Blumhagen and Editor Angela Anderson.  In their change management strategy, they consulted with their readership and stakeholders to produce a moving-forward publication that will continue to connect paramedicine from coast to coast, and advertising the Canadian way to other international markets.

I have some experience in leading change.  After being clinically active as a paramedic in Toronto for 10 years, I took the opportunity to lead change in the Region of Haldimand-Norfolk, where I prepared the regional government to accept the legislative responsibility of paramedic services from the province of Ontario.  Two years later, I became involved with the County of Oxford in their preparation of assuming direct delivery of paramedic services from “contract operators”.  And my most recent experience in change was with Hamilton Health Sciences, where I administered the realignment of three district paramedic base hospitals into a centralized regional program.   From these experiences, I have observed some commonalities in leading change.

When leading change, you will soon discover the critical commentary that will emerge.  On one end of the spectrum, there is the constructive criticism, whereby individuals and agencies will express concerns about the initiative.  This type of criticism is valuable to the change manager as it opens dialogue with those who have a vested interest and are willing to engage in the discussion.  And at the other end of the spectrum, there are those who will resist change based on no merit but to simply defend the status quo. As a change manager, it is also equally important to be aware of this resistance.  According to researchers, the difficulty of implementing change is often exacerbated by the mismanagement of resistance derived from a simple set of assumptions that misunderstand resistance’s essential nature. It is suggested that leaders may greatly benefit from techniques that carefully manage resistance to change by looking for ways of utilizing it rather than overcoming it.

From analysis to strategy formation to implementation plan, every once in a while you may encounter the saboteur.  The antagonist whose sole purpose is the prevent success due to reasons that are beyond comprehension.   The key to overcoming this obstacle is receiving advance and continued strong support within the senior executive reporting structure.  There is much emphasis on the “soft” side of transformations, such as leadership style, corporate culture and employee motivation.  Though these elements are critical for success, change projects can’t get off the ground unless organizations address harder elements first.  According to the experts, the essential “hard” elements are duration, integrity, commitment and effort. These hard elements are known as DICE:

  •     Duration – The time between milestone reviews, where the shorter – the better.

  •     Integrity – The project team’s skill and thus ability to meet project goals on time.

  •     Commitment – The senior executives and the line managers dedication to the project.

  •     Effort - The extra work employees must do to adopt new processes—the less, the better.

As stated by the experts, “By assessing each DICE element before you launch a major change initiative, you can identify potential problem areas and make the necessary adjustments to ensure the program’s success. You can also use DICE after launching a project—to make midcourse corrections if the initiative veers off track.”

It is concerning that over 75 per cent of business transformations fail. It is suggested that there are two primary reasons why these failures occur.  One problem is the lack of communication with employees and the failure to recognize the impact of change.   Thus, it is imperative that change managers create an open and transparent line of communication amongst employees to ensure knowledge of the change is being captured.  This includes updating employees on each stage of the transformation, measuring the front-line feedback to the changes being made, and continuously reviewing that the communication strategy is on track.

In the public sector, there are various drivers that prompt the need to change.  Whether the drivers are based on legislation, community needs, economic factors, or innovation and research – leaders are compelled to respond.  Findings indicate that in many cases the change that occurs is imposed on the leaders themselves, and it is often the pace of change that inhibits the successful re-engineering of the culture.

In Canada, paramedic services are indeed in the midst of a national transformation.  A review of the EMSCC (Emergency Medical Services Chiefs of Canada) white paper, entitled “The Future of EMS in Canada: Defining the New Road Ahead”, contains many transformations to be expected within the future culture of paramedicine.  In this paper, leaders in EMS identifie six key areas of focus on the road map to change. One such focus is the ensure EMS is on the national stage for policy makers to consider when determining public health and safety initiatives.

So if you find yourself in an organization that is starting to, or is in the midst of change, it is acceptable to ask questions and provide input.  You may be pleasantly surprised by the positive interaction that will develop.  As a paramedic, system controller at communication, supervisor, commander, deputy chief or chief – communication and timing are essential for a successful transformation.

Are you ready to lead the change?