The Impact among the SAAS Personnel and Volunteers and Their Clients - Case Study Example

Introduction Inasmuch as every organization needs to adapt itself to the vicissitudes of time in order to be relevant, change is a fact-of-life for any organization. While organizational change may be occasioned from within the organization or externally, it is nevertheless planned and systemic. In this paper, the case of the South Australia Ambulance Service (SAAS) is studied. It will be told how this organization metamorphosed from observing a military-like order to having a set up involving independent and self-managed ambulance teams. This paper would also show the impact among the SAAS personnel and volunteers and their clients by embracing the said shift in the organizational set up. The South Australia Ambulance Service (SAAS) South Australia Ambulance Service (SAAS) is a government agency under SA Health, which serves as the sole provider of emergency ambulance transport, clinical care and patient transport services. It operates throughout the state of South Australia covering an area more than seven and a half times the size of England (around 983,482 km2). It serves a population of more than one and a half million. SAAS has more than 2,500 career and volunteer staff responsible for its ambulance fleet of 300 vehicles deployed in its 107 stations state wide (South Australia Ambulance Service [SAAS], 2009). More than attending to the usual emergency care, SAAS is actually doing or providing other services – such as, educating its own paramedics, attending to all non-emergency cases, serving as emergency operations centre, and maintaining its own Special Operations Team (SOT). For purpose of delineation of tasks, SAAS is organisationally divided into the Information Management and Technology Department, the Corporate Communications Department, the Customer Service Centre, Building Services Team, the Fleet Workshop, the Communications Engineering Department, the Supply Department, the Workforce Services Department and the Finance Department (SAAS, 2009).   The SAAS Organisational Culture Besides the immense and expansive coverage area of SAAS’ operations, the organisation similarly needs to address the fact that anywhere in the state of South Australia a customer would need its services every four minutes. These are involving life-and-death situations; thus, these are indeed essentially urgent operations to ensure that expert paramedical interventions are brought to whoever calls for help. Similarly important it is to note that SAAS is never underwritten by the government; hence, it would always want to recover its cost of operations (Frontier Software, [n.d.]). Because SAAS has a herculean task to fulfill, it is not surprising that in its bid to be as effective and as efficient as possible, SAAS has patterned its past organisational set up after the military. That is, SAAS was formerly characterised by its being typically military style of administration. The head called the shots, while the subordinates followed orders as the protocols of the institution. The organization was understandably hierarchical and very centralized. Realising, however, that SAAS belonged to health care industry and not to a military institution, SAAS progressively sought to improve its organisational structure – in particular, its human resource management system – as to be able to not just cope with the demands of their work but also to raise the standard in the ambulance service industry. In practice, as the SASS came to terms with the limitations of its previous organizational setup, it has tried to veer towards a clinically focused patient care organisation (Grantham, 2002). This set up requires an effective interfacing between the management team and SAAS personnel in the frontline. With the introduction of self-managed work teams, the SAAS is rendered into a flat organisation, which is structured for team-based and empowered people at the point of service (see Grantham, 2002). Complementing these work units, SAAS similarly has adapted the roster system, which provides for at least ten fully qualified paramedic officers in every station as they are backed-up by volunteers (Frontier Software, [n.d.]). The organisation has recognised that communication among the geographically dispersed workforce of SAAS is very crucial, as information is considered as lifeblood of such organizations (Grantham, 2002). In principle, the organizational change at SAAS is in keeping with its adoption of the principles of total quality management (TQM). In fact, SAAS resolved to improve all its aspects of organisational existence and operations was made evident in its decision to shift from an intranet software mandated by the Australian government in 1996 to Complete Human Resource Information Systems (CHRIS) in 1998 (JEPHC [n.d.]. This shift was more than just a shift from one kind of software to another; it was also a significant shift towards an increased focus on human resource management. The use of user-friendly but very functional human resource software is crucial, because it can boost an organisation’s efficiency and effectiveness (Frontier Software [n.d.]; see also Vision 2010: SAAS Strategic Plan 2005, pp. 13, 15; confer a parallel example in Dalcher 2006). The Management Styles Within SAAS Together with the steps that SAAS has been taking to improve its organisational system, there are modifications too in the management style of the organisation. Clearly, as observed by Grantham (2002), the current management model of SAAS allows for autonomous practice by paramedics, regulated by regular evaluation and continuing education sessions that will facilitate a true earning of professionalism among the SASS personnel. Accordingly, this management model of making the organisation operate by independent work terms is more akin to medical typology, rather than to a protocol driven military model. In the past, paramedics were given little tasks relative to pre-hospital emergency care; if they were asked to do pre-hospital emergency care, it was externally controlled. Generally, paramedics’ involvement in the provision of pre-hospital care was restricted only to transportation of patients to the hospitals – which was ultimately evaluated to be deficient. Under the current management set up of SAAS, the day-to-day running of paramedic practice has been transferred to the practitioners. The result is the integration of pre-hospital emergency medicine from the rest of emergency medicine (Grantham ,2002). Likewise, SAAS management style provides for features of unpredictable and uncontrollable environment where its people find themselves in by allowing its personnel some degree of freedom to move within guidelines (that allow for choices but do not remove direct control). In this case, SAAS personnel are able to tailor their intervention to the need of their customers. And this proves to be effective because of SAAS workforce’s depth of knowledge and experience constantly checked by an internal process of review (Grantham, 2002). This management style makes SAAS a learning organisation, its continuing education program that it provides its paramedics with the principles and details of patho-physiology relating to pre-hospital emergency care. The pedagogical methodology puts premium on problem solving and lateral thought as much as the simple fact acquisition. Independent work teams, or ambulance teams, in the SAAS are trained to have the ability to consider problems from a broad perspective and evaluate differing evidence on their case at hand. This practice effectively eliminates excessive aggression and overly dogmatic approaches. Too, a very valuable feature in SAAS management style is its conception of mistakes as a part and parcel of learning process. Even then, the operational management side of the SAAS is similarly influenced by this model of management processes, which appreciates the value of objective evidence and logic; hence, understandably, it encourages clinical debate (Grantham, 2002). Cognisant that its management style needs to constantly adapt to the changing time and always strive for excellence, SAAS is training its sight already now in the improvement of professional behaviours of its personnel by developing a research base within its pre-hospital care. With this mechanism, attitudes and abilities that are necessitated by paramedical profession can be taught and will develop (Grantham, 2002). Motivation and Performance of SAAS Personnel While the literature that focuses exclusively on motivation and performance of SAAS personnel is scant (Sperou, 2005), there are existing literatures on the issue of motivation and performance among ambulance service workers in Australia. Critical consideration of what these research studies offer would actually point to the fact that their findings hold true even on SAAS. Sperou (2005) posits that SAAS personnel have relatively high job satisfaction. According to a report, ambulance workers’ motivators are coming from multiple sources (S-3). Firstly, the major motivation for ambulance workers is their desire to serve the community. This underlines the need for SAAS to strengthen social capital and reinforce the benefits of community engagements by its personnel. Secondly, training is another major tool to keep up the motivation of the SAAS personnel, and as emergency workers, SAAS personnel would always want to undergo high quality, flexible, and competency-based trainings. Thirdly, since ambulance service is similar to other healthcare services, pre-hospital service workers are motivated by a supportive environment that readily provides clinical support, communications, and a professional work situation. Similarly it is also an environment that recognises the contribution – thus, the worth – of every one of its members not only in the delivery of its services but also in the management of the organization. As regards SAAS performance, Vaughan (2009) reports that the organisation officers are actually the quickest at reaching their customers among the ambulance service providers in Australia. SAAS reaches 90% of life-threatening cases in 14.2 minutes or under – a record best in the country. Likewise, SAAS officers respond to emergencies in urban areas within 6.5 minutes fifty per cent (50%) of the time and 10.7 minutes ninety per cent (90%) of the time. This sterling performance of SAAS is reportedly linked to the dedication and hard work of the ambulance officers and the new initiatives that had been implemented to improve response times. Change Management Strategies The SAAS has opted for self-managed work teams to deliver its services to its customers instead of the protocol laden military management/administrative style. This organizational change was supplemented by the use of human resource management software, CHRIS (Frontier Software, [n.d.]). Of course, there were more available change management strategies for SAAS. For one, pre-hospital care may be provided with the help of a real time remote medical control. This system provides for medical acts that are authorised on an individual basis as they occur, with the use of radio communication to assist the contact between the medical authority and field practitioner. Obviously, its advantage consists of an experienced medical practitioner influencing and actually guiding the management of care at a distance. At least, in theory, the patient has the chance of getting the benefit of being serviced by a professional even when they are physically apart. On the negative note, however, there are some logistical problems with this management option. For one, this system necessitates that people on both ends of the communication line have mutual respect and possess a very advanced ability to communicate using only a common medium. Otherwise, delays and misinterpretations of the situation may ensue (Grantham, 2002). Another change management model is the use of protocols, or standing orders, that authorise medicals actions without the need for actual contact to occur between a paramedic in the field and professional medical personnel in the office. All this system requires is that pre-hospital practitioners are trained to establish whether a clinical situation meets the inclusion criteria before they are to proceed with the protocol. Expectedly, this system provides pre-hospital care in a shorter time frame. But, since protocols were usually written by experts in the field taking into account the most recent research in that field, these are unsurprisingly unable to cater for the outlying cases. Besides, reliance on protocols can similarly possibly lead to a very blinkered view of the situation and fail to appreciate a subtle difference that would demand application of another management strategy (Grantham, 2002). Conclusion In the case of SAAS, organisational change was spurred by the adaption of the principle of TQM resulting to the organisation’s shift of management paradigm that has made it, so far, successful in its operations. The organization has changed from a military-based management structure to a team-orientated and self managing organizational structure. And this shift in the organizational set up was even made to be supported by its use of human resource management software! Definitely, the SAAS had its reasons then that made it adapt its former organizational set up. It is interesting to note, in this light, how SAAS had acknowledged the limitations of its old set up in view of delivering better services to its client. In fact, the shift in the management paradigm has not only made SAAS’ delivery of ambulance service better; it has also been a factor that accounts for the relatively high motivation level of its personnel. The SAAS case study may provide a model for other organisations that intends to follow suit in re-generating or re-creating itself for purpose of continued existence and effective delivery of goods or services. After all, organisations are never meant to be fossilized; and in order for organisations to be relevant, they need to change with time. References: Dalcher, D. (2006). Emergency: Implementing an ambulance dispatch system, in M. Khosrowpour, Cases on information technology and organizational politics and culture. Hershey (PA): Idea Group Publishing, pp. 247-263. Frontier Software Pty Ltd. (n.d.). South Australian Ambulance Service. Retrieved from http://www.frontiersoftware.com/public.docs/case.studies/sas.pdf Grantham, H. (2002). New paradigm paramedics. Retrieved from http://www.saambulance.com.au/publicweb/para.html Journal of Emergency Primary Health Care (JEPHC). (n.d.). Ian Pickering. Retrieved from http://www.jephc.com/Profiles/National/Ian%20Pickering.cfm O’Meara, P. (2003). The pre-hospital community-volunteer model has a place in rural Australia. Journal of Emergency Primary Health Care, 1(1-2). SA ambulance service(SAS). (2009). Retrieved from http://www.saambulance.com.au/index.html Sperou, J. (2005). Job satisfaction, organizational commitment and value congruence in the emergency ambulance officers of the South Australian Ambulance Service. Retrieved from http://digital.library.adelaide.edu.au/theses/09HS/09hss749.pdf Stand Up and Be Counted Project. (2002). Emergency services in Australia and New Zealand: Problems and prospects for volunteer ambulance officers. Retrieved from http://unpan1.un.org/intradoc/groups/public/documents/APCITY/UNPAN009687.pdf Vaughan, J. (2009). South Australian ambulance officers quickest. Retrieved from http://www.news.com.au/adelaidenow/story/0,22606,26257315-2682,00.html Vision 2010: SA Ambulance Service strategic plan (2005). Retrieved from http://www.publications.health.sa.gov.au/cgi/viewcontent.cgi?article=1001&context=ptrans Read More