“Something New? – A Rare Find”

I believe in Bigfoot. There, I said it. I love the thought of discovering something rare, and I look for him every time I am in the woods.

Now, many of my friends make fun of me and laugh at my belief, but I spent my youth in the Northwest sitting around the campfire with loggers, outdoorsmen and fishermen – all of whom believed Bigfoot is real. Whether he is or not, I do enjoy the search for something rare.

As a consultant, I travel across the country and I am fortunate enough to see many different system designs and a multitude of different methods for completing the complex tasks of EMS. I love seeing something I have never seen before – something new, different or rare.

There are many organizations that do a fine job, and many of them excel in their performance, but I sometimes feel that the art of “benchmarking” just leaves us with a “me too” method of providing EMS: copying good elements from other people and moving on. In systems that are on the cutting edge of EMS, such as MedStar in Fort Worth, Texas, and its Community Healthcare Initiatives, “new” and “rare” might be expected adjectives. But it’s refreshing to see something truly unusual, especially in an organization that isn’t necessarily in the most innovative segment of our industry – the inter-facility transport world.

A New Phrase
I was in California spending some time with Steve and Eve Grau, owners of Royal Ambulance, and their management team. I was enjoying my visit and learning about the company and its history. During my time there, I kept hearing managers talk about “their alumni,” a phrase I had never heard before in the EMS context. I was curious.
Royal Ambulance is a private ambulance company, operating out of the San Francisco Bay Area. The company functions primarily as an inter-facility transfer company employing mostly EMT-Basics. Management has no illusions about where this places their company in the healthcare continuum. Royal understands many consider it an entry-level company hiring mostly entry-level employees, usually Generation Y employees.

Generation Y employees range between the ages of 18 and 28 and have certain tendencies that some employers find difficult. Robert Half International found that, in a recent survey of multidiscipline Generation Y employees, by their own admission they expect to have “more frequent job/career changes” than previous generations. In fact, 59 percent of this generation’s members don’t expect to stay in their current jobs for five years, and 16 percent of them don’t expect to stay with their current employer for one year. They tend to “job hop” and are not considered particularly loyal. Most also agree it takes a sophisticated management style to manage this smart, energetic, technologically advanced generation of employees.

For a company like Royal Ambulance, you would expect that this group of employees would be extremely challenging and should cause the organization a great deal of concern. A recent study by another major national human resources firm identified that these employees believe that they should only spend one to two years “paying their dues” in entry-level positions. Given these statistics and Royal’s entry-level service, you might expect this combination to be a recipe for disaster, a constant flow of employees headed out the back door for the next step in this industry or other healthcare industries without giving Royal a second thought.

Positive Comments
Enter the “alumni” concept. Eve Grau, who functions as the human resource manager at Royal Ambulance, is responsible for conducting the company’s exit interviews. This process ends with a 10-question email survey, to be completed and returned by employees on their own time.
These surveys were frequently returned, with extremely favorable comments. Although not always so, Eve said a vast many of the comments were so positive and compelling about the employees’ experience at Royal that it seemed a shame to lose that positive connection to the organization. She began to contact the employees to ask permission to use the comments in newsletters, on Royal’s Facebook account and on the video boards around the main station; she was always given enthusiastic permission.

It struck her that these people were proud of their EMS origins and of the job they did while in the employ of Royal. For the most part, they left the organization for the “right” reasons: They were going to paramedic, nursing or medical school or had an opportunity to work in a 911 system. But they clearly cared for the organization.
Moving forward, Royal Ambulance formalized The Royal Alumni Group and expanded the program to include inviting the alumni back to speak at orientations and company meetings. Alumni recently provided a panel discussion geared toward helping the current employee understand the options and needed background for the work world outside of Royal Ambulance.

When I asked Eve what she thought the employees get out of this, she answered, “I think the employees see that we, as a company, are serious about providing them a great industry level experience and that we encourage them to take the next step, which often means leaving the organization. Employees get advice on skill development and the program adds to their greater sense of community.” “We want them to see Royal Ambulance as a building block to their career instead of a stepping stone,” she added. “We think there’s a big difference.”

Steve and Eve are equally proud of what the alumni get out of this experience. “Most of the people who are now part of the Royal Alumni Group had stepped into additional roles in the organization while employed,” they said. “They were Field Training Officers, supervisors or leaders in other departments where they seemed to enjoy taking their knowledge and experience and sharing it with those coming up behind them. This group is just an extension of that helping attitude.”
The program has expanded to more than 30 members. Alumni personnel are highlighted in the company newsletter under a “Where Are They Now?” segment, and certain alumni function as mentors to current Royal employees contemplating their next professional move.

The Royal Alumni Group seems to work in an organization that clearly understands that:
(1) Their employees are in an entry-level position
(2) They don’t want to stay in that position long
(3) Most of the opportunities for advancement exist outside the organization

By understanding that reality and building on the sense of community, Royal has found a way to develop a culture that supports the employee and his or her value to the organization while employed and celebrates an appropriate departure for the right reasons. Royal Ambulance is a building block instead of a stepping stone. I like that, It may not be Bigfoot – but it’s pretty cool.

Steven Athey is the president of the EMS Consulting Firm, Health Care Visions. Steve has worked in the ambulance industry since 1971 and has managed large and small EMS organizations. Steve holds his undergraduate degree and his MBA from Texas Wesleyan University where he holds an adjunct faculty position in the School of Business. Steve, is always on the lookout for something new or rare.

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