Annual EMSC Grantee Meeting

Joint Session with State Partnership Grant

Managers and Family Representatives Advisory Committees:

How to Develop and Utilize the Best Team for EMSC Initiatives

June 20 – 22, 2006

MELIA JENKINS: Thank you. Before I started, I want to recognize three other individuals in the audience that are really key to the success of our committee. One of them is -- will you all raise your hands -- one of them is Patricia Cannon, and she is our EMSC Coordinator. Julie Bacon is our EMSC Advisory Committee Chairperson, and Conni Wells is our family representative, and trust me, I would never be able to do it without all of these people. They are a tremendous resource, and I know they would be willing to share their experiences with all of you, so, take note who they are, and ask them lots of questions.

We have the advantage of our committee, having been established by statute in 1997. The statute says, specifically, that the committee advises the Florida Department of Health on matters concerning preventive, pre-hospital, hospital, rehabilitative, and other post-hospital medical care for children. I need to let you know that even though this committee is mandated, the participants and the members -- it’s strictly voluntary. So, even though the committee itself is mandated, we recognize we still had work to do as far as recruiting members, and getting people involve. If you’re just starting out, if you’re a new coordinator, I’ll be glad to share the language with you; it’s very brief, it’s very simple. At least, it gets you started.

This is an organizational chart that shows where our committee fits in with the structure for the Florida Department of Health. The secretary of the department actually, appoints the committee members, and we have a distinct advantage in that the secretary of the Florida Department of Health, also appoints our Florida EMS Advisory Council Members. So we work very closely with that council. And that council is a representative of our constituents in the state of Florida, and it ranges anywhere from paramedics, EMTs, hospital administrators, nurses, so we do have a very distinct advantage in that we are connected with this council.

And then, the bureau, actually dictates what they do -- that’s okay -- and the EMSC program falls within the bureau of EMS, within the department. And we felt this, though, by mandating this committee and having them appointed by the secretary, it would provide a higher profile for us, and give us more visibility within the state. And we do have a liaison to our Florida EMS Advisory Council. Actually, our EMSC Advisory Committee Chairperson Julie sits on our council as a liaison, and we are currently trying to get the chairperson of our EMSC Advisory Committee as a voting member for our EMS Advisory Council.

The statute indicates that the current members can serve additional terms. Their initial term is two-year terms, but they can also serve additional terms, which provides an advantage for us in that there’s some continuity, and the members have some historical background and perspective as to what’s happened, and they can bring that to the new members as they come on board. And the way we solicit our members is, we send a letter out to probably between 800 and 1,000 pre-hospital, hospital, and post-hospital constituency groups and individuals, and we tell them that the EMSC Advisory Committee is currently soliciting nominations. If you’d like to nominate someone or nominate yourself, send a letter to the department. And then, we review them, and there are several criteria involved in the selection process.

This year, it became apparent that as outlined in the performance measures, there are specific individuals that need to be -- and organizations that need to be represented. We were fortunate enough that we did have most of those representatives currently on our EMSC Advisory Committee. There were a few areas that we were lacking. I think namely the Florida hospital -- the hospital association, the hospital administrator and a trauma manager. But we went directly to the source. We went to the Florida Hospital Association, we outlined what our committee was; the purpose. How they could facilitate change in the state, and we asked them to provide us with a name of a representative. We did the same thing. We have an organized (inaudible) in Florida called Florida called the Florida Committee on Trauma. We sent a letter to the constituency group asking them to please nominate someone. We alerted them to the advantages of having someone representative on this committee. And we look specifically for a pediatric (inaudible) representing all aspects of the continuum of care, and we have been very fortunate in securing representatives.

We have a lot of pediatric physicians, we have nurses, we have paramedics, we have EMTs, we have hospital representatives, we have highway traffic safety, so we’ve really been fortunate, and I have to tell you this didn’t happen overnight. This was quite an intensive process and we work very hard at it. And Florida, as you know, is quite large. We have 67 counties and we had to take into consideration, for political reasons as well, geographic location because you want all areas of the state represented, and some areas of the state are highly rural and some are very urban. So, we also take into consideration geographic location.

As I said before, the secretary of the Florida Department of Health appoints the members to a two-year term, and the number of members is not limited by statute. I think we currently have 24, 22, and we also have liaison positions, which are individuals within the Department of Health, particularly Family Health Services, Maternal Child Health, Children’s Medical Services, because it’s important to incorporate the expertise from other individuals within the department. A lot of times, you find that they’re doing things that you don’t know about, and we’re doing things they don’t know about. And we could really be coordinating. So, we’ve appointed liaisons to our committee.

And as part of our new member orientation, we do a welcome letter. We indicate that we have quarterly meetings. We indicate the key contact information, which is Patricia. And as part of that orientation package, we usually do a one-page brief history of our program, so that they know where we’ve been and where we’re headed. We usually include previous meeting minutes; give them an idea of what’s been happening in the committee. We provide our grant goals and objectives because that’s our primary purpose, to achieve our grant goals and objectives. And this year, we also reprinted the performance measures and we included them as part of the orientation packets, so that they know that the performance measures are very important, and they’re also a large part of our grant goals and objectives. We include previous EMSC newsletters. We do have a newsletter that we publish. And we compile contact information for all of our committee members. We provide that so that they know who’s on the committee, what their affiliations are, and how they can work with each other.

And naturally, state travel guidelines. I know there’s always a problem inherent in mandating things and not providing funding. I have to tell you the Florida Department of Health mandated the committee. They did not provide provisions for funding. Our members are strictly voluntary. We do support travel expenses, which seems to help the individuals that participate on the committee. We actually write it into our EMSC grant, and we have quarterly meetings, so that helps them to be able to afford to come to the meetings, because typically, some of them don’t have the funding available, so even though we don’t pay them for their services, we do try to compensate in several ways, and one of those is supporting their travel.

Advisory Committees

RHONDA PHILLIPPI: Tennessee is similar to Florida in that our state committee is mandated and the legislation was established back in 1999. One of the differences that Tennessee is fortunate with is that we, our state committee on pediatric emergency care advises both the board for licensing healthcare facilities, so the hospitals, as well as we advise the EMS board on pediatric issues. And our legislation was set up to establish the committee on pediatric emergency care, but also to look at national guidelines and to advise these two boards on how to write rules and regulations that would take into account facility equipment, standards as well as qualification of facility personnel, as well as continuing education. So, we’re very fortunate that our legislation had all those components in it to begin with. Separate from the state committee is a foundation that we established to help raise funds to support EMSC initiatives. Our state committee was established like Florida in that we were established but we were not funded at all. Our state committee on pediatric emergency care chairman is here, Dr. Holbert, Emergency Medicine, right there.

COPEC is what our state committee is called, and it’s comprised of a diverse group of stakeholders. We have all those people that are on the performance standard measures, but we also have other people. And so, if there’s people in your state that can either help you achieve your goals, or that are going to hinder you achieving your goals, this is the place to pull them in and get them involved in the beginning because as a legislator in our state says, “It’s better to pull the pit bulls in, in the beginning, than to try to sway them later down the road.” And we have found that to be very true. We do not pay our committee members to come, and we do not pay their travel. The only thing that’s provided for them is a lunch, because we usually meet quarterly from 10:00 to 2:00. So, we don’t pay for them for their travel or anything like that.

How they’re selected is, each of those organizations are sent a letter that the president can nominate someone to the committee, and then the nominations are reviewed by the principal investigators. We have a principal investigator at every children’s hospital in the state of Tennessee, plus the COPEC chair and vice-chair. Just to look at them and review them to ensure that we have a balance of geography, and we have specialties. We’ve never had someone be -- I shouldn’t’ say that, we’ve had one person that created conflict in the COPEC, and so, we’re kind of the gatekeepers of who gets to be sent to; the nominations that are afforded to the chairpersons of the licensing board and the EMS board. They are appointed for two years, and typically, the chairpersons always appoint the ones that the EMSC program put together, of the people that were selected from each of those organizations.

Our orientation involves a history, operating rules for COPEC. Traditionally, in the past we were -- any organization over time goes through different transitions, and we’re in the cycle of needing to provide more definition to things. We were a very loose group of stakeholders that all were banded together to be advocates for kids, and everybody that started COPEC was the renegades of the state, and we all were going in one direction. Well, as 10 years have gone by, those people have gotten promoted or moved, and we don’t have that same rah-rah team, and so we’ve had to develop more by-laws for the committee, including voting and non-voting members. Each organization that’s on COPEC gets a voting slot. But like, if for instance, we have two people from family voices on state community pediatric emergency care. We only have one family voice vote. Or the hospital associations, sometimes we have more than two people, and so they only have one vote. And we had to establish attendance requirements. They have to attend 75 percent of the meetings, or whoever nominated them, gets a letter stating that they hadn’t met their attendance requirements, and so forth. And they also have sub-committee requirements, as well as what their role are. We include membership and contact information, as well as previous minutes.

How to Develop and Utilize the Best

SCOTT HOGAN: Thank you. Well, I was asked to speak because Washington is in a different position, and we’re one of the states that does not have a mandatory established EMS Advisory Committee, probably like, a lot of you, sitting out there in the audience. And what we do have is a voluntary committee, and I want you to understand that a voluntary committee can be very powerful and can be very active. One of the big benefits is that you get -- you have a lot of people who are very committed, and who want to be doing what they are doing, and so you’ve got a lot of strong advocates coming together to be a loud voice for pediatrics. So, those are your constituents and your stakeholders coming together to speak loudly. Okay.

This is what our Department of Health has put together. So, down there in the lower left hand corner is our Pediatric Technical Advisory Committee. It is a sub-committee of a statutorily mandated steering committee, which is the governor’s EMS and Trauma Steering Committee. And they report directly to our EMS office, which provides -- the steering committee provides guidance to our office, and then provides guidance to the Department of Health, which provides guidance to the legislature. So, I have a dotted line going to other technical advisory committees because, as I’ll talk about briefly later on, we’re going to be having to interact with these other advisory committees we have, there’s 10 other ones that we work with. And then we also have medical program directors as a dotted line going to them, so we’re not out there floating by ourselves. So, we have to get assistance from these other groups, okay.

So, historically, in the late 80s when trauma was a big issue in the country, it was also a big issue in Washington. We looked at whether or not we wanted to form a statewide trauma system, and so a lot of people got together to look at this as a concern. And so, pediatric people, constituents decided well, we’re going to form our own little group and be heard; be a voice. And so, they formed their committee and started to work, and then they stayed together and in 1990, the legislation was passed. And so, we did have a trauma system established, and so the tack was officially formed as the subcommittee of the steering committee. And for a dozen years or so they were very effective and very active, and provided, as it says, their advise and recommendation to the Department of Health and is one of 11 sub-committees and they range from hospital, rehabilitation, we have a cardiac committee, one for costs and reimbursement and there’s a number of other one’s. And, you can go to the next slide.

So, we interact with all of those other sub-committees. So, our membership is completely voluntary. And one of the things that you need to know is the chairman of all of these tacks is always a member of the governing steering committee. And usually, the vice chairman is also a member of the steering committee. We have no term limits and no term appointments, so you don’t have to be appointed for two years. You can be on there for as long as you’re interested. And unlike what we just heard, if you don’t show up for 75 percent of the meetings, you don’t get a letter to your organization saying, you might check into this. Nobody follows you on the carpet.

However, momentum has been lost and they kind of lost interest probably because things have been going really well and there weren’t a lot of issues coming up that needed them to come to the table and say, “Wait a minute, you’re forgetting us. Something’s not happening right here.” But then, recently, things had come to the fore and primarily in education levels for providers of trauma care in hospitals, a lot of physicians primarily were balking at taking continuing education for pediatric care. And a couple of other issues and so people were coming to me saying, “Well, you’re the MSC manager, why don’t you get the pediatric group together again, because they’re not doing anything?” So, okay. We also have this grant coming down the pipeline that’s requiring us to have an advisory committee, so, yeah, I think I can do this. So anyway, the timing was really well, really good. And so, I talked with the chairman, because one of the things that we had never done was to get rid of the chairmanship of the pediatric tack. So, we had this figurehead, floating along and I just approached him and he said, “Yeah, you know, we can do that. We’ll do it.” So, what are we going to do with them?

We are going to be discussing policy, and organizational issues, and clinical issues, definitely the grant. Definitely performance measures. Did I mention the grant? So, some of these things -- I always get ahead of myself. So, they’d already been in existence and so I had an old roster so I went to the old roster. And I went to that -- no, no, no. You’re fine. You’re doing great. So, I pulled it out and I said, “Okay. A third of these people no longer are working in the field.” So, I called them out and I went to our database and we have a trauma nurse coordinator who works in our office and I said, “Who are the new people?” And because we do have pediatric trauma facilities designated in our state, and so I have pediatric trauma nurse coordinators that I could go to and so, I added them on to my list. And so, I sent out a list to all of the hospitals, specifically identifying the -- all the coordinators and everybody else that was currently on the list, and who else did I mail it out to? Does it say on there? Well, anyway, a lot of folks.

Several phone calls were made. I talked to our regional coordinators and saying, “Please I need to have specific names,” because I did not have a lot of pre-hospital personnel for which I really did need to have, because we had -- let’s see what it looks like. Yeah. Okay. That's fine. I didn’t have a lot of hospital personnel, and so they were very helpful in giving me some good leads. And so, I just went directly to them and I said exactly what I want. I want some real providers and I want people who are interested in pediatric issues, and people who have contacts in their communities and, who are willing to work and that’s what I got.

So, I wound up getting a pretty big group of people; hospital, pre-hospital, fire. I didn’t get my hospital administrator yet, I did get some interested parties who said that they would think about it, but they’re not willing to become members yet. So, I have a lot of clinical experts and I have a lot of people who I think are very credible spokespeople in their communities and within their profession and they can spread the word when we get going. We have only had one meeting and we’re meeting on Monday next week. And I’m going to be worn out. I was a fool to agree to do it but I take them when they can meet, so onward.

Melia Jenkins: Our second objective today speaks to leadership and strategies for promoting member involvement.

One of the key leadership strategies we feel in Florida is that your committee chairperson is committed to children and families alike. At lunch, I said to our chairperson Julia, I said, “Why you have to have a passion for it?” And she said, “You have to have the passion but you also have to have the ability to project that passion.” So, it is key when you establish your committee to be sure and secure leadership that has a passion for children and feelings and that can project that passion. (Inaudible) we found that was key to promoting member involvement was to promote member ownership. These are very, very busy individuals and you need to try and make them feel needed or (inaudible) the need to participate. We include our members in -- traditionally include them in the development and the implementation of our program goals, objectives and activities. And Connie’s been with us for a long time and she can tell you that they are critical and they are crucial when we’re developing our grant goals and objectives.

So, if you promote ownership and make them feel as though they’re making a difference and they have input, they will stay involved. We keep our members engaged with meetings; we have quarterly meetings and we have identified those times to meet when our EMS advisory council is meeting. I don’t know if any of you all have an advisory council (inaudible) at the EMS level not just in EMSC. We found it to be would very helpful to include our EMSC advisory committee meetings during that time and it afforded them the opportunity to participate in other meetings because most of them are involved in the Emergency Nurses Association; the Florida Medical Directors Association. And they could participate in their other meetings and then we have them there and they are a captive audience. They also -- most of them -- a lot of them participate in the EMS advisory council meetings as well. We schedule conference calls on a regular basis; we have a mid-quarter conference call. The purpose of the mid-quarter conference call is to keep them engaged, let them know that we’re still here, we’re still working, tell us where you are, what progress have you made. Just to let them know we’re still here, don’t forget us, we’re not forgetting you.

And we have special assignments, when we have our quarterly meetings we have an agenda, we normally identify special assignments. We’ve had committees that we’ve put together to help us work on EMSC day activities. They promote activities statewide. So, we also keep them engaged by keeping them involved in special assignments. The most recent committee of which Julie is the chairperson, we’ve established work groups kind of on the same idea as a focus group. In the past, we’ve gone to these meetings and the chairperson has gotten up and lectured. And these people are too busy to have someone stand up and lectured to them. We shared a lot of information but we weren’t keeping them involved. We’ve found that our membership participation was kind of falling off. So, when Julie came on board, she said, “I really think we need to change the format of these meetings.” So, we’ve identified work groups. We let the members identify the specific areas of interests and expertise. We aligned our work groups to the performance measures but we also recognize that are other areas that are key as well, not just the performance measures.

One of those areas, living in Florida, is disaster preparedness. So, we also have a disaster preparedness work group and one of the most essential groups that we have is our family center care group. I know, and those of you that have been around for a few years, you know that in the past, our grants have focused on family center care. With the performance measures coming on board, we didn’t want to loose that momentum. So, we established a work group with Family Center Care to address family center care issues and actually what they will do is they will interact with each of our sub-groups, each of our other work groups, to ensure that the family issues are being addressed. And we’re fortunate to have Conni, who is just a dynamic, dynamite individual. And she, believe me, she keeps people going. So if you want some pointers, you need to speak with Conni sometime while you’re here. And the other thing for promoting member involvement is to establish your relationship with your committee. You need to let them know that how essential they are to your mission and to accomplishing your goals and objectives. If you don’t keep them engaged and let them know on a regular basis how essential they are, They -- I can tell you they will go away, they won’t participate.

And it’s also important on the flip side, and when we were at lunch Patricia and Julie mentioned this, they said it is also important for them to know that as staff members we’re there to support them. So that when they have assignments or the workgroups have some things to do, it’s important to let them know that you’re the creative ones, you’re the experts. We will do the legwork for you. We have work groups we set up -- I shouldn’t say we. Patricia sets up the conference calls, she types up all their information she disseminates information and she does all the administrative work for the work groups. And I have to say, I have to interject that we are fortunate in Florida and that we have several individuals that are dedicated to the EMSC program. It hasn’t always been that way but we worked very hard to get to that point. And the other thing with keeping your members engaged that I forgot about is frequent communications. We are continually sending e-mails. We have a list serve, the Florida Department of Health, our bureau of EMS has a list serve, we included our EMSC Advisory Committee members on that list serve.

So when anything goes out about EMS they get that information. When NEDARC sends us a message that we think or information that we think might be important or of interest to them, we forward those when -- and our sea sends us messages. So we’re continually communicating with them and it has been very effective in keeping them engaged.

SCOTT HOGAN: That’s neat, that looks familiar. The over committed committee chairperson, I said that it looks familiar because that’s exactly what I have -- I have -- you probably all do. Except for Melia. Well, my committee chairperson is a wonderful man. He is very dedicated to the cost for taking care of pediatrics. He is the chairman of the Governor’s Steering Committee. He is the chairman of the Pediatric Technical Advisory Committee. He is the Director of the Emergency Services of Mary Bridge Children’s Hospital in Tacoma, and a father of a 6-year-old boy who runs around the room all the time. Who knows what else he does. He’s very passionate and extremely committed to what he does. He’s very difficult for me to get a hold of. And that’s my sense of -- that’s my frustration with him but when I get a hold of him, he’s more than willing to spend time with me and that’s terrific. But it’s just a matter of pinning him down. So sometimes it takes a lot to support him and he expects the manager, the EMSC manager, to do a lot. And so the EMCS manager does a lot.

And I have to be constantly aware that -- to expect a slow response from him at times. And I have to be willing to go out on a limb at times and just make the decision myself and just trust myself and do it. And I have a lot of credibility because I’ve been in my job for a while and he trusts me, and I just have to keep reminding myself of that and I think you can all get there, just show him a couple of times, or show her a couple of times, and that really will go a long ways. So, I think that’s fine. Let me see what it says here; my notes are different than that so I don’t want to leave something out for their benefit. Okay, one of the things that’s happening that’s taking a lot of his time, is the fact that he has decided that he -- it’s time to take of an overall look at the entire state, EMS and trauma system. And so, that’s everything. And so the pediatric tack is a component of that, and so he wants the pediatric system to be looked at as well. And so, he is over here looking at the global and we’re looking at a portion of the global. And, so he’s pretty pre-occupied.

So anyway, we have our job cut out for us, and it’s quite as they say, in interesting times. One of the things that I have to keep remembering is this bottom point here, is that I have to be cautious. Historically, this particular group of people, or some of them are old people, the pediatric tack, they have a tendency to want to get things done now. We see a problem and we want to fix it. And so, they move quickly, and okay, you showed that this is a problem; we’re going to fix it now. And the rest of the world doesn’t move like that. Why should it be fixed like that? And so, since we’re only part of this global problem that’s happening, I have to tell everybody, don’t move quite that quickly. If you want to move that fast that’s fine, but don’t expect everybody to go along with you that quickly. So, prepare yourself to run up against this adult group that’s not ready to move that fast. So, and that’s what happened in the late 80s. So it’s going to happen again, I just know it will. And anyway, I just wanted to say that because I thought it was fun. Is there more to me?

RHONDA PHILLIPPI: Yeah, you have one more slide.

SCOTT HOGAN: I have another slide. Okay, this is what I’m doing. I am, I didn’t put it down there but I have to because of what Melia said. I want to say something about she said, “We do this things,” she said, “No,” I think it was you get to do this thing about organizing everything. I get to do these things. I get to do all the logistics. I get to decide where the meeting is. I get to send out all the notices. I get to order the lunches. I get to do all of this. So, I don’t have anybody to help me do that, so. That’s just the way it is, and maybe eventually I will. But --

MELIA JENKINS: I said we were fortunate.

SCOTT HOGAN: You were fortunate, yes, but anyway, I do get to plan the meetings with the chairperson, and those are important things. We have to plan the agenda. We have to strategize how things are going to get done. What kind of policy are we going to be discussing? What kind of direction are we going in? I need to do a pre-analysis on what’s going to be discussed at the meeting. What are our options? What can we do? What do I want to get out of the meeting? What’s the outcome that I’m expecting? I do a literature research. What kind of materials do I need to take there? What kind of research do I need to do? What kind of data do I need to analyze and bring to the meeting? What’s expected there? And everything need to be organize and be in a manner that’s presentable and understandable, and people can look at it and not have to scratch their heads and have a whole page full of data that they don’t understand but I can just squash it all down and say, “Well, this is the important stuff.” And if you want all the back page stuff I can show you that later. We currently don’t have a vice chairman because we haven’t, we’ve only met one time and we didn’t have enough time to discuss that, but we need one and I need somebody that is strong, who can fill in for the chairman, whose overworked and stretched pretty thinly. So we need to make that decision and make a good decision. And when I hopefully get one, I need to be able to give a lot of information to that person so that they can be informed and be up to speed with what’s going on.

All sub-groups need to be kept moving. I’m thinking down the road and I’m playing off, of what Melia is talking about. Like I said I’ve only met once, but we’re not going to be able to do everything in one group. We’re going to have sub-committees, so they going to have a meeting on a routine basis between the larger groups and I need to make sure that they continue meeting and keep moving.

We’re going to have -- these other tacks are going to be meeting, between the times when our group meets, and I’m going to have to function as a liaison between those groups and maybe even nab somebody and say, “Come on you’re going to go with me and represent the pediatrics with me.” And there’s also other Department of Health groups that need to be informed about what we’re doing so I’ll work with those group as well and I also have to work with the chairperson to say, “Yes, we’re working on these things today, but what are we going to look at down the road?” So that long range planning needs to go on, so that if he decides to stop what he’s doing, we can continue going without him, so the group can still continue to move forward. Okay next, if there’s any conflict, I don’t have any conflict.

RHONDA PHILLIPPI: Me neither. I’ve been around a long time so we have had conflict, but before I go into this subject, I do want to say a couple of things. One, if you’re in the EMSC manager over years, you’re chairperson over time is going to have different strengths and weaknesses just like we all do and you kind of have to learn how to work with each other as time goes on.

Dr. Hobert is the easiest one in 10 years to get of hold of. I can always find him within 2 hours. There’s other I couldn’t find within two weeks. So he is great at being able to be found…

SCOTT HOGAN: I’ll get the two weeks one time.

RHONDA PHILLIPPI: And then, I did learn if you put money signals in your email that they’re much more quickly to respond to your email. And the other thing is that, I used to do everything like Tom is at the stage doing, not Tom, Scott --

TOM: You’re right. I’m still doing everything by myself.

RHONDA PHILLIPPI: Okay, that’s something that Tom make the talking and came over and that’s right.

UNKNOWN SPEAKER: She was looking at you Tom.

RHONDA PHILLIPPI: And that is so hard to do maintenance every day to day things from quarter to quarter that you don’t really have time for long range planning. And so we’ve got an additional funding and I’m funded a percentage of my salary is funded out of four different grants that are a part of the EMSC continuum, so, I’m not doing non-EMSC things, but it’s provided enough money that now I have a 20 hour administrative assistant to coordinate meetings. Doing conference calls and arranging those can take your life away from you. But there’s a new tool that I learned from Jane called meeting wizard, it’s a free tool on the web. It has revolutionized our ability to plan conference calls quicker, so we can tell you about that.

But moving on to conflict, and I’m sharing with you this because I really, 10 years ago when I started this job I thought everybody had the same commitment to children that I did, that everybody loved children and no one but the devil would not want to support EMS for children.

And so, I’ve shared of this with you of lessons I’ve learned or lessons that my peers have learned so that, I wish I had known some of these stuff when I went into this and also, just know that the old people, the new people, there’s something to gain from each of us, and if you have questions please ask because somebody around the table has had the experience and can help you miss maybe some of the landmines.

But the important thing is to focus on the mission. When everybody is going down a hundred different paths, it’s important for you to focus on the mission of EMS for Children. People can divert your attention to a hundred other things but that’s important to do that. Listen and be available, establish relationships. You cannot be on every committee that -- of every contingencies state quarter group that you have on your committee, but strategically look at how can you help them achieve their goals too so that you’re not just always asking them.

Return phone calls, send birthday cards, I know the dates of my chair people because of sending your CV in with the grants, so now I’ve send some birthday cards. Celebrate the birth of their children, if they’ve had a death in their family, send a sympathy card. Just be a nice person and have a relationship with people. They’re much more willing to go the extra mile for you if they have a relationship with you.

Seek first to understand but realize that every single person has an agenda. When you’re new, and I know like 50 percent of the coordinators are new, use it to your advantage. Do you plan naiveté, “You know I don’t know how this works, how would you best want to do that?” You will find out people’s agendas, what motivates them, so much just by asking a question,” how would you do this,” or whatever, you will find out how people think, what people are going to help you meet your goals, what ones you are going to have to steer to another direction.

And also, it’s so important to diversify your stakeholders because if you diversify your stakeholders, your group is going to develop a norm and they are going to push that norm forward. So when you have a hospital administrator, I swear this happened that said, “Why do I need to put any money into pediatrics in my Emergency Department? There are only 10 percent of my visits. Why do I need to put any money there?” Well, that was like water on a duck to that group of norm of people, so that really changed that person’s influence.

And if you can get the pit bull on your table, within your thing, they’re your best cheerleader.