Organisational effectiveness case analysis

Following a public tender, the government selected Medavie Blue Cross to develop the plan for AYV and to operate the provincial ambulance service. Medavie Blue Cross established a wholly-owned subsidiary, Yorkville Emergency Medical Services Inc. (YORKVILLE EMS) for this purpose. The government negotiated a ten-year performance-based contract with YORKVILLE EMS to manage Ambulance Yorkville and its personnel.

YORKVILLE EMS employs the managers within AYV. The YORKVILLE EMS managers act as agents of the government to manage AYV’s public service employees.

Organization of YORKVILLE EMS

Collective bargaining structure

The approximately 900 employees of Ambulance Yorkville consist of 850 paramedics, 40 dispatchers and 15 nurses.

Since the employees who were previously employed within the Regional Health Authorities remained provincial government employees, little changed when AYV was formed.

The paramedics and dispatchers formerly employed by other operators were integrated into the CUPE local when they joined AYV. They were credited with seniority based on continuous service with their previous employer.

The Yorkville Nurses’ Union represents the 15 nurses, who are all associated with the air ambulance service.

A government -wide local of CUPE represents the paramedics and MCMC personnel.

Collective bargaining relationships

AYV personnel are covered by collective agreements written to cover the entire health system of the government – Regional Health Authorities plus AYV. The agreements’ focus remains hospital operations, and AYV is scarcely mentioned.

YORKVILLE EMS places fewer demands on the government for HR support than the Regional Health Authorities did but must still work with the Provincial Department of Human Resources for job classification and for legal support in the arbitration of grievances.

Management’s pre-AYV experience affects early approaches to labour relations:

· In the Regional Health Authorities, human resources management was reactive, and many HR affairs such as classification and labour relations were controlled closely by the government ’s Department of Human Resources. The labour relations climate between the RHAs and CUPE was mildly adversarial. The focus for management was always on hospital operations, and paramedicine was something of an afterthought. Former RHA managers came to believe that the union’s view of issues would prevail over management’s.

· The Department of Health had little direct responsibility for labour relations matters. Any internal departmental issues were directed to the provincial Department of Human Resources. AYV managers who were formerly government employees also came to believe that the union’s view of issues would prevail over management’s.

Context of your mandate

The YORKVILLE EMS management team has done an outstanding job at putting together a functioning, highly professional, state-of-the-art service in a year.

During the first year, they hired more than 100 new paramedics, most of the flight nurses, dozens of dispatchers, upgraded the ambulance fleet, created new maintenance standards, developed new standard operating procedures, transferred and equipped more than 800 employees, negotiated for the takeover of services from 39 contractors with more than 50 contracts, assisted in the negotiation of a new collective agreement, and established a central office and MCMC.

But with the huge workload, YORKVILLE EMS senior managers have not been able to work on a strategic human resources plan. They have not been blind to this need; they have simply been unable to find the time.

Employee relations are hampered by the nature of the business. The MCMC and air ambulance employees are mainly based in Moncton, but other employees are scattered across Yorkville. There are more than 60 stations, and for most of the day paramedics are on the road in their vehicles. Employee communications and personal leadership are difficult. Front-line managers have a heavy burden of administrative tasks, such as scheduling paramedics. It is easy to revert to management by email.

Assume that the following symptoms have begun to emerge, reflecting the organization’s difficulty to date in giving HR the priority that management knows it must have in the future:

· There are concerns over the level of engagement by paramedics. It is obvious that there are pockets of front-line staff who have not bought into the new system. Paramedics are not generally motivated by career progression, since they have fairly limited opportunities to move up in their organizations. However, they take intense pride in their skills, abilities and technology, and are critical of anything that may take away from their public image. They sometimes express uncertainty about the new system.

· Managers are reverting to their former employers’ business styles and there is a danger of multiple disconnected cultures emerging:

· Managers who were previously private operators acutely feel their lack of freedom now that they are in a larger organization. They can no longer just buy a new truck when they want to. They can’t have their own administrative assistants. They have to adapt to new and different standard procedures. In many cases they were non-union and now they have to comply with a collective agreement.

· Many managers who were public servants believe that “nothing can be done” about many HR issues, because their former managers often did not deal with labour relations issues effectively. They believe the union is able to “win” any time they take a stand.

· The employee experience differs across the organization, based on differing management styles among the Operations Managers or Regional Managers. Some are described as blunt and black-and-white about issues, while others are more like friends. Some hold information meetings with staff and others do not. In some cases, policies are discussed and in some, they are issued.

· In a number of cases, HR has learned about serious issues too late to have an influence. Front-line managers have already taken a position. HR has sometimes had to modify the manager’s position at a later date. As a result, there has begun to be some friction between HR and Operations.

· Tensions exist between dispatch and paramedics. While this is a common state of affairs in emergency services, it is undesirable and may be growing.

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