The People, Process, & Progress Podcast - Transitioning Leadership Skills from the British Army to Emergency Medical Service with Rob Lawrence | PPP #60

Episode Date: November 24, 2020

From the United Kingdom to the United States, Rob Lawrence is an internationally recognized leader in the EMS industry, a friend and mentor to me. Don't miss this episode to hear nuggets of Rob's wisdom and follow him at @ukrobl on Twitter.

Hey everyone, on People Process Progress Episode 60, Leadership in the Emergency Medical Services, my friend, mentor, and former leader in the emergency medical services, Rob Lawrence and I have a great chat. Rob is in California by way of Richmond, Virginia, where we first met. And prior to coming to the United States, Rob completed a military career, which we'll hear more about, and service to the state as a leader in emergency medical services where he was involved in response and preparation for the London bombing and many more things. So thanks again for coming back to the show. Please check out peopleprocessprogress.com.

All the episodes are up to date now. Did some administrative work there. We've got a store, a bunch of templates, good stuff like that. So thanks again for coming back. I really appreciate every listen download share review please hit that subscribe button share it with people that you think this will help and let's get started with this great talk between myself and rob lawrence in three two one

kevin it's a pleasure to be here and it's also a pleasure to watch how your career has progressed as well. So, yeah, mentor and kind of, you know, one of those proud parent moments. So thank you for inviting me back. That's cool. Yeah, absolutely. Both in the podcast space, which we discussed earlier, it's interesting to have podcasters talk to podcasters and speakers. And I'm sure we'll get into it. I definitely want to learn more and share more with the listeners about public speaking public

information you know I know that's a big part but you know kind of to let folks know that don't that listen you know we have a mix of military public safety project management folks here kind of where you grew up and your your early days your career and then kind of bringing us to to maybe where you and I met and some of the other key events that happened before then. So potted life story then. Okay, let's do it. So as you can tell, I'm from the United Kingdom, and my career profile started in the British Army. I spent 22 years on active duty, a graduate of the Royal Military Academy Sandhurst which is the west

point of the UK had an amazing time in doing a lot of pre-hospital evacuation medical corps type stuff and ticked to the the northern the northern wastes of Norway and and the Arctic circles I've done both Arctic and Antarctic circle in my time, pretty much all the way around the world. Left the military, then got into civilian ambulance services, and I was in the National Health Service for the East of England and the East Anglian Ambulance Services in the UK, where I was the Executive Director of Operations, and then the Chief Operating Officer. Then the call came to the US and I came to Richmond, Virginia, which is where you and I met Kevin and to the role of the Chief Operating Officer, the Richmond Ambulance Authority and went from a very large UK ambulance service to Richmond.

Not that it's that particularly big, but actually what it does is it's a high performance system that does a lot of, as you know does a lot of system development and as the COO I was allowed to come and think and develop and be creative and I absolutely loved that did it for nine years and then the call came to go and get into the private sector for a little bit and I came across here to California where I live now to be the chief operating officer in Alameda County which if you don't know where that is, that's on the San Francisco Bay, on the eastern side of the bay. And then after that, I moved down here to LA, where I'm now doing a number of things, actually. You give up one job, and then you get four. So I'm the executive director of the California Ambulance Association, job number one. I'm the director of strategic implementation for pro ems in cambridge massachusetts so i'm now covering two coasts

i'm the resident resident staff writer at the uh at ems1.com and also help at police1.com and also i'm the chairman for the American Ambulance Association, which is quite fun because I'm the guy that has to deal with the major national news channels, outlets, newspapers when they come after EMS for either good or bad reasons. And obviously the last 12 months, Kevin, we've been in the public eye a lot. Obviously, we've been promoting our people, we've been promoting the selfless task they've been doing at the tip of the spear for all of that good stuff, but also because it helps us tell our story on Capitol Hill, where we're trying to legislate to keep EMS pretty much funded, because as you know, in EMS, if you don't transport, you don't get paid, and core volume is dropping off off COVID is causing

attrition on staff and you know there's a lot of a lot of hurt out there so that's where I ended up so UK to US but in the meantime also as you know I was also worked for the Pan-American Trauma Society and spent a lot of time in South America as well which is really kind of cool to go and see how other EMS systems work particularly. And I've also enjoyed hopefully mentoring and leaving a lasting impact, hopefully good, not bad, on people I've met along the way. Absolutely. So let's comb through some of that. Particularly, you know, particularly one of the things, you know, I like to share and have guests share is one about you, which is awesome to learn more. And we'll share kind of your contacts where folks can read a little bit more about you and read some of your articles and stuff. But also that process and particularly with the Afghanistan-Iraq wars, wars of the past,

or folks getting out of particularly the military and having a career there. What was that that kind of process like for you transitioning from a career in the military to the I guess it's is it, you know, still a government position when you were in civilian health, like when you got out of the military? I think transitioning from the military into any EMS, no matter what country you're in, is interesting because quite simply, both careers are not jobs. They're actually ways of life. And so it's not a nine to five environment that you're in on one side or the other. So that makes life a little bit easier to transition um you of course have to speak and i know you've had to do this kevin you have to learn to speak civilian because the military and ems actually but has there is acronyms and phrases

and sayings and words that are you know that you have to take on a whole new way of thinking about how you communicate with people um because you spent so many years just you know in that kind of military language and mindset but I found the transition relatively easy because you were going from a group of formed individuals doing a very focused job to a group of formed individuals guess what doing a very focused job so I found that bit easy I relished the fact that I was able to bring a lot of what I learned in the military. And of course, what people think about the army, particularly, is it's very tick-tock, left, right, do as I say, you know, acting under orders. But of course, what the military is today, particularly those that kind of embrace, you know, NATO doctrine, is the fact it's a cerebral

activity. It's an exercise in thinking. it's an exercise in thinking it's an exercise in being able to outthink and outsmart the opposition as opposed to this sort of you know the the drill of you know what people think maybe the military is and so that also was something that i was able to bring with me and and the way that i've always worked with teams is that you know we've got some smart people providing you know know, I trained you and I trusted you and I trusted you, Kevin. You know, the simple aim is to be, you know, describe the effect I want you to achieve and then let you go away and get on with it because I know that you'll do a great job. And so I was able to bring that kind of ethos with me into my, you know, management career, as it were. That's great points. The other thing I found,

you know, coming from a corpsman to civilian is at the time, what you could or couldn't do even clinically, you know, the differences there between how that could or couldn't translate, which today is way better. So if you're a corpsman or a medic or a PJ or something else, and you get out at, you know, your medic or your EMT translates, but you're right. It's really the critical thinking you have to have, you know, regardless of what kind of job you have, particularly when you're in the medical field or medicine related, you know, in the military when you get out. And I guess that's that paramilitary nature of public safety, you know, across the board, how it translates so well.

And, you know, a lot of folks in public safety were in the military or going into the military. I think it sets a lot of folks up for success as well. So that's, that's really neat to hear too. And that leadership style as well. And, and also interesting, as you said that, I thought, you know, even still, and again, you know, and thank you again, you know, wishing each other, you know, having better and say to the small percentage of folks that actually did serve, because I think it's. You know, when you're in it, you think, oh, everybody knows about it or knows what it's like, but that's not true at all. You know, it's a small percent. And you can tell when you meet someone that was or wasn't kind of into some at some extent. Yeah, you certainly can. But I think, you know, you bring with you a great work ethic you bring with you a can-do attitude uh and those two things alone are going to help you get on no matter

what you do and and certainly that that is something that i i appreciate now of course there are others that have had struggles have had post-traumatic injury, have had experiences. But of course, you know, that's something we also have to look out for. And it very much depends how you channel those experiences as well. But by and large, you know, I think that folk like us have, you know, again, have that, the approach that this is not a job. This is a way of life and, and it, and it sometimes takes 23 hours a day to do it. Yeah, absolutely. It's definitely not a, not a clean clock in and out, but both physically and mentally to your point. I mean, you know, there's, I'm sure we both have, and others listen to have stuff that's just locked in your brain.

It's going to be there forever. But that's, I think, to your point where we look at our folks, and I'm sure we're talking about this too, and we're talking about leading EMS in particular that, I mean, sees tons of horrible stuff, some great stuff too. So when you got out of the military, how did you kind of get to your next step? What was your in? Did you know someone that was working in the health service? Or did you see something that kind of piqued your interest there? That's a great question, actually. And it all comes back down to years before I left the military, we were tasked to deploy to the former Yugoslavia. And what happens in British military units is that if you receive

instructions to deploy, then of course, the first thing they do is they send you all the reinforcements and everybody arrives and the unit goes up to strength and you've got all these new people that great you've got lots of people but they're not indoctrinated trained and ready to to do the job and so one of the things I had to deal with and I was the operations officer of my unit so as an air mobile unit so we go to operations in helicopters and Chinooks um and so a there's a bit of training that goes with that but b getting the medics proficient we had a lot of new guys that came out of the training depot or depot as we'd say and so oh my god what are we going to do now so i called literally our local ambulance service national health ambulance

service of course unlike the us their regional ambulance services so you know the the local ambulance service to us had like you know 200 ambulances ambulances in you know 50 stations and so we said look we've got this problem we've got these new guys and they have literally not laid hands on a you know a casualty as such and so can we send you some people just to ride along with the ambulances just to see how it you know goes just to learn you know the important things like bedside manner how to speak to people what's required what you see and that they embrace that and uh we sent people and i got to know you know some folk there went to bosnia had a very bosnia and uh croatia uh had a very eventful tour

um those guys had been out on the road really benefited from that. And let's go back and talk about when we used to have the PJs come to us. But anyway, so that time passed by. And then when I came to finish my time in the army, the British army, and I think the US do the same, you had what's called a resettlement period where they would pay you to go and take college classes or to go and do resettlement courses or everything else. And so I had some some time to spare and I called up again my contacts. Hey, I've got a few weeks here. You know, is anything you need doing? And then, well, actually, we have this whole logistics system that needs reorganizing.

We have stores everywhere and it's it's a mess and we're going to go to this kind of centralized thing called make ready uh which as you know and i'm like okay well let me go and have a look at that and so i wrote for the east of england i wrote their make ready just in time logistics um system setup uh and then from there a little bit later but oh there's this job going would you like to apply for it and i applied for it and got it and the rest as they say was history and then i joined the civilian ambulance service uh as the executive director of operations and then eventually the chief operating officer and then over to america and so again a good contact led from you know one thing led to another and you know one of those things kevin i think is sometimes you know i i

always say i've been very, very lucky in my life. But, you know, and I have sort of gone from one thing to another. But, of course, you have to create your own luck. And so I have been lucky. And that's kind of how that all came about. Yeah, I the three great a lot of great points there with the three big ones. The first one we were talking about getting new people, particularly new medics into situations that are going to be uncomfortable, hard, et cetera,

does reveal the, you know, a lot about a person, not that you gotta be perfect your first time out because everyone is going to get freaked out when you see a bunch of blood or, you know, child delivered, or even if it's not,

you know, some horrific scene, but it's an outstanding way to, to get that ball rolling and, and, and to weed people out, really. I mean, because some folks can't handle it, which is good to find out early, I think, until they're decades in and then they're totally burned out or something.

And, of course, that takes you and I back to when the boot was on the other foot and we were approached by Air Combat Command of the U.S. Air Force to say, we've got these trainee pararescuemen and they need to do their clinicals and can they come and work with you in Richmond? And of course, we then hosted for a number of years a number of PJ classes. And of course, they did their clinicals. And the one thing in our city that they all got pretty much before they deployed to any war zone was hands on a gunshot wound oh my gosh penetrating trauma and so we luckily we we caught up with one a few years later and it kind of made my day made my

year in fact when he came out and said you know what the things that we picked up with you guys i carried forward as they call it downrange into operations and the lessons that we learned from your medics on the street because of course in in our city back then you know i always said our medics got experience in terms of dog years one year in a normal service you know he's like seven in hours because of because of the things the guys were were learning and they were able to pass those things on form firm friendships were formed and you know we met a guy later who said this this was this set me up and so i think that's one of the proudest things i i think that we did back then was to help our future warriors to be prepared to go down range and i'll always

i'll never forget that absolutely especially for a group like that you know who's so critical in the in the you know the chain of survival on the battlefield and called upon so much i mean they're the pjs can't say enough about them super great folks yeah um you know that and and to your point of networking but not networking to expect to hand out networking to get your foot in the door and then you doing the rest i think i like that point too like you've got to put the work in, in whatever field you're in, you know, in this particular, it sounds like, you know, which, which also isn't surprising knowing you, but, but that's a great point too for folks is, you know, if you have an interest in something, reach out, the worst that

can happen is no, or you get a chance. And then once you get it, don't expect a free ride, like put the work in and let them see your value. And I think the other thing is when you change careers, sometimes you have to go down a step in order to go up a step. And a lot of my sort of, you know, officer friends who are leaving at about the same time were looking for these jobs that were, you know, six-figure salaries. And I'm going to jump straight into this. And actually, no, it sometimes doesn't work that way. And you may have to, you know, move down, but then, you know, through hard work and through showing your, your spirit and your grit and your determination, then of course,

things will happen for you. You know, don't assume you're going to, you know, always move up if you're particularly for changing careers. That's something that I always tell people. That's a great point. That's where definitely your, your, your professional and personal ego are both together, have to just get out of the way and realize, one, if you just need the change because you're burnt out because of whatever, hey, a little bit less money for more happiness is great. Or to your point, this is a great opportunity and you can see kind of a future in it and then beyond. That's an excellent perspective. Yeah, yeah. Yeah. So from really airborne logistics, training up medics operations to state health or regional health and that logistics system. And really, you know, is it is it patent right?

Like nothing. I'm probably screwed through the thing up. But, you know, there's no victory. Nothing happens without logistics, which is so true. Did you find that was so key, both obviously in the make ready changes that you made, and then once you came over to Richmond and other services? Yes, indeed. Because just from even a finance perspective, there are two really expensive things in certainly an EMS organization. One is people, the other one's equipment. And if you don't manage that equipment very well, then you're going to hemorrhage cash.

And that logistic lesson always stays with you, that you've got to have serviceable equipment, functional equipment, new equipment, and stuff that isn't out of date. And so it takes a lot of, you know, material management is very, very important. And so that's something that, you know, whether we are running an ambulance service or whether we are getting ready to deploy into some sort of NIMS all hazards incident that requires,

you know, resources. In the NIMS world, we love the word resources. So let's throw resource around. So if you know, but that resource has to be available serviceable and ready to go and then when you finish with it it has to be serviced and then returned to stock or to store or to or to readiness and so sometimes we know we're all about getting in there getting the job done and then you know going home not forgetting about the fact that we know we still have to clean up after us and so that's you know a key thing is always to make sure that you know you've

got enough horsepower left to clean up and put and make and re reset you know it's a bit like you know our friends in the fire department you know when they finish a fire they don't just you know throw all the hoses in the back of the cab and then go go and have dinner of course there is a whole reorg uh you know demob and reset that goes on before every after every operation and so that you know shouldn't shouldn't be forgotten because sometimes people forget that at their at you know their expense and when when you come to go again then something's not there not prepped not ready batteries not charged or whatever and so that that's that's a vital task in anything that you do yeah absolutely

and and nobody wants to do it for for if it's clean it and suffer oftentimes or demobilize kind of that the right way and that's not to say really everybody but you know the other benefit you get in that in particular from you know my kind of brief time as a firefighter you know out in the region where we were is that's also a time to decompress from the call you just ran, right? While you're getting things cleaned up, while you're talking things out, while you're just, you know, taking a breath in the back of the medic unit or while you're rolling up the hose or something else. So the practical preparedness value that you talk about is huge. There's also that, you know, kind of on the spot after action

or just, just talking to your people, you know, kind of on the spot after action or just talking to your people, you know, part of that to your point of like you live. And that's, you know, another great parallel is, you know, you're living this life as a first responder. You're not just clocking in and out. And so that brotherhood, sisterhood, you know, camaraderie is in kind of all those different aspects when you're running the call, when you're cleaning up, when you're getting ready. And that's huge. And, you know, one of the key things you talked about was preparedness and this will kind of lead us in you know the the terrorist attack in in london is how much were you involved in the preparedness of the staff and the supplies

getting to and this is you know one of the big areas we work together a lot. It's emergency preparedness for incident response before the London bombing. So in the UK, we had what we always call the Irish Troubles, which was the Northern Ireland situation. And so there has always been a terrorist threat in the UK. And because of that, there's always been a level of preparedness that has gone on. The UK is also not immune to weather and low-lying floods, not so much tornadoes and hurricanes as such. But there's always those threats that have gone on. And so emergency management and eventually what led on to what's known in the UK as HART, hazardous area response teams, have always been a part of the UK, you know, ambulance scene.

And so, you know, we always had an emergency manager. Each one of our counties had emergency managers and we had stockpiles of equipment, whether it's PPE, whether it's, you know, hazmat type response material. And so that was something that, you was always there and ready and so when you know things like London came along of course our emergency managers you know a bit like your role when we worked together Kevin of course you know you knew everything was you had everything lined up you knew where to lay your fingers on stuff and it was a similar thing that certainly when we had the nod that things had happened in London, our support role was to send formed units of ambulance crews and supervisors south to staging positions ready to be called forward. And our emergency management team had that all sorted out within the hour,

not only taking people off the current shift to go and form these packets, as we call them, of units to go down to head south, but also to make sure people came to work or were recalled to work to support the backfill that, you know, and getting all of that organized. So, you know, an emergency manager's job was then and is now a very professional one and uh you know i'm delighted to see that it is a career field here in the u.s now you can go and get your degree in it and you know it's an essential task that because you know sometimes people think oh he's the emergency manager he's not doing too much but actually you know it's all in the prior preparation and planning and if you don't do that then you can't respond when it happens. And so they saved us, you know.

That's great points with – and something that makes me think about, too, the difference, one, obviously, in the U.S. being younger, right, just overall than the U.K. And – but to your point about me not thinking about, you know, the troubles and the bombings and things. So, you know, for us, incident command sweeping and just – And we've been doing response, you know, kind of like that. But our kind of evolution from Incident Command and, you know, coordinating together, getting better from the 70s when that started, which was still not everywhere. Right. It was in the woods largely. And maybe in, you know, near where you are actually where ICS started to then finally towards 9-11. It's just interesting to hear much more history of national coordination out of necessity. Right. Because we're pretty sheltered from that. I mean, you know, barring some other attacks and natural disasters largely. So it's a very interesting contrast to me, you know, just out of the necessity. And also, I think the blend, it seems right, of military and state or civilian services all working together on the streets, where that freaks people out here in the U.S. a lot sometimes. You know, like just the thought of that.

Yep. And so having the military on the streets is an operation in the the uk known as maxi military aid to the civil community and so if you need to have i mean most recently of course when there has been high levels of terrorist threat you then see you know places like london heathrow airport you have a civilian armed police officer with a a hector cock rifle and a paratrooper with his sa80 rifle and so And so that, you know, working together. And so, you know, that is not unusual in the UK for periods such as that. And so, you know, that's something that you become used to. But also, you know, the thing that I always talk about here is, and I just did an article on the Boston bombing with our friend,

Superintendent Joe O'Hare. And the point that I wanted to bring out there is and i just did an article on the boston bombing with our friend superintendent joe o'hare and the point that i wanted to bring out there is the fact that you shouldn't be meeting your opposite number on the day of the event uh you know we are responsible for ensuring huge levels of liaison huge levels of preparedness huge levels of training and actually huge levels of familiarity familiarity with our opposite numbers and And as you know, in Richmond, we were good friends with our police and fire, you know, colleagues. And so it felt second nature to go into big operations like the UCI World Championships, like the various protests we had that went on around, you know, civil war statues, for example.

Right. And everything was second nature because we had that prior established relationships and the uk was no different i was in in the uk they have these things called scg strategic coordinating groups which was ambulance police fire environment agency because of things like flooding um you know the local county council emergency planners and we would form up and have regular exercises and of course exercises are the other thing that we need to you know continue to have to breed that familiarity to understand how we all work and so that was no different either and I was actually

honored to be one of the first ambulance officers nationally to chair one of these strategic coordinating groups which is like a state um you know eoc function and uh the chief constable the head you know and again states have police you know like imagine the state police in the uk sort of thing so i was asked to become the chairman of that and which is which is quite the honor but also you know because we worked hard trained hard knew each other and got on very very well professionally that we could run an operation and didn't matter what cap badge as it were was in charge if it was a it was a health related issue then the medical person ran it if it was a civil order thing then the police constable chief

constable ran it and so you know again that familiarity that comes through training is the thing that's that saves the day and going back to Joe O'Hare in Boston, of course, they had a, you know, like we did in Richmond, they had that all hazards team that knew each other that made the battle day just a little bit easier. And I geeked out as a planning section chief and, you know, MS captain and all that so much. Unfortunately, when I heard one of the surgeons, right, that was

given some after actions, some updates as events were unfolding there, talk about we activated the incident command system, we use our incident management team, things like that, that's exactly what you want to know is happening ahead of time and when it happens, you know, and, you know, because they put the prep work in. And a question I have too from, you know, because they've, they put the prep work in and a question I have too, from, you know, as an EMS or health leader being asked to lead where you have police and fire, did you find similar silos or challenges to get to that point? You know, because while we were really close with our folks and got along, could have the tough conversations when, you know, maybe we bumped into each other traditionally, right. Police and fire can kind of jockey for position.

Did you find the same thing there where eventually you said, hey, these folks really know what they're doing, so let's just have them coordinate it? I think, first of all, you have to be a professional. You have to have a bit of personality. You have to be gregarious to go and meet these people and understand who they are understand what they do make sure your organization of course is the best that it can be and you know for from our perspective those sort of things you know we say myself in fact my photographs on the wall here right now myself a deputy chief constable and the deputy fire chief still sitting here from from Suffolk County back in the UK where we you know got again it's that professional relationship where they go actually you know he's not just you know the ambulance driver or he's not just whatever he is a you know a credible commander and so that's the thing that you know that if you are a professional leader you

also have to be a credible commander you have to have that ability to step up when the going gets tough. You have to have that command presence when you go into a room and, you know, something needs to be done urgently in a crisis. Then you have to have that ability to actually go, you know, Kevin, this is the mission. Here's the tasks. Off you go and do it. We need to do this within half an hour. Maybe I've said that to you in the past i don't know probably probably but the point being is you have to know when to step it up and when to have your you know to put on the command presence to get something done because obviously you know the the pressure is on because of the the situation that's unfolding in front of you yeah that um that command presence is is huge and I think both where we talk back to brand new medics, EMTs, whomever get in a situation, or firefighters, police, whomever, new, we're throwing you in this high stress where you're expected to have command presence to the point of giving confidence to others and leading them is a critical thing.

And I think part of that is ingrained depending on the person, but it's certainly a learned and a kind of exposure-based item. So it sounds like your colleagues certainly recognize that and that does sound like a great opportunity. It was, and I was honored to be that person. And again, of course, the other thing is that every day you learn something. There is never a day where you do not learn whether, you know, either a good or a bad lesson. And, of course, I learned a lot from doing that. So looking back now, and I know you just interviewed Boston Chief and your London response. Do you see a lot of parallels both in what should happen and what we can learn from maybe is and do better in the future or that we've maybe addressed already

i am absolutely uh focused slash paranoid and you can choose which one about communication in a crisis and i acknowledge and understand and this is from military from my military experience all the way through looking at things like you know the after action or the aftermath of 9-11 is that the first casualty is always communication. It's always and it's because of that kind of fog of war, as we used to call it, that gets in the way that doesn't help you, that you can't establish that common operating picture immediately. And if you don't get a grip of that straight away then you'll never get it back um and uh you know i when we had incidents you know even back in richmond you know my duty station was to be in the communication center standing there watching listening and directing not so much getting out

on the ground i felt my task was to was to be the the you know the coordinator of of command and control from the center in order and people sometimes would get a little you know oh my god he's bugging us again for information you know you know send me a sitrep now etc and so because you know without that common operating picture without you know to try and clear the fog of war as quickly as possible to understand what's going on helps you win the situation that you're trying to combat and so i am absolutely focused on making sure that the comms element doesn't fail or the comms element if it you know dips because of as i say you know trying to gather the picture in the situation we get it back as quickly as possible and that's not only just radio communications

it's actually you know the whole command and control span and aspect. So I will always focus on maintaining command control and importantly communication from the get go, because if you don't gather it, you'll lose it. That's my thing. Absolutely. And come back to that in a second, the, you know, to that point, and I know I've heard you say it and I'm all in with it is no plan survives, you know, first contact with the enemy. Part of those plans include we're going to talk to these people and we're going to do this. And when everybody's stressed out and there's horrible stuff happening or, you know, something's going on, it's super easy for people to forget that because they're focused on what do I need to do? Plus the stress. Plus, what if it's their people and and that's a huge advantage and and something I've talked about even even in the

project management world I'm actually going to talk about in the episode that comes up for this one is escalation right I need something I can't handle this it's not a bad word it's what you should do so helping in that chain of communication but also knowing hey I have this person that I can reach out to is super helpful that's in that community control communication, but also knowing, hey, I have this person that I can reach out to is super helpful. That's in that command and control element or the unified command, you know, whatever verbiage it is. Go ahead. And to that, so, you know, in looking at helping responders, helping teams communicate, helping everybody have that common operating picture how did you did you naturally transition into that public information media coordination messaging role because you had you have a big history and experience with that as well was that kind of a natural evolution or was there a certain event that said hey i need to do well it's it's yeah

it's it's a twin track thing but just before we move on to that bit, it was von Moltke. Von Moltke was the chief of the imperial, chief of staff of the imperial German command in the 1800s who said, as you say, no plan survives contact with the enemy. What he meant by that was that, you know, the enemy, whatever the enemy can be in this day and age, it's probably COVID, reading our aren't reading our instructions they're not forced to play by our playbook and so therefore we have to have a little bit of flexibility in order to adjust the plan in order to win the day and the way that you do that is to make sure that everybody is trained and is ready and is prepared both physically and mentally to take on the challenge and has actually the cerebral capability to understand that, you know, if I can just do this one extra thing, I will achieve the mission. And so that, that's where, you know, what,

what I understand by what von Moltke meant. And of course, Eisenhower famously said, you know, failing to plan is planning to fail. And so that's the other, the one now communication is the other the other half of communication was the kind of dealing with the media piece and it's kind of a twin track actually and what happened to me was as the the chief operating officer of my ambulance service in the uk sadly somebody died uh sadly it was because the classic, we didn't have enough ambulances to go around when this one call came in. And the family lived there, spoke to us through the front page of the local tabloid newspaper. And it got to the point where we agreed to meet that said family.

And we went into the house and sat down and started to talk. And then in the door open, and as as it turned out in the kitchen was the Lloyd reporter and photographer and in they came and we are talking and I'm on the front page looking like a sort of you know deer caught in the headlights almost when the guy walks in and the camera starts you know it's almost one of those paparazzi moments where ambush it was an ambush it was a media ambush and that made me realize that whilst i you know had the common sense to you know deal with that that i needed to make sure that we weren't you know we were never on the back foot we were prepared and so um i've always been one

around you know that there's an adage that 10 it takes 10 good stories to trump the one bad one and so i've always looked to make sure that we keep our organizations of the public eye, that we keep our media on side, that we keep them briefed. And actually, we don't become a no comment organization because that's the worst thing that you can do. Because if you say no comment, it equates to cover up. And so I work very, very hard to make sure that we can achieve those things. And of course, the flip side of that is it puts your organization in a really good light and it lets your people know that they're doing a fantastic job. You know, the TV want to come along and see how we're planning this, how we're doing this, the great work that you're doing. And so that's always worked. And so that's what I do now with the American Amateur Association is to promote what we're doing, because by doing that, it'll help our elected officials understand the role that we're doing. So when it comes down to those four little words, all those in favor, then we may get a good result from it. first and then I've you know leveraged that into being you know the kind of media handler that I've I've become and of course uh you know we we go out and teach classes in this now in how to how to work

with your local media how to actually you know prepare stories for slow news days uh what you know how to become the good guys how to become that great community resource how to put on things that the community will understand your value and worth. And it doesn't take much to do, but you'd be surprised, Kevin, the amount of people that don't do it. Yeah, that's what I was going to say. So for you, it sounds like you are and need to be, or anyone needs to be in an organization, in particular in public safety or anyone that needs funding. You know, you have to proactively engage so that they're an ally and really almost like a tool in the toolbox to not, you know, that lesson learned from the ambush and tool meeting, hey, we can get the media to help us with this.

And then it helps, you know, as a catalyst to get the word out a lot more. How did you find that early when you started reaching out did you have someone else that had contacts for you or did you have to start from scratch well going back to my uk experience what happened next was the local tabloid newspaper had the ambulance watch column where they would find anything wrong and once a month or once a week or whatever the you know even had its own little logo on the top ambulance watch and they would you know criticize us and so in the end we i i did the first thing was go to once a month or once a week or whatever. They even had its own little logo on the top, ambulance watch. And they would criticize us.

And so in the end, I did the first thing was go to meet the editor. And the editor taught me this thing called the impactful headline. As he said to me, I'm going to put this really strong headline on, but actually that's how I sell my newspaper. But get into page seven where the story is.'s not as you know it's not as bad as the headline is so you know beware the impactful headline but what i said to him then is you know all these people are calling 999 for these various spurious reasons and the reason you know we may use ambulances up is because there are a lot of people that are you know don't necessarily need

an emergency and so we actually took over ambulance watch which was us watching the the citizens and so we then we then used that we then turned that column around to actually talk about what what you should call 9994 you know think and and actually i got a guy that was a reasonably good writer and i helped him with some you know some edits etc and he actually then became carl fryer his name was and he actually the column. And so we managed to flip it over. And from that point, I became a very good friend with the editor. And in fact, when I came to the US, he asked me to write a Letter from America column, which I did for a few times for that very newspaper,

which is bizarrely how I got into writing for EMS magazines in the US because they published my Letter from America column. And so, you know, one thing led to another. But of course, you have to work it. You have to, you know, it's it's I always say it's like a prize rose garden, Kevin, you know, to have a prize rose garden, you have to prune, you have to preen, you have to clip, you have to make it, you know, you have to keep on top of it all the time. And that's very much what media handling is and keeping yourself in the public eye. It's an activity that is nonstop. When you talk about helping educate the public on when to call, when not to call, which I guess technically I don't know if you could say don't call, but hey, there's other resources, which we see in America too for the sick person, which is the person with their bags packed.

They don't use other – they don't go to the doctor or something to the hospital, the ambulance is their doctor essentially, right? Did you find a lot of that in the UK as well? And both in the UK and with public information, you know, in Richmond, in the US and where you are now, do you look at and find value in, okay, we started this campaign. Let's look at the numbers on, are those kind of air quote, you know, the sick person type stuff going down the stuff that doesn't need an ambulance, but we can get them a community resource. How did you find the effect on those if you were able to track that? Well, let's break it down into this question into parts, sort of each part being numbered. Almost the first bit is around the fact that, you know, you never, you should never ever say don't call. And the reason for that is, is around the fact that you know you never you should never ever say don't call and the reason

for that is is because the person that probably needs the is having the emergency gets the attack of conscience to go oh i don't want to really bother those those fine people i won't call and the person that probably shouldn't call does call and so that it's it's interesting because you know so you have to be very very careful but so that you get into the fact of if you are experiencing x y or z or z depending where you're listening from right give us a call but if you've had a cold for 10 days and you just need an aspirin perhaps the ambulance service isn't the place for you so you know you have to kind of almost break it down into scenarios because we found that you know it was always that sort of classic case of the little old lady that needed an ambulance wouldn't call because you know those poor

dears are probably busy so i won't call and so it's it's a very difficult one to try and find that balance but of course just example you know giving examples probably scenario examples as opposed to saying do not call us because that, you know, could be fatal for somebody because they don't want to call. And interestingly, in the era of COVID, people have, you know, the volume for ambulance services has gone down considerably because people don't want to call an ambulance and go to hospital because they may die in the hospital of COVID. Yet, by not calling the ambulance, our cardiac arrest rate went through the roof um there was a point in new york where stemmes which are as you know are myocardial infarctions slash heart

attacks they didn't have any for weeks now you both we both know this is a daily occurrence but people are going oh i'm not going to call i'll just grin and bear it and of course then you know they they go into cardiac arrest and die and And so we had, interestingly, a media campaign. You know, the initial thing was, think about, you know, when you need, if you need an ambulance, call us. But if you don't need an ambulance, don't call us. So people weren't calling. And then we had to go back and reverse the campaign by saying, if you're having chest pain, if you're having, you know, these serious conditions, please call 911. Because people weren't calling and the volume was dropping and it's still dropping but but you know we were trying to you know write that write that

issue so that was that was the first uh the the first challenge is again you can't say don't call because people actually won't when they need you so when you look at the effect of your messaging and you're putting that out there you're trying to help how did you track that and did you see some correlation there yeah as far as call volume decrease those kind of things well well certainly one of the things we did at richmond as you know is that we always had a public health fellow uh luckily vcu virginia commonwealth university had a really good public health program and so we were able to get some undergraduates to come in and of course what ems has is tons of data tons of information and so we were able to get some undergraduates to come in and of course what EMS has is tons of data tons of information and so we could start to you know allow them to go

and data mine issues that we were having and the classic example of that I think is that we had a hypothesis that our local Latino population weren't using 9-1-1 as perhaps they should do again because when we started to geographically map it we could see there was no 9-1-1 activity going on everywhere apart from in this little geographical sort of enclave if you like where we knew the majority of our latino population were living and so we that then led on to you know investigating why they weren't calling and we we then got into a local liaison with the lulac which is the lead the league of latin american citizens um we then discovered of course they were reluctant

to call 9-1-1 because they felt that 9-1-1 equaled ice and so we then got into public health messaging and public health campaigns and that's where we got into to to partnership with the police to work with latino police academies and in the end that turned into the latino ems academy where we would have people in you know the the youngsters particularly to educate them that you know what what we did as an ems system and also to know to let your parents know who usually didn't speak as you know english but of course we had spanish-speaking folk that would would do this with us right To understand that, you know, we are not immigration officers. If you are having a medical emergency, please call 911 because, you know, we're not going to deport you.

We want to help you. And so that was one example of how we use data and, you know, research to then get into to change a community population health issue and that's you know sounds like it you can't do that also without that messaging piece we're talking about and and i love data for that one of those kind of kind of nerds but also the you know data is an inroad to solutions you know it doesn't lie it's pretty straightforward unless you know you have garbage in garbage out that kind of stuff but when you have good data like you're talking about um you know, it doesn't lie. It's pretty straightforward unless, you know, you have garbage in garbage out, that kind of stuff. But when you have good data, like you're talking about, you know, look at what it revealed. And that's one thing that's interesting to me now, COVID wise, and having been in public health and EMS and public safety is looking at,

you know, a lot of what's kind of being billed as new problems, new disparities are not new, right? Or challenges. And this is probably related to both the funding stuff we talked about, the, you know, how do we spread this budget that we do or don't have in whatever department to these different programs and many different factors. But that's honestly, somebody on the sideline seeing this, it's like, this has been like this for a while. And there are solutions to them. I don't, I certainly don't have all the solutions. But I think that's one thing where this data, even this data now, I'm hoping both for, you know, health disparities that are that are ethnic based or whatever demographic also, the underlying health condition base base is not just another push for another round of

prescriptions for everybody, but it's also, you know, the healthier lifestyle that gets rid of half of the major underlying conditions for COVID or can help them, you know, that kind of thing. So hopefully we start using the data, I think, a little more proactively. And there's two things there. One is that I'm a great proponent of the fact that, you know, we are the EMS is the Marine Corps of the public health Navy. OK. And so, you know, if public health was very much sort of in the shadows, they shouldn't have been. They've now become almost, you know, the villain of the day in some cases when you think about it in the last few months. But actually, you know, if we have to pay attention to what our public health doctors, our public health specialists are saying to us, because right now they're going to save our bacon.

But of course, you know, the population at risk and the public health issues of the population at risk and community health studies are, you know, the things that we should be, we should be when we should have been and we must pay attention to because that's the thing. You mentioned data. And of course, that takes me full circle back to the military that's the thing you mentioned data and of course this takes me full circle back to the military that uh you know having data it's all part of the intelligence cycle and the intelligence cycle is how you take information you identify where you want to go out and collect you collect it you collate it you analyze it and then you turn it into actionable intelligence and so all the information that we have, EMS data, is part of

that intelligence cycle. And therefore, we've got to make sure that every turn of the wheel or the intelligence cycle, that we're actually turning that into actionable intelligence, whether it's how to improve your EMS response or how to improve the outcomes for your population at risk. Think about our Latino community. To that, when you talk about response, a question I had is, you know, so we did the system status management, which just very generically is, you can see where stuff's going on on the map. You send units close to there

and then those units respond. And there's, as you know, because you've written some of it, there's literature about this. People can learn about unit hour utilization, that kind of stuff. You mentioned not having enough email, which is on that one call, that one time. And did you have a you mentioned not having enough ambulances on that you know that that one call that one time and did you have a system like that in the uk so that you're already kind of used

to that before you came to the us yeah and actually the system status management which is you know putting the right ambulance in the right place at the right time i was like a duck to water in this when i came from the the military the military use a system called IPB, information preparation of the battle space. And that's taking all the information, all of the data, working out, you know, whether it's, you know, an exercise or an operation where you're going to be attacked by the enemy, let's say, working out where all of that's coming from, working out where those decision points are. In other words, if they're going to, you know, let's say the enemy going to cross a bridge the decision point is do i blow the bridge or do i let them across and get them later so there are a series of you know intelligence inputs there are a series of decisions you have to make there are a series of things in which you have to make you know time by which you have to make those decisions by and that's how you prepare the battle space

to go into battle now fast forward that into ems as you prepare the battle space to go into battle. Now, fast forward that into EMS. As you know, the emergencies are pretty much predictable. Highway accidents occur on the highway, you know, and they occur when people are coming to work or going from work. You know, on a Saturday night, people go out and get drunk and fall over. There's a whole rhythm, a battle rhythm to what's going on. And so by understanding that, you can then start to create your response and your response plan based on the intelligence and information that you've got and actually that's no different whether you're planning a battle or whether you're planning your

your response on a saturday night now the thing that confounds that is sometimes people are sick don't come to work and you don't have enough vehicles to go around and that's the human factor that you have to of course you know be prepared to deal with on the day that it happens. Which is another opportunity that I know I get to take advantage of when we get to grab our radios and head out there and try and help quell the calls. But I think that's too a good perspective. You know, we talk about leadership and kind of situational awareness, the big common operating picture that I think if you're doing boots on the ground, you know, you're getting moved to different posts, those kind of things, it's hard to see the big picture. But not, you know, not that folks weren't given the big picture. But I think that's an interesting contrast. And when you're a leader, and you have

to look, have that that strategic view, right, versus the tactical view and understand, we may just have to move you because, you know, the load is shifting and that's just it and there's really no discussion about it yeah in in the in ems you know people say it's the helicopter view it's understanding what's there at the thousand foot view in the military it was always called it was always known as big hand small map you know you're running your hand across the map and it's a vast expanse but you have to you know be able to understand the whole situation across the entire space battle space map or area in order to you know figure an outcome and sometimes people in the trenches or on the ambulance don't quite get that and so again it comes back to communication and it comes back to letting people know what's going on you know from a from

a public safety leadership perspective you know you need to make sure you're having town halls you need to be make sure you're briefing people we created what we used to call the still call the word on the street if you remember that you know every day we'd have a news item just to let people know what was going on whether it's an anniversary a new truck anything that's happening you know there was there was always there's always a piece of truck uh anything that's happening you know there was there was always there's always a piece of news and actually that's now coming up for its 10th year anniversary in the middle of this month uh believe it uh every single day one news story went out one piece of news just to let people know what was going on and so you know that that's just

a method to keep people informed as to the general situation now of course when you have an incident everybody wants to you know to run in and be there and be in the epicentre of the operation. And of course, sometimes you have to say, no, no, you can't go into the operation because I need you back here managing the other station or the other response post. And so that's when people get a little bit annoyed and heated

because they want to do the best for the person that's having the emergency, but they can't see the fact is we still need to cover the ground around it as well. And sometimes that's a challenge to get people to understand. That's a great point. And something I think as leaders, rise is a hard thing for, and again, even in project management for folks to say, hey, we're not going to talk about that now in a project meeting, which is very, much less emergent than a call in the street or the system blows up or there's a mass casualty incident or something like that.

But to that point, as a leader, when you're coming out, being able to say, no, no, no, less is more in this instance. You don't need to be in here. We need less crowded people. Practically, honestly, especially if you're dispatched, like need to hear and be able to focus, not have 25 people all around them, which can get back to messing up the communication and all those kind of things. And that's a question, you know, I have too. And I think some advice for other folks is your process from your time in the military, you're being a leader at the state and then the chief operating officer. And then now what are kind of some nuggets and what we've touched on that folks can really take away is when you are kind of some nuggets and what we've touched on that that folks can really take away is when you are moving up in leadership and your communication and your

how you're directing folks how you're trying to optimize your response or anything that you can share with people well as we said already prior preparation and planning prevents insert the p performance uh first of all so So make sure you understand the situation that you're about to go into, whether it's administratively, whether it's financially, or whether it's operationally. Richard Branson said, you know, always try and train somebody for their next job, you know, and actually then they may not leave you. So, you know, training is absolutely key. Train people to the job that you need to do and then of course

from that training comes trust once you trust somebody then you have a formed team and then you can trust them to get on and do the task and so very much certainly in Richmond that you know we had lots of you know our morning meetings where we spent 15 minutes only. You're in there. We got on with it. And the meetings were so short is because we all had the same doctrinal view. I trusted my teams, and hopefully my teams trusted their teams. And we got in, got the messaging right, got out, and got on with it. And so the preparation phase is the key bit there. And it's actually what's

known in the military as the maneuverist approach to operations if you trust if you train your people if you trust them they will then go and achieve the aim for you uh and that's very much my approach to things um some people will say that's very much a free reign approach as opposed to being an authoritarian and i've certainly never been that authoritarian in my approach now authoritarians you know do get results but actually at the expense of the people whereas you know if you if you have a great team that team will take pride in what they do and work hard and of course free reign means i've still got the reins i can reel it in if i need to but actually if we've got a good team and a good team environment and a great ethos and developing that teamwork and that ethos is key to actually having a successful team.

And then they will take great pride in the results they achieve, whether it's, you know, planning played up that you played a part in and you worked hard in and you know i i know you are proud of what you achieved there without a doubt because that was a fantastic effort um that you coordinated and everybody contributed to and so you know kudos to you because i i saw in what you were doing then was you know again i think you said the word geek earlier perhaps that's appropriate right but actually we were infused infused to get this planned and to get it executed and to be successful at the end and i think there was a team effort in that because the team were trained they were trusted and they got on with it which yeah one thank you it uh kind of like how you you know took advantage of an opening um you know when i saw the opening to join richmond ambulance and then this event happened to also be happening the same year and

go hey this guy's already in the imt when he knows what he's doing and then have a chance to be in the resource unit and then be playing sheep one day for the event and work with the teammates that i've already worked with plus other folks in the city. It was like, hey, Kevin, if we could design an event that, you know, you have to work like an incident, who would you pick? Like, that's what it felt like. You know, some great lessons learned early. Like, you know, we learned from the Boston bombing. We learned from some other training.

We did some quick tactical combat care, all that kind of stuff, and worked through stuff that teams do, right, when they all haven't worked together and not everybody's bought in on methodology but yeah the outcome was fantastic and i think just about everything we talked about here stuff i've talked about before the relationships before the process the communication the agreement that get your egos out of the way all of that happened like all everything in a course that we say should happen happen now everything in a course that we say should happen happen now everything in a course

that we say shouldn't happen also happen to different levels right we're gonna have healthy disagreement there are going to be some egos some people are gonna be upset because they aren't this position to that but but yeah to your point when you get that team you know and we all keep in touch with those folks as well and i think everyone involved in that event um hangs their hat i mean it is a career event it really is without a doubt and also because of the the exercising because of the preparation you know the the day of the race literally felt like the training and it really takes me back and i just remembered you know one of these these moments in my military life where i remember the day i was sitting in in bos in Bosnia in a command post and you can hear, you know, gunfire going off.

And I seem to remember and I said to somebody, this is just like the training exercise we did before we deployed. Then I realized, no, the training exercise was like the battle day before we deployed. In other words, the training was realistic enough to help you prepare for the day that it happened. And so, you know, if you think about that, good exercising, good preparation, good planning, good training, and more exercising makes that day go a little bit easier. Absolutely.

And in particular with, you know, in the past few years and just in general and the great value of that tactical combat casualty care, tactical emergency casualty care that that, you know, folks from our organization help lead for the region. That is some of the most realistic and unnerving training between the makeup, the screaming, the ammunition. But to your point, it sounds like a real gunshot. People scream like that. Like it's fantastic to your point, it sounds like a real gunshot. People scream like that. Like it's fantastic to that point. And so I think, you know, whether you're practicing to write a good project charter, it should be super realistic or to that extreme. I just mentioned where, you know, you're practicing a mass shooting with police going in there with real guns, with ammunition and those kind of things.

And it'd be great if we didn't have to practice that. But to your point, doing it as realistic as possible will always, always pay off. Yeah. And I guess to bring it all the way back to project management, that, you know, the planning P, the operations order, and in NATO doctrine, every operation has a set way that it's delivered. Like you have the planning P over here. In NATO, everything is described by, you know, and it's embedded in my head. Ground, situation, mission, execution, command and signal, service support.

Everything comes under those headings. And so, you know, you know what to plan, you know, and also, you know the way it's going to be described to you and then you know what to plan, you know, and also, you know, the way it's going to be described to you. And then what you have to do and then you understand how you extract from those orders or those instructions you've been given your part in the plan. And then we deliver a perfect we deliver the perfect operation apart from no plan survives contact with the enemy. yep exactly and i think that's where then being prepared helps you decide oh i only need three out of these five things that that the plan says i need to practically on the ground yep so you're not wasting time and money and you know people aren't doing that and i i love the parallels in just good process because you can see it in everything you know when you get some experience

when you see the different methodologies and the ones you mentioned, and it's just, there's really not a lot of variation. I've been very fortunate that the folks I work with in healthcare saw that when I got out of emergency management, public safety, like, oh yeah, it's the same things, different forms and terminology, which is totally true. And to your point about the daily help is 15 minutes. I did some of that before. In fact, you know, the other plan chiefs and I would have contests like, all right, can you do this in 12, like your briefing or, you know, just trying to just be snappy because most meetings you could get a lot done or get a lot of information out in 15 to 30 minutes easily, right? If a lot of the fluff is cut out,

if it's not a working session, those kinds of things. And I see huge value in that daily. There is. And of course, value in that daily. There is. And of course, two things that add to the success of that, having a short, succinct and sharp meeting. One, it's a bit like my NATO doctrinal headings, which is why I wrote what we called our OCC, our Operations Coordination Conference. It was templated. You knew what was coming next.

You knew when your part was coming along. And you knew who was going to speak next it wasn't a free-for-all and also it's what's known as a by exception process in other words you're not obliged to say something if things are fine and actually a lot of people get nervous about that if i don't say something then i might be perceived as being weak no because you're in the team because you're in the trusted team if you have nothing to say that's okay because what we need to do is address the issues and solve the problems and win the day and of course as i always used to say you know we win the ems prize and the ems prizes

we get to do it all again tomorrow right for uh to little segue. So for folks that want to get to know you better, read the products for you, EMS one, listen to the podcast, EMS one stop. Um, how did they do that? And kind of what's the focus? Cause he, you know, as we both know, EMS and you better than I is a huge thing, right? There's, I mean, it covers so much and there's so much to it. There's Firebase, there's EMS Sandalone, there's all this. So with EMS One in particular, has there been any certain, I know you've touched a lot of kind of media focus, messaging focus. Is there a certain genre that you focus on when you write for EMS One? Well, firstly, I'm kind of the weekly columnist for EMSOne.com. And so it's my columns called and what they've done is

actually given me free range carte blanche to cover the issue of the week almost and so i've done everything from uh you know mass shooter situations to what we're just in the boston bombings to my experiences in in supporting the london operation through to uh emergency triage treat and transport to any area. And so I'm kind of covering those hot topics, legislation, lobbying, how to be a good legislator and how to get to know your local elected officials, et cetera. So I cover a real broad range of stuff. And in my own podcast, as you say, we've got a podcaster talking to a podcaster.

I've jumped on the bandwagon of doing the long form narration of my column and then i have a guest on that's not going to repeat what i've just said but actually that we can then expand and explore that particular topic and that's been relatively successful and so ems1.com my one-stop column and also you can follow me on twitter at, appropriately, UKRobL, which is where I am. Awesome. Rob, it's been good catching up. We could probably talk for a lot longer. That is one thing in podcasting still and keeping this going and sharing that message is, you know, losing like the commuters and that, you know, there's chunks of time, but it seems like folks are ready for great information. I think for this in particular,

whether you're in public safety, EMS or not, this has been super valuable in learning leadership and letting folks grow and a lot of that kind of stuff. And again, I appreciate everything you did for me and have done for the listeners. It's been a really good, really good talk. Thank you, mate. So yeah, you make a really good point that if you are listening to this on the commute keep your hands on the wheel keep your eyes on the road and don't play with your phone just listen can't say any better than that thank you everybody for tuning in godspeed