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Trust:
The oil that keeps things going when the going gets hot

By Dianne Crampton
Copyright ©1999, TIGERS Success Series, Bend, OR

Summary
Core values are beliefs and codes of conduct that identify what an organization holds to be important and non-negotiable. Core values shape behaviors and explain how work life is on a daily basis. In this issue we explore behaviors that build trust in a merged air ambulance service. We also investigate how trust builds organizations and stabilizes operations. We also identify avoidable behaviors that damage people’s willingness to trust.

The tide is changing. Privatization, community-based emergency management partnerships, and health care mergers can cause dangerous undertows for response teams set adrift in changing times. The undertows come from financial decisions that look good on paper, but fail to account for human relationships.

Lack of appropriate preparation can drain resources and influence worker morale, how people make decisions, resolve conflicts, solve problems, and trust future relationships. Could this drain resources? Sure. Does it affect patient services and response times? It can. Enthusiastic people who trust and are proud of the organization they work for act differently in the field than people who suffer from low morale and feelings of betrayal.

Field professionals are not immune to confusing values. What was once considered a bastion of stability and as predictable as red fire trucks and apple pie can fall prey to incomplete growth strategies or divisive leadership practices. The good news is that with proper planning and core value-weighted outcomes, success is achievable.  

Core values, are beliefs and codes of conduct that identify what an organization holds to be important and non-negotiable. Core values shape behaviors and demonstrate how life is on a daily basis. The six core values that boost team collaboration are trust, interdependence, genuineness, empathy, risk and success.

Trust is the belief and confidence in the integrity, reliability, and fairness of a person or an organization. It is also an essential human value. Group psychologists claim that trust in one’s self and other people is so important to human relationships that it influences everything a person thinks, feels, says and does. Trust also blends with all other values and is viewed as a basic human need. This means that trust is necessary self actualization and applies to both an individual and a group.

One air ambulance service that tackled trust issues that surfaced during a merger is Northwest MedStar. Serving Eastern Washington State, Northeast Oregon, Idaho, and Western Montana, Northwest MedStar was formed by combining two Inland Empire critical care airlift ambulance services. A division of Inland Northwest Health Services, Northwest MedStar’s mission is to provide safe emergency air and ground transport services to patients of all ages. An elite team of critical care nursing, respiratory, and dispatch professionals staff the company.

When two or more competing organizations merge, turning the focus of competition away from each other and onto a new set of goals and the creation of a new and improved culture is the key. Northwest MedStar achieved this.

The company worked hard to develop a mission based on the collaborative input of all the employees. Northwest MedStar employees also identified core values like trust that supported the mission and identified behaviors that demonstrated the values both in leadership and maintenance operations.

In many ways, trust is like oil necessary for keeping expensive engines running when parts rub together causing friction. For emergency response teams, it is critical when danger, conflict and misunderstandings arise. Like oil it is hard to salvage when spilled. And when trust runs too low, teams freeze up and sometimes stall.

In practical terms no police officer, fire fighter, or air ambulance crew member would run headlong into a life threatening situation with unreliable equipment or with untrustworthy team back up. In emergency response situations, faith in staff and equipment can make or break successful operations.

Trust is also important to the following:

During the development and deployment of proper agency policies and procedures
When clear policies are in place, emergency response crews can function at their best. Agency policies help people do what they are suppose to do and create stability in unpredictable situations.

In the development of thorough, experiential-based training programs
Agencies that provide practice instill confidence.

In effective leadership practices
Trust flows from the top of the organization down. If management is unpredictable, unfair, reactive, or unskilled in communicating with the teams or in solving problems, trust will be shaky at the bottom level too. Weak trust is seen when team members spend their down time complaining about how thing are rather than putting their energy into making things better.

In effective protocols
If one team responds to situations in one way and another team responds differently and one fails -- without protocols, it is difficult to debrief a situation so that responses are successful in the future. Protocols create consistency. In those situations where protocols must be abandoned, teams can debrief it for what it was.

In behavior predictability
Predictable behavior falls both on staff in the field and on superiors. Responses damage trust if behavior is inconsistent, strongly competitive, or combative. When people assume leadership positions without training in good leadership skills, look for trust issues to eventually surface.

Asking for help
Leaders who surround themselves with professionals who know their jobs, and who are willing to ask for suggestions build team trust and confidence that they can deliver the goods.

In general, the following questionnaire provides a check-list to help you sort through behaviors and procedures that support trust.

1. Yes No
     _    
_    Are leadership decisions perceived to be fair?

2. Yes No
     _    _   
Is leadership behavior predictable?

3. Yes No
     _    _   
Is co-worker behavior predictable?

4. Yes No
     _    _   
Do people follow-through with what they commit to?

5. Yes No
     _    _   
Do people confront one another and give one another feedback in
                straight forward and respectful ways?

6. Yes No
     _    _   
Do people gossip about one another behind each other’s backs?

7. Yes No
     _    _   
Do workers and supervisors freely exchange truthful and complete
                information in a timely fashion?

8. Yes No
     _    _  
Do people discuss disappointments in an open and responsible
                way?

9. Yes No
     _    _   
Is there a feeling of mutual support at the base and among teams?

10. Yes No
      _    _   
Is there high confidence in one another’s ability?

11. Yes No
      _    _   
Is there divisive competition between people on the team or
                 between teams?

12. Yes No
      _    _  
Do leaders fear that empowering employees will usurp their power
                 base?

13. Yes No
      _    _   
Do team members and leaders ask for help when they need it?

14. Yes No
      _    _   
Do leaders make all operational decisions by themselves without
                 input from others?

15. Yes No
      _    _   
Is drug or alcohol use an issue during work hours?

16. Yes No
      _    _   
Does off hour drug or alcohol use effect work performance?

17. Yes No
      _    _   
Does equipment meet or exceed industry standards?

18. Yes No
      _    _   
Is equipment properly maintained on a consistent schedule?

19. Yes No
      _    _   
Is equipment routinely checked before each emergency encounter?

20. Yes No
      _    _   
Is cooperation valued between response teams?

21. Yes No
      _    _   
Is it easy to exchange members of response teams without
                 affecting team confidence?

If you answered yes to questions 6, 11, 12, 14, 15, 16, trust is being affected.
If you answered no to these questions and yes to all others, your trust and leadership practices are in excellent shape.

In order to correct problems that affect the core value trust, administrators, response crew leaders and team members must commit to trustworthy practices. The commitment is carried out in deeds and in appropriate behaviors that are modeled daily.

Many emergency response organizations recognize trust and trustworthiness in their mission statements. Those able to point to specific actions that anchor and elevate trust within daily operations experience trust.

The good news is that change and growth strategies that include mergers and strategic partnerships can be achieved with trust intact. Core value weighted decisions, effective systems, good planning and a reward and recognition system favoring behaviors that build trust makes for smooth sailing.