Document Detail

Coordination of the EMS system: an organizational theory approach.
MedLine Citation:
PMID:  9709336     Owner:  NLM     Status:  MEDLINE    
Emergency medical services (EMS) systems include autonomous organizations with high degrees of interdependence. The need to coordinate system participants has long been recognized but seldom achieved. This can be explained by organizational theory--specifically, the study of the relationships among organizations. Existing models identify the total system's functions, but fail to explain roles and relationships among the system's participants. Coordination among organizations is more difficult than coordination within an organization because of lack of an authority structure. The EMS system can be described as "a functionally interdependent system," consisting of multiple autonomous organizations with high degrees of interdependence in their technical functions. Communities have five potential management approaches, varying according to their aggressiveness. These are laissez-faire, where even voluntary coordination efforts are not tried; voluntary cooperation efforts, such as coordinating councils; external planning agencies without regulatory control; "framework organizations" with regulatory control over the system participants; and bureaucratization, placing the system participants within a single organizational hierarchy. The "multicratic organization" is a model for management of multiorganizational systems. A "system lead agency" plans joint activities and manages relationships among system participants in the way that the management of a uniorganization integrates departments. A lead agency is usually a unit of government or organized pursuant to government action, but a managed care organization can also fill this role. In extreme application of the model, the system is viewed as a framework and temporary modules are attached. Their interests are limited, as needed, to optimize the entire system. The lead agency sets policies affecting relationships of modules and policies crossing organizational boundaries.
R A Narad
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors     Volume:  2     ISSN:  1090-3127     ISO Abbreviation:  Prehosp Emerg Care     Publication Date:    1998 Apr-Jun
Date Detail:
Created Date:  1998-09-10     Completed Date:  1998-09-10     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9703530     Medline TA:  Prehosp Emerg Care     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  145-52     Citation Subset:  IM    
Department of Health and Community Services, California State University, Chico 95929-0505, USA.
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MeSH Terms
Decision Making, Organizational
Emergency Medical Services / organization & administration*
Interinstitutional Relations*
Job Description
Models, Organizational*
Operations Research
Organizational Objectives
Systems Analysis
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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