Enterprise Risk Management (ERM)

Enterprise Risk Management (ERM) What business risks keep you awake at night?

Enterprise Risk Management Plan Enterprise Risk Management is a strategic discipline, a defined ongoing process and a leadership commitment that; 1. Prospectively identifies risks, hazards and errors 2. Determines systemic issues of concern 2. Manages risks to reduce uncertainty 3. Ultimately provides reasonable assurance that the organization’s objectives will be met

SJIEMS ERM Plan - Risk Ranking Impact Likelihood Impact Example text Vulnerability Concern

SJIEMS 2017 ERM Report - Risk rankings, mitigation t Example text

SJIEMS 2017 ERM Report - Risk rankings, mitigation, lead t Example text

Framework content • The planning process, purpose and objectives • Where we are today • Where we need to be, how we intent to get there • Our Framework • Vision and Mission • Strategies and Tactics • Values • Goals, objectives and a dashboard • Board guidance, oversight and support

Framework for continuous improvement • Vision; what we aspire to be in 3 years • Mission; our purpose, why we exist • Strategies; actions to fulfill mission, achieve vision • Values; actions people take that enable success • Framework; a picture of organization’s direction

Framework for continuous improvement Vision We exceed the expectations of our unique Island community DRAFT We serve our community before, during and after an emergency Mission Patient Centric Community Engagement Strategies Financial Stewardship Management Systems One Team Respect Trust Values Teamwork Commitment Safety

Culture defined • “An organization’s personality” • “The way we do things around here” • Engage with the community we serve • Board works collaboratively together • Board and Chair partner with Chief • Chief supports each individual and the team • All work together as one EMS team • All provide patient care and services

Values importance • ”Values do eat strategies for lunch” • Often largest barrier to best intended strategies • Can be your greatest opportunity for success • Value statements are just words on wall • Behavior actions must demonstrate the commitment • When expectations are clear you can select, coach, train, evaluate, recognize & insist on accountability

Effective values must • Guide how stakeholders work together and provide expected level of care and service • Include behaviors that demonstrate the commitment • Enable mission accomplishment, vision achievement • Support strategies and tactics • Address challenges/opportunities • Be measurable and coachable • Be led and exemplified at the top

Trust: we are open and transparent and always act with honesty and integrity. • Actions that demonstrate Trust: • I recognize trust is earned through actions • I establish clear expectations • I am responsible and accountable • I do what I say • I act with integrity • I provide open, timely, effective communication • I support a respectful work environment • I listen, ensure I understand & “close the loop” • I invite and accept feedback • I am fair and consistent • I honor confidentiality • Actions that undermine Trust: • I withhold information • I have a “hidden agenda” • I blame others • I say one thing, and do another • I say what others “want to hear” • I simply say “no” without providing a reason • I gossip and spread rumors • I draw conclusions before facts known Orca Partners LLC

Respect: we show respect for all beliefs, perspectives & contributions • Actions that demonstrate Respect: • I earn respect by demonstrating trust • I treat others as I want to be treated • I seek out others input • I consider viewpoints and interests of others • I recognize all have something to add • I am available and approachable • I praise in public • I coach in private • I honor confidential information • Actions that undermine Respect: • I ignore or belittle others • I raise my voice, use rude language • I interrupt while others are speaking • I bully, intimidate and undermine • I use inappropriate behaviors • I use inappropriate non-verbal communication Orca Partners LLC

Teamwork: we work together and support one collaborative team • Actions that demonstrate Teamwork: • I understand I am one voice of many • I embrace we are one integrated team • I support the value of working together • I actively participate in teamwork • I share knowledge and information • I identify challenges and offer solutions • I appreciate team member input • I support the team and my teammates • I share my opinions & support team decisions • I follow the chain of command • Actions that undermine Teamwork: • I consider it is “us and they” • I focus upon personal interests • I take the position “it’s not my job/problem” • I am close minded • I complain without offering solutions • I “bad mouth” team decisions • I disregard team decisions Orca Partners LLC

Safety: we place safety at the forefront of all the decisions we make • Actions that demonstrate Safety: • I support ‘3 to go, 1 to say no’ • I place safety first in the decisions I make • I coach others to place safety first • I plan and organize my work • I embrace continuous improvement • I ensure I have the right resources • I adhere to processes, procedures & practices • I wear appropriate safety gear • I readily ask for guidance & help when needed • I acknowledge and learn from mistakes • I am accountable for my work • Actions that undermine safety: • I am complacent • I rely on the way its always been done • I think “I know it all” • I resist change • I am concerned about asking for help • I blame others for my performance Orca Partners LLC

Commitment: we are responsible, accountable and supportive • Actions that demonstrate Commitment: • I acknowledge all have areas for improvement • I focus on future challenges and opportunities • I embrace continuous improvement • I promote our organization’s best interest • I am self motivated and persistent • I demonstrate a positive attitude • I am responsible for my personal learning • I am fiscally responsible, use resources wisely • I self assess my actions • I take responsibility for mission readiness • Actions that undermine Commitment : • I compromise our organization's interests • I make unreasonable excuses • I am negative and defensive • I disregard policies and procedures • I am indifferent, disengaged and apathetic • I waste resources Orca Partners LLC

Framework for continuous improvement Vision We exceed the expectations of our unique Island community DRAFT We serve our community before, during and after an emergency Mission Patient Centric Community Engagement Strategies Financial Stewardship Management Systems One Team Respect Trust Values Teamwork Commitment Safety

‘A’ task ‘B’ task 1. Community engagement strategy #1 PRIORITY ✔️ ✔️ #2 PRIORITY ✔️ ✔️ ✔️ ✔️ ✔️ ✔️ ✔️ ✔️

2. Patient centric strategy • EMS capabilities are often only ’seen’ when the team is onsite providing advanced or basic life support. • In addition to the critically important onsite work there is a great deal of activity and resources dedicated to before and after an incident, ensuring each 911 call is patient centric and care is efficiently and effectively provided. • The strategies and tactics associated with ‘before-during-after’ a call are being reviewed in depth with respect to the cost/value added of each service.

2. Patient centric strategy #1 PRIORITY

2. Patient centric strategy - continued

‘A’ task ‘B’ task 3. One team strategy #2 PRIORITY #1 PRIORITY ✔️ ✔️ ✔️ #1 PRIORITY ✔️

‘A’ task ‘B’ task 3. One team strategy #1 PRIORITY #2 PRIORITY Task priorities TBD

‘A’ task ‘B’ task 4. Management system strategy #1 PRIORITY #1 PRIORITY #2 PRIORITY

‘A’ task ‘B’ task 4. Management system strategy - cont. #3 PRIORITY #1 PRIORITY

‘A’ task ‘B’ task 5. Financial stewardship strategy #3 PRIORITY #3 PRIORITY #1 PRIORITY

‘A’ task ‘B’ task 5. Financial stewardship strategy - cont. #1 PRIORITY #1 PRIORITY

Framework priorities summary #1 • Enhance community engagement • Align organization structure with Framework • Ensure ‘One Team’ EMT engagement • Clarify roles, responsibilities, accountability • Set training priorities, ensure program effectiveness • Embed values in daily work • Establish patient centric strategic priorities • Establish financial reserve • Prevent expense creep

Framework priorities summary #2 • Align Framework and budget • Establish operating contingency • Maximize revenues, minimize costs, build reserves • Pursue collaborative association opportunities • Align governance work with Framework • Prioritize policy renewal work

Framework goals - being developed • SJI EMS Operational Key Performance Indicators • SJC EMS Key Performance Indicators • Education and training • Financial performance

EMS Dashboard - will be developed

Orca perspective of EMS organization ... -- Committed -- --------- Dedicated --------- Demonstrated during very demanding period Shown during planning process

Thanks you for your input Tom Van Dawark Orca Partners LLC 206-786-1127 tom@orcapartnersllc.com

Framework report format • Introduction; Chief and Board Chair • About us • Planning process, purpose and objectives • Where we are currently; challenges and opportunities • Where we’re going; Vision and Mission • How we’re going to get there; Strategies and Values • How we measure; Goals, Objectives and Dashboard • Resource requirements; Budget, Capital, Reserves • Appendices

Enterprise Risk Management (ERM)