Membership Involvement

ACEP chapters are involved in a wide range of activities based on member needs and key state issues. Because the health care environment is constantly changing, new challenges and opportunities arise almost daily.

Each chapter faces unique circumstances, but some of the most common areas of ACEP activity around the country include continuing education, EMS/out-of-hospital care, government affairs, practice management, public education, physician reimbursement, and health policy issues.

Planning is the best way to chart a course of action for the chapter because it is the rational determination of where the chapter is, where the chapter wants to go, and how the chapter is going to get there.

A plan is a narrative statement describing an action program - what will be done, who will do it, and when it will be done.

Planning can help determine what needs to be done this week, this month, or this year to put the chapter in a positive position next month, next year, or five years from now. Planning is not intended to eliminate risks, but to help foresee and cope with crises and to use the chapter's resources as effectively as possible.

The main goals of a planning session are to identify the major challenges the chapter faces and decide what activities it is willing to undertake to meet them.

The chapter board, interested members, and committee chairs may serve as the planning committee. Enlist a group large and diverse enough to ensure a variety of backgrounds and outlooks. Compile and distribute basic information to prepare them for planning. An example might be recent articles about the health care environment. Allow at least one full day to complete the planning session, preferably in a retreat-like atmosphere where interruptions are minimal. For assistance with planning, contact Chapter Services.

Next is an overview of the basic steps in the planning process.

This is ideally a broad-based, open discussion to get members thinking, "crystal ball gazing," and creatively looking at their environment.

• What is going on now in the state, nation, world?
• How is emergency medicine affected?
• How is the chapter affected?
• How are individual members and society affected?
• What does this mean to members and the chapter?
• What is likely to occur in the future?
• What are the strengths, weaknesses, opportunities, threats to the chapter and its members?

The mission is the main reason the chapter exists. What is the basic purpose of the chapter? The mission should be carefully and succinctly stated in one or two short sentences, easily understood by all. (See Sample Mission Statement)

Review the chapter's current situation.

• Where is it currently involved?
• Are efforts successful or unsuccessful?
• What are its overall strengths and weaknesses as an organization?
• Where will it be in three to five years if it continues to do just what it's doing today?
• What are the major issues facing emergency medicine in the state?
• What factors affect chapter and member activity - declining physician reimbursement, new laws and regulations, increased competition for meetings and products, changing emergency medicine practice patterns, etc.?
• What are the opportunities and threats?

• Which of the issues identified needs the chapter's attention first?
• Which need can be accomplished by the chapter?
• Who are potential allies?

Establish the top priorities, keeping in mind the chapter's resources.

Goals should follow the SMART principle.

S = Simply Stated
M = Measurable
A = Achievable
R = Realistic
T = Time-based

Ideally, there should be three to five major goals, enough to challenge, but not enough to overwhelm.

Give everyone an opportunity to offer ideas on how to meet the goals. Avoid judging ideas and simply write them on a flipchart.

A good objective spells out what is to be done, by whom, under what conditions, and how it will be assessed as completed effectively. Objectives specify what will be accomplished, not how.

Brainstorm and look at all the alternatives. Strategies to increase membership might include special mailings to identified nonmembers, "Meet ACEP" introductory meetings held in hospitals around the state, or reduced rates for new members at chapter educational meetings.

All of these strategies might help meet the objective of increasing membership by five percent, but not all will be practical for the chapter.

Analyze potential strategies by asking questions like these:

• What will it cost if it works?
• What will it cost if it fails?
• How long will it take?
• What personnel would be required (volunteers, staff)?
• Can we coordinate our efforts with other organizations?
• Does the solution fit with our mission and purpose?
• What are its general advantages?
• What are its general disadvantages?

Once each strategy is analyzed, select ideas that:

• best balance risk and benefit;
• match the chapter's mission and purpose most consistently; and
• have the greatest number of advantages.

Make decisions about which strategies to pursue based on the best information available at the time.

Workplans are the final step in the planning process - spelling out the specific steps in each strategy, who's responsible, and dates for completion. These plans can be drawn up by the planning group or by the committee that will be working on the strategy. (See Sample Workplan) For example, if the chapter chose to hold "Meet ACEP" meetings in four hospitals around the state by March 1, the workplan for that strategy might include asking members for the names of colleagues who are nonmembers, identifying target regions, enlisting contact physicians in each hospital, developing meeting content and format, etc. Each of these steps would list a chapter member or staff person responsible and a completion date designed to meet the strategy deadline of March 1.

Armed with objectives and assignments, the next challenge is to get and keep members motivated and involved in turning chapter plans into reality. Chapter leaders and staff executives play a key role in helping members increase their effectiveness.

Chapters sometimes have a difficult time getting members involved. Too often, committees consist only of current or past board members, and the same few members do all the work year after year. The challenge is to broaden chapter involvement - to tackle the tough job of convincing members they are needed. Requests for "volunteers" in chapter newsletters or special mailings often have few takers. Members may think that "someone else will do it" - especially if the chapter counts on the same small group of proven workers to get things done.

Getting more members involved provides the chapter with new ideas on chapter activity and new expertise in important areas. It helps stabilize the chapter membership base, too, because members who are involved are more likely to renew. Broader involvement reduces the chances of leader burnout and ensures the ongoing leadership of the chapter.

Tap members who have never been active. Review the membership roster and contact members who have been named fellows of the College. These members show a commitment to emergency medicine and may be interested in volunteering for a chapter project.

Ask members who are currently active for referrals. There's a good chance they have colleagues with interest and expertise.

Contact the chapter's new members. These physicians clearly have an interest in the College - but they may think it's hard to "break into" chapter activity. Let them know that all it takes is commitment and willingness to work.

How can we get people involved?

The main reason people become involved is that someone asks them.

• Personally contact the potential volunteers – by phone, in person, or by letter.
• Convince them they’re needed.
• Ask them to do a specific task or project for a specific time period.
• Thank them when they complete the project, preferably publicly, such as at a chapter meeting, where others can see the benefit of volunteering.

Emergency medicine residents are the active members of tomorrow. Getting them involved on committees and projects today paves the way for strong leadership and commitment later.

Individual and committee work assignments should always be tied to the chapter's priorities. Enthusiasm wanes when members feel their efforts are unimportant.

Make sure work assignments are clear and volunteers understand what they're being asked to deliver. Definite deadlines are important, but be ready to make adjustments when necessary.

Contact chapter workers every other month to make sure they're doing well and to let them know they're not forgotten. Encourage members working in similar areas to get in touch with one another.

If all goes well, volunteers will have the personal satisfaction of completing their assignments with positive results. It is important to recognize their efforts. Include project updates and feature articles in the chapter newsletter, and thank volunteers publicly at the annual meeting. Certificates for project completion and personal "thank you" letters are two inexpensive ways to recognize efforts of members.

The chapter has a great opportunity to strengthen and amplify the efforts of its members through cooperation with other organizations in the state that share similar goals.

Depending on its objectives, the chapter may want to consider coalitions with organizations that provide sources of strength.

Sources of Strength

• EM residency programs
• State hospital associations
• EMT/paramedic organizations
• Emergency nurse associations
• EMS organizations
• Other State specialty societies
• Public health organizations
• Senior citizen groups
• State medical societies

Many ACEP chapters work closely with these groups on lobbying efforts, public education campaigns, and joint educational meetings. By identifying and maintaining contact with organizations that share its point of view on key issues, the chapter can multiply its effectiveness and impact.

Meeting and collaborating with faculty and residents in the state provides an opportunity to communicate, network and share resources and expertise. Because many residents stay in the state in which they train, frequent interaction with residents may result in building your state membership and leadership bases.

The state medical society is one of the best sources of information on government activities. Given the medical society's resources and lobbying expertise, the chapter should encourage members to join and participate in the medical society activities.

In many instances, the medical society has already developed effective methods for monitoring and influencing state legislation and regulations. The society's government affairs staff can provide the chapter with information on state issues and policies.

Chapter members should become actively involved in setting and implementing the medical society's overall government affairs strategy. That involvement helps to ensure that the interests of emergency physicians are considered.

Medical Society Involvement

To accomplish this goal, there are a number of specific things the chapter leadership can do to involve members:

• Encourage members to join and be active in the state medical society.
• Make every effort to get chapter members appointed to the medical society committee charged with monitoring and responding to state legislative and regulatory activity.
• Invite the chairman of the medical society's government affairs/legislative committee to address the chapter's board of directors regularly.
• Build a relationship with the medical society's government affairs staff. Ideally, the lobbyist will contact the chapter when issues develop that affect emergency medicine.
• Submit resolutions to the medical society on pertinent issues.

Although the medical society may be a valuable resource for working with the state legislature, don't depend totally on its support. Be prepared to take independent, but confidential action when the society does not act on issues of importance to emergency medicine. For assistance with building coalitions and working with state medical societies, contact the ACEP State Legislative Office.

As the chapter works toward its goals, make periodic checks of progress and results. If it is not making progress, make adjustments in the approach.

Review the resources committed to the project. Additional support in time and money may be necessary to make the effort succeed. If the resources necessary to succeed are not available, then modify the plans or terminate the project.

Review work that's under way. Are members actually performing the activities detailed in the workplan? If not, should they stop what they're doing and get back to the plan, or are their "improvised" efforts getting the job done better than the original strategies? If their efforts are working, don't hesitate to modify the original workplan to reflect these actual, successful activities.

If the planned activities are impossible to accomplish - and what's actually being done isn't making any progress - the project may need to be terminated.

Success?

When a planned project succeeds, take time to evaluate how the actual outcome compares to the planned outcome. Look at whether the objective was accomplished on time and whether the cost of meeting the objective was worth the benefit. Could the chapter have met the goal with less activity and fewer resources? Is the project something that would be worthwhile for the chapter - or another chapter - to do again?

Failure?

When the chapter efforts don't succeed, ask the same kinds of questions to determine what went wrong:

• Did the chapter provide the resources (time and money) it planned for?
• Did the chapter do enough - were the activities sufficient?
• Did the chapter do the right things - would other activities have been more effective?
• Is the project worth trying again with different activities and/or resources?

Every project the chapter undertakes - successful or unsuccessful - gives hands-on experience it can use to plan new activities. Taking the time to sit down and evaluate efforts makes sure that valuable information is not lost.

Record the evaluation and keep it with other chapter documents for future chapter leaders. Information about failed projects can be as valuable as information about successful ones.

Each chapter has the exciting challenge of determining the best way for it to meet member needs, educate the public, and address health care issues. Planning, member commitment, and effective coalitions can be the best tools in meeting the challenge. For more information on planning and program development, contact Chapter Services.