Shelby Bock

SPCH 301

Essay 4

One influential approach of the communicative constitution of organization (CCO) is The Four
Flows which consists of membership negotiation, self-structuring, activity coordination and institutional
positioning. The purpose of this paper is to examine The Four Flows within two separate organizations.
The first organization to be examined is the EMS department of Good Samaritan Hospital where I am
currently employed. This department is the 911 emergency response unit for the city of Kearney. It is a
hospital-based unit of ambulances that work alongside the fire department, police force, as well as
emergency department within the walls of the hospital. The second organization to be discussed is the
VFW Post 759 Auxiliary unit, of which I am also a current member. The auxiliary unit of VFW Post 759 is
made up of the direct family members to veterans involved in foreign warfare. This group works
alongside the post members to provide support, aid, and recognition to our local veterans.

The first of The Four Flows that we will discuss is membership negotiation. To become a member
of Good Samaritan EMS one must apply, interview and pass the hire on screening. Aside from the basics,
EMS personnel must possess and maintain specific licensures including BLS, ALS, PALS, NRP and more.
On top of licensure, personnel must continue to attend monthly educations and meet quarterly
competencies. At the VFW Auxiliary, membership is obtained via an application to verify eligibility and
then followed by annual dues. If annual dues are paid, membership remains valid. Membership
negotiation is clearly more demanding at the EMS department and very simplistic at the VFW. Each
process is appropriate given the different end goals each organization has. EMS has a select number of
positions available that require qualified individuals. The VFW benefits from the sheer numbers of
members, the more the merrier.

The second flow to examine is self-structuring. Good Samaritan EMS follows specific state and
hospital policies. The department itself has specific protocols to guide patient care in certain situations
and parameters while prehospital. There is a standard monthly meeting where announcements can be
made, and issues can be discussed. Self-structuring at the VFW follows a book of by-laws that lay down
the guidelines of how the auxiliary should conduct its business ranging from meetings to events. With
annual dues invoices, calendars are distributed to maintain monthly meetings where events, elections,
and committees are withheld and discussed. The flow of each organization is successful, however the by-
laws at the VFW auxiliary have become outdated and there is extreme difficulty updating these terms. At
the hospital, medical research is ever changing algorithms, and the hospital itself does have a lengthy,
tedious process at keeping protocols updated. Both organizations could use some improvement to keep
the flow current and smooth.

The third flow we will look at is activity coordination. Aside from the monthly meetings, most of
the EMS department’s coordination is accomplished via face-to-face exchange, email and text. At shift
change, shift report is given from one crew to the next. Emails are utilized to announce department
events. Online scheduling and text messages are used to coordinate crew configurations for duty, event
standbys and students/orientees. Activities are coordinated through the VFW Auxiliary via calendars and
monthly meetings. At the meetings, events are discussed, and responsibilities delegated amongst all
members. Members also utilize texts and phone calls to communicate with each other outside of the
meetings. The presence of cell phones has made a huge difference in communication in both
organizations. The EMS department does have one setback in the use of hospital email because it cannot
be accessed from home. Therefore, some announcements can be missed if personnel take several days
off. The monthly meetings are more effective at the VFW than the hospital due to the size of operation.
The activities of the VFW Auxiliary are significantly less high risk and frequent than those at Good
Samaritan EMS and a monthly meeting is enough to discuss activities fully. EMS could benefit from more
frequent meetings to work out more frequently occurring hindrances.

The final flow to be discussed is institutional positioning. The EMS department fits into the
structure of the hospital itself, which is also a part of a nationwide chain of facilities. EMS operates
within the state protocols and personnel have specific state and national licenses. EMS then operates
within the protocols of the hospital which outlines personal behavior conduction, education compliance,
materials management, and patient care procedures. This department utilizes a top-down management
style. The VFW Auxiliary has much different institutional positioning as conducts much different
business. The Auxiliary utilizes committees, such as veteran and family support committee and youth
activities committee, that supervise the activities expected of the Auxiliary on a state and national level.
Conventions are held that committee and/or certain post position members can attend and collaborate
with other VFW posts or “canteens” to lay out goals and priorities. The Auxiliary utilizes lateral
management in that positions are elected, committees are appointed, and all business affairs are voted
upon with no single voice holding more power than another. Both organizations are successful in their
institutional positioning practices that are appropriate for the organizational purposes.

In conclusion, this paper has examined The Four Flows approach of CCO within two separate
organizations, Good Samaritan EMS and VFW Post 759 Auxiliary. We have discussed strengths and faults
in either organization relative to the specific flow. This paper has discussed how The Four Flows look and
operate differently in contrasting organizations but can still achieve favorable results.