Manage your authority gradient to create effective teams
I recently teamed up with Nick Roder - an experienced Mobile Intensive Care Ambulance (MICA) paramedic (and my uncle) - to give a talk at Agile Australia where we explored what organisations can learn from paramedics about teamwork, collaboration and leadership. We shared how paramedics deal with their unique, complex environment, and how they create a collaborative culture that enables effective teams.
This is final article in a series of four, detailing the insights and practical techniques from paramedicine that you can use to help your people do their best work, every day. If you haven’t already, you can read the first 3 articles here:
There are no heroes in paramedecine
MICA flight paramedics are "trained to perform advanced treatments in challenging environments such as on a boat or 10,000 feet in the air"1. Their work is a mix of critical interhospital retrieval, search and rescue and ‘primaries’ (car accidents, workplace trauma, heart attacks, etc.). In some instances, they are called in by other paramedics to provide specialist care and support.
“Hey team, how can I help?”
Picture this. You’re a well-trained ambulance professional at the scene of an accident. You realise that you need help so you call for support. You know that help has arrived when you see the helicopter approaching in the distance. Or perhaps you hear it before you see it. The helicopter approaches with a cacophony of sound, the wash from the rotors blowing the leaves in the nearby trees. A tall, uniformed man steps out and strides over to you.
How do you feel? What is the power dynamic in this situation? I’d wager that it would be hard not to feel at least a little intimidated.
In his 24+ year career in Air Ambulance, Nick has experienced this situation countless times. He makes it clear that when he responds to a call, his role is not to be the hero. Because there is no such thing as a hero in his industry. Paramedicine is a team sport, and no single individual defines success. In fact, his first words every time he arrives on a scene are: “hey team, how can I help?”
This is because Nick knows the importance of managing the authority gradient.
Authority gradient and its impact
I hadn't heard the term authority gradient before my conversations with Nick, and as far as I know it's not commonly used in organisations. Originating in the aviation industry and adopted by medicine and paramedicine, authority gradient refers to the established, or perceived, command and decision-making power hierarchy in a team or organisation2. It is the status difference (real or perceived) between 2 or more people in a team.
At one end of the spectrum, an extremely steep authority gradient is where an individual holds all of the power. An example is a team lead who has a controlling or prescriptive management style - "it's my way or the highway". Team members are expected to do what they’re told and not ask questions or express opinions. This results in fewer perspectives and ideas, reduced communication and collaboration, lower team engagement and an environment where feedback is not given freely.
At the other end, an extremely shallow authority gradient is where everyone's opinion is valued equally on all topics. There is no difference between experienced senior team members and more junior ones. Everyone's voice is heard and feedback is given freely, but decision-making may be slow and/or poor and responsibilities may be unclear.
Studies show that getting authority gradient wrong can have disastrous results. When officers of different ranks occupy a helicopter cockpit together, the rate of aircrew mishaps increases3. Medical students are "willing to give deference to personal authority over scientific merit in clinical decisions"3, even when it affects patient outcomes. Doctors and nurses may hesitate to speak up when they observe colleagues breaking the rules, making mistakes or displaying incompetence, even when this behaviour is repeated over long periods of time4.
I've seen the impact on teams and organisations myself. I once worked with a team developing a proof of concept for a new digital product with the primary purpose of learning what users wanted. The cross-functional team was talented and experienced, but they were hamstrung by a leader who had an authoritarian leadership style and a fixed view of how things should be done. The team did not feel safe to suggest a better approach, so they followed the leader's directions slavishly. The result was a lot of wasted money and effort and very little learning.
The impact of an authority gradient is exacerbated when a senior person can influence a junior team members' career progression. This is true even for leaders who actively work to manage their authority gradient. This may be why at Toyota, "a worker's immediate supervisor does not have the power to hire and fire"5.
Authority gradient is also particularly important for work on complex problems (i.e. most of the work we do in organisations), because this entails a high degree of uncertainty and risk. In their 2004 paper, Cosby & Croskerry have the following to say on this topic: “The solutions may be more complex in medicine where real-time decisions often take place in the face of incomplete information, uncertainty, and risk...most clinical situations do not have an obvious right or wrong action and may generate conflict. Often, diagnoses and actions are proven only after a test of time, when the patient responds (or fails to respond) to therapy. Uncertainty is a part of medical decision making, and teaching to help the individual and team manage uncertainty and risk is necessary"3. This passage stands out to me because, while it's written about medicine, I think it applies to teams in most industries. We often have to make decisions based on incomplete information, under conditions of high uncertainty and risk, where there is no obvious right or wrong answer, where people hold conflicting opinions and decisions and actions are only proven right or wrong by the results they achieve.
Leadership and followership
“Without some form of followership there can be no leadership”
Organisations invest a lot of money and time in developing leaders. You only have to look at the size of the leadership development program market (over USD $82B in 20246) to see that this is true. While I agree that effective leadership is important, focusing solely on leadership development overlooks the fact that the most important part of our teams is actually the 'non-leaders'.
In their 2023 paper, Haslam et al. make the point that "leadership is not a solo process but one that is grounded in relationships and connections between leaders and those they influence... the ultimate proof of leadership is not what leaders are like or do but what their followers do. For without some form of followership there can be no leadership."7
Paramedics leverage this idea to collaborate effectively. All paramedics can be both leaders and followers, adjusting dynamically depending on the situation. For example, it’s not uncommon for the first crew on an accident scene to retain the leadership role, even when a more senior paramedic arrives. They may even enlist that more senior person as a ‘follower’, leveraging their skillset to get the best outcomes for their patient.
Being a follower does not mean passively following orders. In high-performing teams, followers anticipate the next step, offer different perspectives and solutions and demonstrate initiative.
Choosing the “correct” authority gradient
There is no single “correct” authority gradient for a team or organisation. It changes based on circumstance. The most effective teams are conscious of their authority gradient and have protocols in place to adapt it dynamically. So while there is no one-size-fits-all approach, there are some heuristics that you can use to determine what is appropriate for the circumstance.
Shallow authority gradients are well-suited to dealing with complex problems. They create a space where team members feel safe to contribute ideas, ask questions, challenge each other and debate solutions. A shallow gradient also helps to create a learning environment because people are more likely to give feedback and share learnings when things go wrong.
Steep gradients, on the other hand, are appropriate in times of crisis, when fast decisions made by an experienced leader are more important than getting a range of perspectives. Be careful not to maintain a steep gradient for extended periods of time as this often makes teams less productive and reduces learning, morale and engagement.
Graded assertiveness
In a steep gradient, it’s also important to have protocols in place that let team members quickly communicate an important message. Graded assertiveness is one way to achieve this. An example is PACE, a model that lets you escalate communication until you get an appropriate response.
Probe: Ask a question to get attention. e.g. has this change passed security testing?
Alert: Voice your concern. e.g. I’m concerned that security testing hasn’t been completed
Challenge: State that there is an issue and what your concerns are. e.g. Security testing hasn’t passed and if there are issues it could expose our customers’ personal information
Emergency: Issue a command to get the person to stop what they are doing. e.g. STOP! This is a significant security risk, we need to get another opinion before we proceed.
Conclusion
For paramedics, the circumstance determines the leader. The team – both leaders and followers – are conscious of their authority gradient and adapt it to their context.
Consciously adapting your authority gradient can deliver tangible benefits. It lets you take decisive action in times of crisis, while also maintaining a collaborative approach to solving complex problems. It makes space for the quiet achievers, giving you perspectives and ideas that you might otherwise miss. It establishes a cooperative environment which improves team engagement. And most importantly, it helps your teams - both leaders and followers - work more effectively.
References
Ambulance Victoria, Types of paramedics, accessed 27 Nov 2024
Skybrary, Authority Gradients, accessed 27 Nov 2024
Cosby & Croskerry, 2004, Profiles in Patient Safety: Authority Gradients in Medical Error
Maxfield et al., 2011, The Silent Treatment: Why safety tools and checklists aren’t enough to save lives
Shook, 2010, MITSloan Management Review, How to Change a Culture: Lessons From NUMMI
FMI, Leadership Development Program Market, accessed 27 Nov 2024
S. Alexander Haslam et al., 2023, The Leadership Quarterly, Zombie Leadership: Dead ideas that still walk among us
