Dynamic Vacillation Between Competing Organizational Goals: Insights from Emergency Medical Services

50 Pages Posted: 13 Jul 2021 Last revised: 22 Mar 2023

See all articles by Timothy Gubler

Timothy Gubler

Brigham Young University

Haibo Liu

Claremont Colleges - Keck Graduate Institute

Alexandru Roman

University of California, Riverside (UCR)

Date Written: March 20, 2023

Abstract

We study how Emergency Medical Service (EMS) crews attend to competing financial and social health goals during 9-1-1 calls. Prior work has highlighted performance challenges from pursuing competing organization-level goals. However, less is known about how organizations resolve these challenges when goals are interdependent and non-separable in key tasks. We propose that EMS crews will dynamically vacillate between competing goals across calls, which allows for concurrent pursuit of competing goals. Using quasi-random assignment of patients to crews in 31 US states, we find that crews routinely prioritize the agency’s financial goal by providing more services to higher-paying patients. This reduces when patient health needs are critical, but increases with agency financial need. Surprisingly, most US EMS agencies engage in dynamic vacillation, regardless of profit orientation.

Note: Funding: None to declare.

Declaration of Interests: None to declare.

Keywords: Multiple goals, goal conflict, healthcare management, healthcare inequity, behavioral strategy

Suggested Citation

Gubler, Timothy and Liu, Haibo and Roman, Alexandru, Dynamic Vacillation Between Competing Organizational Goals: Insights from Emergency Medical Services (March 20, 2023). Available at SSRN: https://ssrn.com/abstract=3871392 or http://dx.doi.org/10.2139/ssrn.3871392

Timothy Gubler (Contact Author)

Brigham Young University ( email )

Provo, UT 84602
United States

Haibo Liu

Claremont Colleges - Keck Graduate Institute ( email )

535 Watson Drive
Claremont, CA 91711
United States

Alexandru Roman

University of California, Riverside (UCR) ( email )

900 University Avenue
Riverside, CA CA 92521
United States

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