Hospital executive changes frontline communication after ER shifts

By Daniel Okafor

Linda Matzigkeit spent six months training as an emergency medical technician (EMT) before working 8- and 12-hour shifts in the emergency department (ER) at Children's Healthcare of Atlanta, where she serves as chief administrative officer.

Her frontline stint exposed a delivery problem: she had assumed clinical staff read leadership emails, but the ER did not offer time to do so. Matzigkeit helped introduce a phone-based tool for quick updates and notifications and began preparing talking points for start-of-shift huddles, the brief face-to-face meetings used by frontline staff.

During the COVID-19 pandemic, Matzigkeit felt helpless as the hospital lost frontline clinical staff quickly. Many mothers stayed home with their children for remote schooling. She wanted to make a difference, so she asked several trusted colleagues how she could become a contributing member of the clinical staff. Their answer was unanimous: become an EMT.

Matzigkeit had long been interested in healthcare and helping people, but she did not want to become a nurse or doctor. She once considered becoming a pharmacist. What she ultimately wanted was a way to contribute during a staffing crisis.

Why did a hospital executive train as an EMT?

With her son away at college, Matzigkeit had time for training, though she feared she might not be able to complete it. The course proved extremely hard and required more work than she expected.

• She attended EMT school two nights a week, from 5 to 10 p.m.
• She picked up weekend training shifts on ambulances and in emergency rooms.
• About six months later, she passed the national certification.

She did not tell her instructor that she held a hospital leadership position. She wanted to be taken seriously and did not want him to assume she would take the course and never use it. He appeared to sense the situation anyway.

Whenever an assignment did not earn an A, she approached him until he said: "There's no valedictorian of the EMT course. You're doing great."

What did the ER shifts reveal?

After certification, Matzigkeit began working in the ER at the same hospital that employs her. Her executive title did not exempt her: she still had to complete 100 hours of EMT orientation, fitting that training around nights and weekends.

Her duties included starting intravenous lines (IVs) or catheters and holding patients during procedures. She also cared for frightened parents. Because she had once waited too long in an ER with her own child, she tried to keep things moving for them.

Because she was already a salaried employee, the hospital did not pay her extra for ER shifts. Matzigkeit describes the work as volunteering from a financial standpoint. It also confirmed how busy her clinical colleagues were.

How did leadership communication change?

Her biggest takeaway was that leadership communication had to change. Sending email and assuming staff had read it no longer worked in an environment where nobody remained at a desk long enough to check. The answer required faster access rather than more inbox volume.

The hospital introduced a new internal communication tool similar to social media, allowing staff to receive quick updates and notifications on their phones. She also began providing talking points for start-of-shift huddles. In the ER's fast environment, she found face-to-face communication more effective than email. Leadership information needed to arrive during the shift, not after it.

What did Matzigkeit take from the experience?

The work left Matzigkeit humbled rather than complacent. She wants to improve at placing IVs and catheters, but she knows she will not match the skill of clinicians who work as EMTs more often. She aims to take one ER shift a month, though she does not always achieve that goal.

Her message to employees who share her initial ambition is straightforward: if they have always wanted to become an EMT, she tells them to do it. She says the experience made a difference to clinical staff and hospital leadership, giving her evidence that an ambitious goal can become an executed plan.

Matzigkeit said: "Becoming an EMT showed me I can do anything I set my mind to." She also said she had learned to set a large goal and carry it out.

For Matzigkeit, the next test is sustaining one ER shift a month; for other leaders, it is simpler: can busy staff receive the message during the shift?