“What happens to a species when it doesn’t evolve in the face of challenges?” Skip Kirkwood, a facilitator at the recent EMS Chiefs Forum at EMS World Expo, asked the audience. “It disappears,” he answered, wondering aloud what will happen to EMS if it doesn’t adapt in the face of unprecedented pressures.
Kirkwood, president of the National EMS Management Association (NEMSMA), which sponsored the Forum, was asked along with other prominent panelists to describe the biggest challenges facing the profession.
Aarron Reinert, chair of the National EMS Advisory Council and a NEMSMA board member, said it is the lack of a single, cohesive voice. We’re made up of passionate, diverse people, he said, and when we bicker about our differences in front of those we’re seeking to influence, “We get sent out of the room.” We need to focus on the 99 percent of what we agree on, he added.
Kurt Krumperman, president of Advocates for EMS, noted that we can be our own worst enemy with a defeatist attitude: “We’re volunteers, it’s too hard, we don’t get any respect, there’s not enough money.” We can get stuck trying to maintain the status quo, he said, when we need to identify and pursue a different future.
Other themes that emerged are the need to build an information- and evidence-based culture in EMS and the importance of being able to morph the profession into what our communities will need, in terms of community paramedicine and a greater public health service role.
There was also a discussion about staffing and education in general, and the importance of recruiting the next generation of paramedics. Kirkwood used a military analogy: It’s a common mistake of armies to train new soldiers to fight the last war. We need to be thinking about training and staffing for an EMS role that will be markedly different from what we’re doing now, he said, with much greater expectations than just transport.
That brings me to the title of this column. With little fanfare, the “EMS Workforce Agenda for the Future” was released in May by the EMS office of NHTSA. (For more on this topic, see “New EMS Agenda Targets Future Workforce” on page 3.) It follows the publication a few years earlier of “EMS Workforce of the 21st Century: A National Assessment.” Taken together, the two provide an interesting and valuable dissection of the issues surrounding workforce supply, demand and need. Ultimately, the vision of the agenda is for a “well educated, adequately prepared, and appropriately credentialed EMS workforce that is valued, well compensated, healthy and safe.”
The Workforce Assessment and Agenda don’t whitewash the challenges to make that vision happen. These include the lack of the most basic national workforce statistics, integration of rural volunteers, lack of wellness and safety programs, and poor compensation (especially in non-fire-based systems) tied to systemic issues of reimbursement, perception and value. One of the biggest challenges identified is the lack of leadership and management training in EMS, essential for recruiting, engaging and ultimately retaining the best people.
Is your organization prepared to meet your future staffing needs? Will our educational system support a pipeline of highly qualified recruits? “In general,” the report notes, “a ‘big picture’ concept of workforce planning … is largely absent from the EMS field.” Reading this report is a first step in reducing that deficit.
Keith Griffiths can be reached at editorinchief@emergencybestpractices.com.
