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5 steps to improve EMS provider engagement

EMS leaders can better understand the types of employees in their agency by assessing the level of engagement and commitment


Steve Wirth and Doug Wolfberg lead a training program for a group of engaged EMS providers. (Photo by Page, Wolfberg and Wirth)

By Steve Wirth

An ongoing Gallup study, State of the American Workplace, covering over 30 years and 17 million workers found that there are essentially three types of staff members in every workplace. You will find these three types, based on their level of commitment and engagement with the work and the workplace, in your EMS agency.

Yes, it just comes down to three key types and understanding these types and how they affect others will go a long way in helping your leadership be more effective in motivating your staff to become better communicators, to do good work and to better serve the patient. This also helps to reduce risk and avoid unnecessary litigation, as most lawsuits in EMS are based on dissatisfaction with the patient experience and not actual negligence.

Here are the three engagement types and five steps for improving staff member engagement that can lead to improved morale and an enhanced patient experience.

The “Engaged”

The “engaged” staff members are the ideal role model individuals for your organization. They have passion for their work, a positive attitude toward EMS and your agency, and in positively interacting with others — particularly the patients.

They are the top-level performers who never cause you angst. They drive the innovation and ideas that fuel the organization’s future. The engaged staff are individuals you want to see in leadership positions and to mentor each new generation of EMS providers.

Their positive energy can affect others in a significant way that will encourage them to want to do their best work. Unfortunately, only about 30 percent of your staff fit into this category, according to the Gallup study.

The “Not Engaged”

The “not engaged” staff members are the ones who do just enough to get by — and not much else. They lack the drive and commitment to improve the organization.

Unfortunately, about half of your staff members may be in this category, according to the Gallup study. The staff members who are not engaged don’t have nearly the level of energy and passion as the engaged staff member, and border on being simply lazy.

The not-so-engaged staff requires considerable attention to keep them headed in the right direction. Staff members in this category can be influenced both positively and negatively.

The EMS agency’s goal should be to surround the not engaged staff with engaged staff members that will serve as positive role models. That will help move these not engaged employees to become engaged.

The “Actively Disengaged”

The “actively disengaged” staff members are your problem personnel. They are the bad apples that can negatively affect those around them.

The problem is that they can often cause the not engaged to join their type, adding to your management nightmares and further bringing down morale. These staff members are too busy blaming others for their problems and lack an objective view of themselves.

The actively disengaged are particularly dangerous, because in acting out their unhappiness, they undermine what the engaged employees are trying to accomplish to advance your agency and its reputation in the community. Their actively negative behaviors lead to problems in communicating and getting along with others, including their co-workers and your patients.

Nearly 20 percent of your staff members are likely to be actively disengaged, according to the Gallup study. With this type of staff member, corrective counseling will not always result in a positive change. Unfortunately, in that case, termination from the organization may be the most effective action you can take to avoid the organizational infection of negativity that the actively disengaged can spread to others.

5 steps to improve staff member engagement

Actively engaged staff members are significantly more productive than their not engaged or disengaged colleagues — some studies say as much as 50 percent more productive. So, the goal should be to improve staff member engagement across the board. Here are five simple steps to help do just that.

1. Set expectations up front and remind often.
It is essential to set the stage for the workplace experience upfront by emphasizing the key personal qualities that are essential to success in your agency. Good communication skills, listening skills and a compassionate and sensitive approach to communicating with others should be emphasized in recruitment, job descriptions, orientation and throughout the EMS staff member’s experience with your agency.

To measure whether the expectations are being met requires feedback. Fundamentally, everyone wants to perform well, yet leadership will often not let the individual know how they are doing in meeting the expectations and what they need to do to improve.

2. Assign a positive mentor.
New staff members should be assigned to one of the engaged staff members who can serve as a positive role model. This will also show the less engaged staff members the core qualities needed for success in your agency.

Never let two disengaged staff members work together. That is a recipe for disaster, including harm to the patient.

Try to keep a more engaged staff member partnered with a less engaged staff member to provide the positive influence necessary for improved engagement. Mentoring provides so many benefits, not just to the person being mentored, but also the mentor and the organization as well.

3. Open channels of communication.
EMS agencies should have multiple methods of upward and downward communications. Transparency in the EMS workplace with everyone practicing active listening should be the goal.

Staff members should be encouraged to ask questions, provide input and contribute to the success of the organization. Leadership must be non-defensive in response to staff member questions, concerns and suggestions. This helps encourage the positive behaviors that contribute to engagement with EMS work and in the organization.

4. Tolerate nothing less than respect and dignity in all interactions.
A healthy EMS agency is one that has healthy relationships between staff members that are respectful, caring and compassionate. When staff members respect each other, they respect their patients. And that is the ultimate goal as mutual respect leads to good communication, good patient care and a positive patient experience with fewer complaints and lawsuits.

Staff members in leadership roles must demonstrate respect in all that they do, and call out those who do not respect their colleagues or their patients. Far too often, leadership members will look the other way rather than confront disrespectful or actively disengaged behaviors because it can be difficult and challenging to do so. But that is a critical responsibility of the EMS leader.

5. Provide regular communications skills training.
EMS continuing education programs are great when it comes to the clinical aspects of our work. But we often fall short on addressing the key human attributes that are most likely to lead to success in EMS and a high-quality experience for the patient — positive interpersonal communications. We need to incorporate interpersonal skills training for all members of the organization so that the proper climate can be set to enhance staff member engagement, which leads to improving the patient’s experience.

Most importantly, improving staff member engagement must start at the top of the organization.

Leadership at all levels must not only “talk the talk,” but they must “walk the talk” in a visible and meaningful way. Leaders who are effective at improving staff member engagement model the positive engagement attributes that lead to improved morale and increased staff member commitment to EMS work, your agency and, most importantly, to the patients and communities that you serve.

For over 20 years, PWW has been the nation’s leading EMS industry law firm. PWW attorneys and consultants have decades of hands-on experience providing EMS, managing ambulance services and advising public, private and non-profit clients across the U.S.

PWW helps EMS agencies with reimbursement, compliance, HR, privacy and business issues, and provides training on documentation, liability, leadership, reimbursement and more. Visit the firm’s website at