Trending Topics

How NEMSMA’s ‘Management of Ambulance Services’ textbook was created

The concept of a college-level EMS text, with collegiate-level research and writing, was something of a challenge in the world of EMS texts written at a much lower level

Updated Jan. 5, 2015

Pearson Publishing recently released Management of Ambulance Services, a textbook written by members of the National EMS Management Association (NEMSMA). This book was an effort that spanned slightly more than three years, required thousands of people-hours, and involved more frustration, personal stress and complex relationships than I ever would have imagined.

But first some background. Early in 2010, I was contacted by Jeff Lindsey, Ed.D., a well-known fire and EMS educator with whom I had done some podcasts and other projects in years gone by. Jeff was serving as the series editor for some texts that Pearson Publishing wished to produce, in support of the FESHE (Fire and Emergency Services) Consortium’s bachelor’s degree curriculum. One of the courses in the program involved managing medical transportation and ambulance services, and I was honored to have Jeff ask me to create a textbook for it.

Honored as I was, I also know my limitations. There are many areas of ambulance service operation about which I am emphatically not a subject matter expert, so I felt that writing a credible text would be beyond my reach. But I was also then the president-elect of NEMSMA, so I had the expertise of the nation’s leading association of experts on ambulance service management at my disposal. So I consulted with the board, and we decided to take on this book as an association project. I would serve as the editor and “ramrod” of the project.

First stop was a table of contents (TOC). Jeff provided some input, and one was developed. This would, with a couple of modifications, serve as the outline for the book. Sticking to the TOC required some discipline, as the project continually battled “scope creep.” Everybody wanted to write a book about EMS system design and development, but that was not the charge. The focus was on management of ambulance services within the scope of that system.

Next stop was the membership list. My goal was to find, among NEMSMA members, a subject matter expert, maybe two, for each chapter. Surprisingly, people were willing. Each signed the appropriate waivers, and each got a template from which to work. By May, writers were well under way (I hoped), with a first-draft deadline of November 2010.

Like everybody else, I was going to wait a few months to start. Yet my progress was impeded when I required cardiac surgery in late June 2010. I was off the table, both as an author and a project coordinator, for the better part of the next three months.

As the deadline approached, a small amount of material started to roll in. I began to communicate with the authors—some could be located, others had disappeared. It took months to assemble even half of the draft chapters. A few authors bowed out, a few had to be replaced, and a few needed some help (read: find and integrate a co-author). Another six months went by. By late 2011, a full first draft was assembled. Now the fun began.

I’d never done a book before. I’d written a chapter here and there, but somebody else had worked with the publisher, editors and such. Now it was me who was in the middle. Honestly, this was not a part that I had signed up for!

I was now the communication conduit between an ever-changing editorial staff, an even more frequently changing publishing staff and the 25 or so chapter authors. For a year, the e-mails flew. Large Word files, with “track changes” fully engaged, went back and forth, with questions, suggestions and requests for missing elements. Finally, in spring 2013, I spent a whole week head-down, powering through the chapter edits, making the changes and filling in the gaps.

The real joy in the process came when it was time to obtain permissions for use of graphics and photos. And, again, I had no idea this was in my job description. Most authors had graphics, and some even remembered where they came from. I quickly found out that for others, it is way too easy to lift a supporting photo from the Web and forget who owns it. So I was in touch with everyone from the Superintendent of Documents of the United States, to the National Academies of Emergency Dispatch, to … well, many EMS organizations and their professional and amateur photographers. It was crazy.

Then there were external reviews. Some unlucky souls volunteered to review the draft and see if it was fit for its particular purpose. There was only a small group available, because few people teach ambulance service management in the academic setting. But a team was recruited, and a lot of good questions were provided. The concept of a college-level EMS text, with collegiate-level research and writing, was something of a challenge in the world of EMS texts written at a much lower level. I had to read and respond to every reviewer’s comments—all 19 chapters’ worth.

Next, all of this stuff went to the typesetters. This was a complex process, involving getting the type set correctly (book-style columns are much harder than flat pages), with figures, illustrations, graphs and charts all wrapped around. Each chapter had to be re-edited, by both a professional copy editor and yours truly. A ray of sunshine was the assignment of a great copy editor, Kay Peavey of a company called The Document Doctor. Kay asked good questions and helped greatly to make the book a “literate” work.

In addition, all of the bibliographic citations had to be verified and made correct—a great challenge, because publishing citation format is far different from the legal citation format with which I had worked for much of my career.

Finally, all 19 chapters were complete. The last project was called “front matter,” where the foreword, preface and introduction were included. I was honored that Jay Fitch, Ph.D., one of our industry’s foremost leaders and scholars, agreed to write the foreword.

The book was complete in the late spring of 2013. Impatient as I am, I was frustrated to learn that Pearson did not plan to release the book until February of 2014, when the entire series would be released at once. But it was done.

In the end, the product was far better than I ever could have produced myself. While going solo would surely have been more efficient, the content would not have been as complete or as useful. Now that the book is in hand, I can see how it will be useful—each chapter could serve as one week of a traditional 15-week, three-credit academic course in ambulance service management, which is what I’d hoped to accomplish from the beginning.

Management of Ambulance Services is a great example of the collective wisdom being better than the wisdom of one, and the membership of NEMSMA has another product of which they can be proud. Thanks one and all to everyone who put effort into this project.

Never again!

Skip Kirkwood has been involved in EMS since 1973, as an EMT, paramedic, supervisor, educator, manager, consultant, state EMS director, and chief EMS officer. He is a past president of the National EMS Management Association, is a vigorous advocate for the advancement of the EMS profession, and a frequent speaker at regional and national EMS conferences.