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How ESD11 achieved 110% staffing in the era of shortages

Doug Hooten shares unique retention initiatives with Rob Lawrence, from doggy daycare to a resilience officer


Photo/Harris County ESD11

This episode of EMS One Stop is sponsored by Blink; the mobile app helping EMS providers to better communicate with their field staff. Learn more about how Blink’s two-way communications features are helping to reduce first responder turnover at

In this edition of EMS One-Stop, Rob Lawrence catches up with Harris County ESD11 EMS Chief Executive Doug Hooten. ESD11 is now at day 80 of being a new service provider – get an inside look at their progress.

Doug provides background on ESD11’s fleet of hybrid Ford Ambulances and the challenges of building a full fleet before the go live date, and also comments on his recruiting initiatives, which – even in the current era of shortages – sits at 110% staffed.

Rob and Doug also discuss operation enhancements and initiatives, from offering staff a doggy daycare, to the creation of a resilience officer post to look after the wellbeing of all staff.


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Building an EMS system from the ground up

Rob and Doug Hooten discuss the challenges of creating a service from the ground up, including real estate purchase and construction

Rob Lawrence has been a leader in civilian and military EMS for over a quarter of a century. He is currently the director of strategic implementation for PRO EMS and its educational arm, Prodigy EMS, in Cambridge, Massachusetts, and part-time executive director of the California Ambulance Association.

He previously served as the chief operating officer of the Richmond Ambulance Authority (Virginia), which won both state and national EMS Agency of the Year awards during his 10-year tenure. Additionally, he served as COO for Paramedics Plus in Alameda County, California.

Prior to emigrating to the U.S. in 2008, Rob served as the COO for the East of England Ambulance Service in Suffolk County, England, and as the executive director of operations and service development for the East Anglian Ambulance NHS Trust. Rob is a former Army officer and graduate of the UK’s Royal Military Academy Sandhurst and served worldwide in a 20-year military career encompassing many prehospital and evacuation leadership roles.

Rob is a board member of the Academy of International Mobile Healthcare Integration (AIMHI) as well as chair of the American Ambulance Association’s State Association Forum. He writes and podcasts for EMS1 and is a member of the EMS1 Editorial Advisory Board. Connect with him on Twitter.