SAN DIEGO — Most EMS agencies know leadership turnover is coming. Far fewer are preparing for it.
During the Pinnacle EMS Leadership Forum session, “Building leaders before you need them, A practical guide to succession Planning in EMS,” Kelly Cope, faculty member with Fitch & Associates and former chief of the St. Charles County Ambulance District; and Chris Cullen, director of operations for Greater Baldwinsville Ambulance Corps, shared that succession planning should be an ongoing leadership responsibility — not a project that begins when someone announces their departure.
Their message was straightforward: leadership development takes years, and organizations that wait until a key position opens have already waited too long.
Following are top takeaways from Cope and Cullen.
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1. EMS has a succession planning problem
The session opened with sobering data from Martinsville Fire & EMS and an ASM cohort study presented at Pinnacle.
Among the findings:
- 67% of clinical providers and 86% of administrators and chiefs plan to leave their organizations
- 73% of respondents said their organization does not have a formal succession plan
- Of those with a formal plan, 75% said it was ineffective
- 62% of field supervisors and 66% of administrators and chiefs reported they do not feel prepared for their current leadership roles
Respondents identified common leadership gaps, including conducting difficult conversations, motivating burned-out employees, communicating organizational decisions and managing performance evaluations.
The presenters argued these aren’t individual shortcomings — they’re symptoms of organizations that promote people without systematically preparing them to lead.
2. Start with your biggest single points of failure
Rather than beginning with an organizational chart, Cope encouraged leaders to identify operational vulnerabilities.
Ask a simple question: If this person unexpectedly left tomorrow, what would stop the organization from functioning?
That might be:
- The only employee with payroll access
- The person who understands a critical reporting process
- A manager who holds institutional knowledge that exists nowhere else
These single points of failure should become the first priorities in any succession plan.
Cope also emphasized that succession planning responsibility lies on EMS leaders — not Human Resources. “HR will give you advice, but they’re not going to have the plan.”
Leaders should also recognize that not every high performer wants a leadership role. Instead of assuming the next step is management, agencies should have honest career conversations, assess employee interest and build individual development plans around each person’s goals.
3. Develop leaders over years, not months
One of the session’s most practical strategies was Cope’s three-year leadership development model.
The program begins by identifying internal candidates and intentionally developing them through education, mentoring and real-world experience.
Key elements included:
- Training everyone to become educators through instructor development
- Assigning leadership reading and peer teaching
- Pairing future leaders with mentors in finance, operations or other business functions
- Sending mentors and protégés to conferences together to expand professional networks
- Giving participants meaningful organizational problems to solve rather than hypothetical exercises
Cope stressed that leadership education should extend throughout the organization.
“As a leadership person, I don’t care where in the organization you are, you are going to be educating people.”
The approach also addresses a common challenge in EMS: promoting excellent clinicians who have little exposure to budgeting, personnel management or organizational leadership.
4. Capture institutional knowledge before it’s gone
Perhaps the session’s most actionable recommendation involved creating operational “playbooks.”
Rather than relying on job descriptions, Cope encouraged every employee to document exactly how they perform their role — from recurring monthly tasks, to annual deadlines and operational workflows.
He suggested agencies can use AI tools to organize and refine those notes into practical playbooks that future employees can follow.
Cullen recommended complementing those documents with secure repositories for critical information such as passwords, contact lists and recurring administrative responsibilities.
Together, detailed playbooks and shared calendars can significantly reduce disruption when someone leaves unexpectedly.
As Cope noted, “We lose a lot when senior people leave. If you don’t garner that and pass it on, you’re going to lose it.”
5. Make succession planning part of everyday operations
The presenters cautioned against treating succession planning as a strategic initiative that sits on a shelf.
Instead, agencies should build it into normal operations by:
- Surveying participants for feedback
- Budgeting time and money for leadership development
- Reviewing playbooks annually
- Expanding conference and training opportunities
- Giving experienced participants opportunities to mentor newer cohorts
Over time, the program becomes part of the organization’s culture, rather than a project that only receives attention during leadership transitions.
Cope closed with a reminder that succession planning isn’t about preparing for retirement — it’s about preparing for the unexpected. “This is something you need to take time for and prepare for and not wait for the bad thing to happen or the unexpected thing to happen.”
Book recommendations
Cope and Cullen recommended the following resources for developing your leadership skills:
- “What got you here won’t get you there,” by Marshall Goldsmith
- “Extreme ownership,” by Jocko Willink and Leif Babin
- “Think again,” by Adam Grant
- “Raving fans,” by Ken Blanchard and Sheldon Bowles
- “The EMS leadership challenge: A call to action,” by Dr. Mitchell R. Waite, PhD
- “Crucial conversations,” by Kerry Patterson, Joseph Grenny, Ron McMillan and Al Switzler
- “The five dysfunctions of a team,” by Patrick Lencioni
- “Take command,” by Jake Wood
- “Start with why,” by Simon Sinek
- “The speed of trust,” by Stephen M.R. Covey
