Editor’s Note: This article originally appeared in the EMS1 industry report, “What Paramedics Want in 2026: The provider roadmap for EMS leaders.” Explore our full coverage in the What Paramedics Want resource hub.
By Chris Cebollero, DBA
Gallup proved it: Your leadership is either driving engagement or killing it.
It’s 6:45 a.m. at a busy operations center. The shift is changing over. The night crew looks exhausted. The day crew is already behind. A supervisor stands in front of the team, reading off assignments from a clipboard — no eye contact, no context, no purpose; just tasks.
One employee quietly mutters, “Same thing every day.”
Another says nothing at all. He used to speak up. He used to care. Now he just does what’s required and goes home.
By 10:00 a.m., a preventable error occurs. By noon, two employees are already talking about leaving. By the end of the week, leadership is asking the same question they’ve been asking for years:
“Why isn’t our workforce engaged?”
Here’s the uncomfortable truth: engagement isn’t the problem.
Leadership is.
The data is clear — we’re ignoring it.
The Gallup Q12 meta-analysis — one of the largest workplace studies ever conducted — examined more than 3.3 million employees across 347 organizations. Its findings mirror what EMS providers told us in the What Paramedics Want in 2026: engagement improves when employees have clear expectations, support from leaders, the resources to do the job and a voice in how work gets done.
Highly engaged teams outperform disengaged teams in every measurable way:
- 23% higher profitability
- 18% higher productivity
- 78% lower absenteeism
- 63% fewer safety incidents
- 51% lower turnover
And yet, despite decades of this data, most organizations are still struggling with engagement.
Why?
Because leaders are still treating engagement like a survey problem, not a leadership responsibility.
Where leadership is missing the mark
Let’s be direct.
Most leaders are not failing because they don’t care. They’re failing because they don’t understand what engagement requires.
The Gallup model makes it simple. Engagement is built on very specific conditions:
- Clear expectations
- The right tools and resources
- Opportunities to use strengths
- Recognition and feedback
- Leadership support
- Growth and development
- A voice in the organization
- Connection to purpose
- Strong team dynamics
None of these are abstract.
Every single one is controlled — or influenced — by leadership.
And that’s exactly where things break down.
1. Leaders talk strategy but fail at clarity
Leaders love to talk about vision. But most employees don’t know what success looks like today.
When expectations are unclear:
- Performance drops
- Accountability disappears
- Frustration builds
Clarity is not optional. It is the foundation of engagement.
2. Leaders manage work instead of removing barriers
Employees don’t disengage because they’re lazy. They disengage because they’re blocked.
Outdated equipment. Broken processes. Poor communication.
When leaders tolerate barriers, they send a message:
“Your work doesn’t matter enough to fix what’s broken.”
3. Leaders underestimate the power of recognition
One of the most overlooked drivers of engagement is simple:
People want to know they matter.
Not once a year. Not during performance reviews. But consistently.
Most leaders say, “I don’t have time for that.”
What they’re really saying is, “I don’t understand its impact.”
4. Leaders avoid real conversations
Feedback is either:
- Too vague
- Too late
- Or avoided altogether
Without consistent performance conversations:
- Employees don’t grow
- Expectations drift
- Accountability weakens
Silence from leadership is not neutral. It’s damaging.
5. Leaders fail to connect work to purpose
People don’t disengage from work. They disengage from meaningless work.
If employees can’t answer: “Why does this matter?,” then they will eventually stop caring.
6. Leaders say they want input — but don’t use it
“Let us know what you think.”
Employees do. And then nothing happens.
This is one of the fastest ways to destroy engagement. Because when people feel unheard, they stop speaking.
The hard truth: Engagement is not an employee issue. It is a leadership execution issue. And until leaders take ownership of that, nothing changes.
What leaders must start doing
If you want to build an engaged workforce, you don’t need another survey. You need disciplined leadership behaviors.
Here’s where to start.
1. Create relentless clarity
- Define expectations clearly and consistently
- Reinforce priorities daily or weekly
- Make performance visible
If people don’t know what winning looks like, they won’t win.
2. Remove barriers aggressively
- Ask your team: “What’s slowing you down?”
- Fix what you can immediately
- Escalate what you can’t
Your job as a leader is not just to assign work — it’s to make work possible.
3. Recognize in real time
- Catch people doing things right
- Be specific, not generic
- Make recognition part of your routine
Recognition drives behavior. What you reinforce, you get more of.
4. Have consistent performance conversations
- Monthly 1:1s are non-negotiable
- Talk about progress, not just problems
- Coach, don’t just evaluate
People don’t improve by accident. They improve through leadership.
5. Connect work to purpose daily
- Explain the “why” behind decisions
- Share real impact stories
- Reinforce mission in meetings
People will go further for purpose than they ever will for a paycheck.
6. Turn feedback into action
- Ask for input regularly
- Act on at least one idea quickly
- Close the loop every time
Nothing builds engagement faster than being heard — and seeing change.
This is about accountability
Let’s stop pretending engagement is complicated.
It’s not.
What’s complicated is holding leaders accountable for doing the work required to build it.
Because here’s what the data — and experience — both show:
Engagement doesn’t improve because you measure it. It improves because leaders change how they lead.
A call to action
Go back to that morning shift.
Same team. Same workload. Same challenges.
Now imagine this instead:
The leader starts the shift with clarity.
- Explains the priorities.
- Connects the work to the mission.
- Recognizes someone from yesterday.
- Asks what’s getting in the way — and fixes one thing immediately.
Same people.
Different leadership.
Different outcome.
If you’re serious about engagement, stop asking: “How do we fix our employees?”
Start asking: “How do we fix our leadership behaviors?”
Because engagement is not built in HR. It’s built — or broken — by leaders every single day.
And the workforce is already telling you the truth.
The only question is, are you finally ready to listen?
ABOUT THE AUTHOR
Chris Cebollero is the Chief of EMS Team, a veteran EMS executive leader, educator and bestselling author with more than 30 years of experience in emergency medical services. A former Chief of EMS and healthcare COO, he has led high-performance teams through crisis response, organizational transformation and large-scale system improvement.
