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5 tips to build a winning EMS culture

The culture, good or bad, EMS leaders cultivate can make or break an EMS agency

This article originally appeared in the January 3, 2019 issue of the Paramedic Chief Leadership Briefing, Active shooter survival | Winning EMS culture | Debrief = critical learning. Read the full briefing and add the Paramedic Chief eNewsletter to your subscriptions.

By George McNeil

Culture, does it mean something to your organization or is it just a soft buzzword that gets thrown around at staff meetings and in emails?

Any organization seeking change for the better should stop and examine the culture within. Culture, good or bad, can make or break an organization. Ponder these questions as you read five tips to building a winning EMS organization culture:

  • What does culture mean to your organization?

  • What kind of culture do you have within your organization?

  • Is the culture good, bad or indifferent?

1. Don’t micromanage

While this may seem like a simple concept, many leaders still don’t understand that they can’t control everything. First responder services, not unlike military special operations, are highly dynamic and are made up of Type A hard-driving professionals. Micromanaging these people will almost certainly lead to conflict and have a negative impact on operational effectiveness. Conditions change rapidly, usually with a degree of unpredictability, and it is impossible for any one person to control all of the variables that feed into a situation.

TIP: Great supervisors give personnel the 10,000-foot view of what needs to be accomplished, and then give them the latitude to act based on your desired outcomes. When problems arise, you can and should provide guidance, just don’t take over. When you trust your people to make the right decisions, you will start to see a shift away from a bad culture to good culture.

2. Communicate your vision regularly

No matter what level of leadership you might hold, you should be communicating with your people on a regular basis. A big mistake that a lot of leaders make is they over-rely on electronic means to spread their vision.

As useful as high tech can be, remember you are leading human beings, and most human beings respond well to high touch. Get out from behind the desk and go out into the engine room or the field. Meet with people in their environment to encourage open dialogue. Good communication is a two-way street, from the top down and – just as important – from the bottom up. Use the tools at your disposal that will best support the open exchange of information.

Now there is a caveat here that I would like to highlight.

TIP: Saying too much can be just as hazardous to the culture of the organization as not saying enough. When you flood the line personnel with so much information they can’t sort through, they will lose sight of what is important and stop paying attention altogether. If what you are sharing does not have a direct impact on mission success, think hard about sharing.

3. Encourage accountability at all levels

From the senior firefighter or paramedic to the chief wearing the white shirt, one of the most important tools in your leadership toolbox is accountability. However, before people can be held accountable, they must understand the “why” behind “what” they’re being held accountable to. Every procedure, policy and guideline within the organization should have a clear statement of cause attached, and it’s your job as the leader to make sure that it’s understood.

TIP: Push your people to police themselves and hold others accountable to accomplish the overall mission of the organization. If your people don’t have a clear understanding behind certain operations, it may be time to stop, examine those operations or policies, and – if necessary – do away with them.

4. Trust your top performers

Most people who work in emergency services are highly motivated, educated individuals. On occasion, though, you will run across some that have done the bare minimum to get hired and will continue to do the bare minimum to maintain employment. These individuals will be difficult to spot sometimes because they are relatively happy in their job and won’t make waves.

TIP: The key to picking them out, is they will never do anything more than is asked of them. Don’t let this select group of individuals detract you as the leader from empowering your high-performing individuals with your trust. As the leader, you have to own everything, but you also need to give others the opportunity to shine. If you don’t, you risk losing talented and motivated people to other organizations where they can show their worth.

5. Know when to lead and when to follow

Jocko Willink and Leif Babin discussed followership in their book, “The Dichotomy of Leadership.” Just as important as stepping up to lead is knowing when to step back and let others on your team take charge and make decisions.

TIP: If you have team members who have specific knowledge or skill sets that you don’t; turn to them and use their knowledge, skills and abilities to accomplish the mission. The last thing you want to do is have the “I know it all” attitude and be left standing alone.

I hope that the tips I have presented here will help you move your organization towards one of positive culture and high performance.

Thank you to Chief Dennis Reilly for helping me with this article. Thank you to every first responder I have met through social media and you have all helped shape me into the leader I am today. Finally thank you Jocko Willink, Leif Babin and Brent Gleeson for providing the inspiration to write this article.

About the author

George McNeil is a full-time paramedic with UMC EMS in Lubbock, Texas, and a part-time firefighter/paramedic with Wolfforth Texas Fire/Rescue. He holds a bachelor’s degree in Fire Science from Columbia Southern University and a master’s degree in Leadership from Grand Canyon University. He has over a decade of experience working in urban and rural emergency service,s and has a great passion for passing on knowledge to other first responders. You can reach him at or on Facebook.