EMS leadership success: a time-tested and proven recipe

These 10 ingredients will help every EMS agency succeed in the year ahead


By Jay Fitch

While there are no easy recipes for success, we’ve found 10 common leadership ingredients for best practices among the thousands of EMS agencies we’ve helped over the past three decades. Including these 10 ideas in your decisions and actions will help you and your agency succeed in the year ahead and beyond.

1. Passion and persistence

If you truly believe in the mission of EMS and your organization, others around you will as well. Persistence does not mean unwillingness to compromise or evolve, but be persistent when it comes to the mission and ideals of the organization and profession and always striving to improve.

2. Strong core values, idealism and vision

The core values of your organization must be more than words written on a plaque on a station wall or in an employee manual. Living those values each day is the only way to ensure that others around you see them as part of the culture. Use those values to help define a vision so everyone in the organization knows where you’re headed, together as a team.

3. Community connectedness and caregiver involvement

EMS exists to serve its patients and the community. In order to do that at the highest level, the EMS providers in your organization must feel a connection to the community. That starts with the leadership, and must be continually demonstrated — not just shown once a year on a community service day or during EMS Week.

Find ways to become involved and to get each and every member of your service involved in the community. That means both big ideas, such as community service activities for the entire agency, and little ones — like encouraging your EMS units to stop at lemonade stands and local parks.

4. Putting service first for all customers

Too often, we think that our customers — whether they be patients, hospitals or others — are there to serve us. We question why people call 911, why hospitals aren’t ready for us when we arrive. While these are legitimate concerns, they can’t get in the way of good service. Because at the end of the day, that’s what EMS is there for: service.

5. Obsession about innovation and continuous improvement

Notice I wrote obsession. The drive to improve must always be present.

Every QA/QI interaction should end with the thought "How can I make this better?" Meetings should be focused on improving the quality of care, the efficiency of service, the patient experience, employee health and safety. An organization that is not constantly and obsessively thinking about improving and innovating is an organization that will fail, eventually.

6. Leadership and skilled management and practices

Management and leadership do not always come naturally or easily. In EMS, we often promote personnel based on clinical skills or acumen, or other factors not always directly related to the ability to manage other people or lead an organization. We also focus most of our education and training efforts on clinical skills, and for good reason.

However, we must accept that management and leadership are also skills that can be learned — and forgotten. Continuing education on management and leadership topics, sharing best practices and ideas among others within your organization and learning from leaders of other organizations are each critical to an EMS organization’s success.

7. Staff pride, enthusiasm and engagement

At times, this can seem like the most difficult of the ingredients to add to the recipe. There’s no single, simple solution to increasing employee engagement and enthusiasm, but there are some key principles that can help you get there. First, set the example. Be enthusiastic and engaged yourself. Also, make it easy for the staff to be proud — give them the tools and support they need to provide the best EMS care possible. If caregivers feel they’re providing the best service to their patients, they’ll be more engaged.

8. Service differentiation and quality

What makes your organization different from all the others? Are you truly doing everything you can to make it better, or is being average okay? Think about ways your organization can provide better and different service — whether that means the care you provide to patients, the way you schedule and dispatch interfacility transports or anything else you do.

9. Collaboration, networking and strategic partnerships

EMS organizations do not operate in a bubble. Every day, you and your colleagues interact with a number of other agencies and entities — from hospitals to law enforcement, other EMS and fire agencies to public health, and more. Continuing to train, plan and function in silos will limit the ability of your agency to be as efficient and effective as possible.

Think of new partners. For example, maybe a local college or university has statistics or public health students who could help you analyze your data and implement performance measures. Or maybe the local high school wants to offer an EMT class that could help you with recruiting or developing new employees.

10. Innovative marketing to tell your service’s story

Marketing might seem like the last thing you need, especially if your agency is the sole provider of 911 EMS response in the area. But don’t think of marketing as advertising or competing for customers. Marketing is simply telling your story, something that can help your organization demonstrate value to the people who support it — including local officials and taxpayers. Marketing can be as simple as posting a story on Facebook or encouraging the local news to talk to your training team about the importance of bystander CPR.  

These ingredients are like one of those recipes grandma used to make — we know the ingredients, but how much of each to add is a bit of a mystery. Every EMS organization faces different challenges, and will therefore have different priorities. But EMS leaders cannot afford to ignore any of these 10 focus areas if they want to be successful.

About the author
Jay Fitch, PhD, is the founding partner and president of public safety consulting firm Fitch & Associates. In addition to consulting, Fitch frequently speaks at conferences and serves as the program chair for the Pinnacle Leadership Forum. Contact Jay directly at jfitch@emprize.net.

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