Fail forward: The leadership playbook EMS desperately needs

By Todd Steele

“Success is not final, failure is not fatal: it is the courage to continue that counts.” — Winston Churchill

Leadership is not about perfection; it’s about progress. I’ve spent over 30 years in EMS leadership and 12 years in the military. In that time, I’ve earned stripes, made mistakes and learned that real leadership comes not from avoiding failure, but from transforming it into fuel for growth.

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Early in my EMS career, I was promoted to a supervisory role. My leadership background came mostly from the military, where discipline and hierarchy were the norms. My bosses saw potential — I was a reliable provider, committed to the mission and dependable under pressure. But what I didn’t yet understand was this: being a strong EMS provider doesn’t automatically make you a strong leader.

I quickly learned that what motivated an 18-year-old infantry private didn’t necessarily motivate EMTs and paramedics. The “my way or the highway” leadership style simply didn’t work. EMS providers have options — and the confidence to walk away from poor leadership. It was a painful but necessary wake-up call. And unfortunately, I see these same mistakes still being made across EMS agencies today.

We talk about the EMS crisis all the time — low pay, poor reimbursement, staffing shortages. But here’s the truth: while many of those factors are outside our control, our leadership and our culture are not. We can choose to lead better. We must choose to lead better.

Own your failures. Learn. Grow. Repeat.

The only people who don’t make mistakes are the ones who don’t do anything. When you mess up — and you will — own it. Don’t deflect. Don’t blame others. Don’t pretend it didn’t happen. Own it, learn from it and move forward. That’s how leaders grow.

I once worked for an EMS agency that paid top dollar and offered the best benefits around, yet they couldn’t keep their trucks staffed. Why? The culture was toxic. Leadership believed money was the only motivator, but they ignored how people were treated. You can’t buy loyalty or engagement. Culture is just as important as compensation, and it starts with how we lead.

Change takes time — research shows it can take 3-5 years to shift organizational culture. But the clock won’t start unless you take that first step. So, start today. Make people your priority.

It’s not about you; it’s about them

When I first became a supervisor, I made it about me — how well I was doing, how much authority I had and how I was perceived. But leadership isn’t about the badge or the title. It’s about the people who show up every day to care for others. Our providers are our most valuable asset; and our job as leaders is to support, protect and develop them.

• Do your people have the equipment they need?
• Do they have functioning radios, safe gear and consistent policies?
• Do they have access to mental health support?

The things our EMTs and paramedics witness are experiences most people will never understand — and they face them daily.

As leaders, we must create an environment where people feel seen, heard and valued.

Build real relationships

There was a time in my career when I didn’t bother learning a new hire’s name until they’d been with us for 6 months. I told myself it was practical — most didn’t stick around anyway. But then I’d wonder why people didn’t feel welcome. Why weren’t they engaged? Why didn’t they stay?

Connection matters. You don’t have to be best friends, but you do have to care. Ask about their family. Check in after their weekend. Celebrate their wins. Know what motivates them and what drains them. Be sincere — and listen. Nothing is more important than the people you lead.

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Under promise. Overdeliver. Follow through.

Don’t make promises you can’t keep. I’ve done it. Even when circumstances were out of my control, I lost credibility. Your word is your bond. If you say you’ll do something — do it. And if you can’t, be honest about why.

I once worked with a manager who always said, “I’ll get back to you,” and never did. Years later, he’s long gone — but staff still use that line sarcastically. That’s the kind of legacy no one wants.

Consistency and courage matter

When rules exist for safety and compliance, they’re not optional. Yet even with policies in place, enforcement often depends on who’s watching. I once led a team where shoulder straps on stretchers were required, but many resisted using them. Some supervisors didn’t agree with the policy and failed to enforce it. It wasn’t until tragedy struck that the culture finally shifted. That failure of consistency — mine included — came at a terrible cost.

Leadership takes courage. It’s easier to look the other way. But silence is complicity. Address problems head-on — with professionalism and compassion — and hold the line when it matters.

Develop the leaders of tomorrow

If I’m being honest, I haven’t always done a great job mentoring future leaders. I’ve let opportunities slip by. But the next generation won’t develop by accident — they need guidance, structure and support.
Set clear expectations. Provide meaningful development opportunities. Show them how to be proactive, how to lead with integrity and how to own their mistakes. Teach them humility. Teach them to say, “I was wrong,” and “I’m sorry.” That’s the kind of leadership that inspires trust.

Fail forward

Failure is not the end — it’s a beginning. If you’re not failing, you’re not growing. So fail forward. Learn fast. Stay humble. Keep your promises. Build real relationships. Lead from the front, and always take care of the people who care for our patients.

Because in the end, leadership isn’t about how good you look in a uniform. It’s about how well you support the people who wear one beside you.

ABOUT THE AUTHOR
Todd Steele is a seasoned EMS leader with over 30 years of experience spanning operations leadership and system management. His versatile expertise covers a broad spectrum of EMS environments — including urban, suburban and rural settings — as well as diverse service models, from traditional 911 response to critical care transport and tactical EMS. Todd’s extensive background reflects a deep understanding of operational efficiency, team development and patient-centered care across every layer of emergency medical response. Todd is currently an area manager with Quikmedic.