How to become an excellent volunteer EMS service

Real ideas for any volunteer EMS agency to deliver valuable, measurable and appreciated service to the community

For several months I have been raising awareness about the value and importance of volunteer ambulance services.

Shining a spotlight on services that demonstrate excellence in customer service and clinical competency helps to offset the frequent stories of failing volunteer agencies. Examination also helps identify the attributes and processes some agencies use to achieve their success.

Many readers, especially after reading this column on 6 cultural changes, have said that they find the information encouraging and informative. Some even proudly emailed to tell me their agency works just the way I describe.

Others felt discouraged and inadequate

This email captures the sentiments shared by several readers:

"Scheduled staff 24/7? Response from the station? Uniforms and education paid for? New equipment? What kind of rainbows and unicorns world do you live in lady? There is no way this is an average small town volunteer squad you speak of. Get real." Name withheld

I get it

I understand the frustration that comes with feeling that the solutions suggested to solve your issues are simply beyond your reach, unrealistic, or overwhelming.

I realize that it is a fight to affect change in an agency paralyzed by the desire to live in the past.

I know that there is sometimes a real animosity between the volunteer EMTs and their line officers, board of directors or town government, often based on personal differences, lack of understanding on both sides, and resentments over issues that should be long forgotten. I’ve been at those meetings, in different places, year after year.

There is no magic bullet

If your agency is broken beyond repair, you have three options: close, keep doing what you are doing and eventually close, or start over with new leadership and focus.

What if long-term members are offended? You should expect that.

What about rules, bylaws, tradition, and charters? Change them to build a stronger organization.

Realize now that no matter what, someone is not going to be happy or support change.

You may lose people

Recognize that you won’t be able to persuade everyone that a cultural change as well as an operational change is needed. The people who have the most influence must be committed, or they need to get out.

Get started

Fix what you can now, and set realistic goals that are both achievable and measurable. Mark Twain said, "The secret to getting ahead is getting started."

You might not be able to change everything at once, but choose one or more of these to get started on change.

Fill the schedule

If you can only schedule full coverage three days a week now, set a goal to have coverage four days a week in three months, five days a week in six months, and weekend coverage in 12 months. Do not demand more shifts from your core providers. Causing resentment and burnout is counterproductive. Instead, use mutual aid agreements or paid staff as you rebuild your roster.

Issue and require uniforms

If funds are too tight for uniforms, adopt and enforce a dress code with professional ID tags, t-shirts and hi-vis jackets. Then budget for purchasing EMS pants, uniform shirts and boots.

Provide no- or low-cost education

Take advantage of free, online webinars and CEUs provided through local hospitals. Consider asking local business to sponsor "educational scholarships" for members to attend state or regional conferences. Provide every member with access to self-directed, online training.

New equipment

Many towns have a grant writer on staff who can help your agency. Be proactive and don’t wait until you are regularly breaking down to ask for help. Also check out the resources from

Don't keep your hard work as an EMS volunteer secret. Share your first steps and ask your questions in the comments. 

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