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NAEMSP 2019 Quick Take: Achieving efficiency and sustainability in volunteer EMS

Autonomy, leadership, resource commitment and integrative processes bolster successful volunteer EMS agencies


Most volunteers stick with EMS because they enjoy serving their communities, helping others and satisfying their sense of duty.

Photo/Quakertown Volunteer EMS

AUSTIN, Texas — Volunteerism is a widespread model for EMS service delivery and sustainability is critical for the rural areas which are highly reliant on the volunteer model. The sustainability of volunteer EMS was the focus of a presentation by Peter O’Meara, Ph.D., at the NAEMSP Annual Meeting. O’Meara has conducted research to identify factors that might improve the sustainability of volunteer EMS in Australia and other countries.

Memorable quotes on EMS volunteerism

O’Meara researches and speaks about paramedicine around the world, including the provision of EMS in high-income and low-income countries. Here are memorable quotes from O’Meara on EMS volunteerism.

“Volunteer EMS systems are not free. People might not get paid, but the system still costs money. You have to put some resources in – uniforms, training, conferences, professional development.”

“The evidence indicates the [clinical] outcomes are not as good in volunteer [EMS] areas. It doesn’t have to be this way.”

“Volunteers do a lot of things [other than patient care] and it’s not always obvious.”

“Our research found people don’t do this [volunteer EMS] for money, but they don’t want to be out of pocket.”

Top takeaways on successful volunteer EMS

Most volunteers stick with EMS because they enjoy serving their communities, helping others and satisfying their sense of duty. Here are three takeaways from O’Meara’s presentation at the NAEMSP Annual Meeting.

1. Aims of volunteer EMS agencies

O’Meara began his presentation by discussing that volunteer EMS agencies, as well as all EMS agencies, share these aims:

  • Effectiveness
  • Quality and access
  • Cost efficiency
  • Sustainability

The focus of O’Meara’s talk was on sustainability, the fourth aim. There are many personal, agency and societal threats to volunteerism and continuing participation in EMS. Some of those threats include:

  • Work pressures and requirements
  • Aging populations
  • Flight of young people from rural communities
  • Increased time and higher expectations for training
  • Too much hassle from management
  • Too little attention from management
  • Competition for people’s time and energy

2. Volunteer model of care

O’Meara described a transformation process for a volunteer model of care. Each task or issue has activities and performance indicators.


Photo/Courtesy of Greg Friese

In Australia, EMS innovation and reform is focused on:

  • Improving clinical outcomes
  • Battling rising demand for EMS
  • Dealing with stressed and underfunded health systems
  • Addressing changing values of society

A successful volunteer system has these components:

  • Autonomy
  • Leadership
  • Resource commitment
  • Integrative processes

Photo/Courtesy of Greg Friese

3. Different roles for volunteers

As volunteers age into their 60s, 70s and 80s, there is an increasing need for agencies to match the changing cognitive and physical capabilities of these volunteers to other roles or tasks within the agency.

Patient care is just one of many responsibilities for volunteer EMS agencies. Some volunteers contribute to the success of the agency through fundraising, administration, training and lobbying. Agencies need to inventory the skills, qualifications and relationships of their volunteers and match people with the needs of the organization.

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Learn more and get involved

Learn more about sustaining EMS and get involved with these resources from EMS1:

Greg Friese, MS, NRP, is the Lexipol Editorial Director, leading the efforts of the editorial team on Police1, FireRescue1, Corrections1 and EMS1. Greg served as the EMS1 editor-in-chief for five years. He has a bachelor’s degree from the University of Wisconsin-Madison and a master’s degree from the University of Idaho. He is an educator, author, national registry paramedic since 2005, and a long-distance runner. Greg was a 2010 recipient of the EMS 10 Award for innovation. He is also a three-time Jesse H. Neal award winner, the most prestigious award in specialized journalism, and the 2018 and 2020 Eddie Award winner for best Column/Blog. Connect with Greg on LinkedIn.