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Frontline Leadership in Action: Redefining the Role of EMS Leaders in 2025

Written by Rob Lawrence on . Posted in Annual Conference & Tradeshow, Leadership & Management.

Frontline Leadership in Action: Redefining the Role of EMS Leaders in 2025

By Rob Lawrence,

At the 2025 American Ambulance Association Conference, the theme of frontline leadership resonated far beyond the breakout room walls. For the third year running, I joined my Aussie mate and Acadian Ambulance President, Justin Back, to co-lead a session that continues to spark powerful dialogue—not lecture—on what it means to lead from the front in today’s EMS.

As with previous years, it was an open and evolving conversation. Justin and I, as always, invited our colleagues in the audience to shape the session with us. Because, frankly, the best insights often come not from the podium, but from the room. And when it comes to defining effective leadership in our profession, EMS is undergoing a long-overdue cultural shift: from top-down command to servant leadership that starts at street level.

“People Don’t Work For Me—They Work With Me”

One of the key themes we tackled was how EMS leaders must embed themselves in the environments they expect their teams to thrive in. At Acadian, Justin holds his leadership team accountable to the “10-day rule”: no one in leadership should go more than 10 days without being back in the field. That means riding in the truck, answering calls, and walking in the same boots as the crews they support.

This is more than symbolic. It’s about closing the gap between policy and practice, between planning meetings and actual patient care. Justin puts it plainly: “The frontline is the top line. Ours is an upside-down pyramid—and it’s our job as leaders to support and serve from the bottom.” That philosophy doesn’t just build respect—it builds real-time understanding of what’s working, what’s broken, and where change needs to happen.

Replacing Preaching with Listening

What makes this leadership conversation different is that it acknowledges a hard truth: EMS doesn’t have the luxury of theoretical leadership anymore. Workforce shortages, recruitment battles, and retention challenges demand that we act fast—and with humility.

In our session, we didn’t preach solutions. We facilitated the sharing of them. Attendees contributed more than we did, offering cross-agency insights on how they’re addressing fatigue, field safety, and the evolving expectations of the workforce. We all walked away with five or more takeaways we could implement immediately.

For example, Justin shared Acadian’s surprising findings from a fatigue study: most preventable incidents were not happening during long night shifts, but during early daytime hours, among well-rested providers. That shifted their focus from assumptions about burnout to a broader concept of “shift readiness”—a term that now anchors their safety culture.

Accountability and Just Culture Can Coexist

Another hallmark of modern EMS leadership is knowing how to hold teams accountable without defaulting to blame. At Acadian, every preventable vehicle incident is reviewed by a centralized safety committee. Team members attend with their local supervisors, and the review process is rooted in a just culture model—one that aims to learn, not punish.

But this doesn’t mean going soft. As Justin said, “The pandemic forced us to bend without breaking, but now we must return to high standards. And we’re unapologetically doing that.” That blend of accountability and fairness is helping Acadian retain high performers and set a consistent tone of professionalism.

Leading the Next Generation

In 2025, leadership must also mean preparing for the workforce of the future. We discussed what today’s EMS recruit looks like—and how to welcome them into the profession even if their journey with us is short-term. “It’s not a stepping stone—it’s a building block,” Justin said. “If we can be part of someone’s broader journey and they leave as advocates for EMS, we all win.”

Leadership today means recruiting not just based on certification, but on mindset. Justin emphasized that Acadian looks for leaders with more will than skill—because skill can be taught, but heart and courage can’t. It also means being intentional about diversity, especially in areas like bilingual hiring, where language skills are becoming as vital as clinical ones.

From the Room to the Road

What struck me most about our session—and indeed the AAA conference as a whole—was the shared sense that the real solutions live not in leadership offices, but in the shared experiences of the EMS community. When we listen, when we ride, when we engage—true leadership takes shape.

Frontline leadership in 2025 isn’t about commanding from a distance. It’s about showing up, staying connected, and doing the hard, human work of leading with empathy, accountability, and consistency. As we say every year when we wrap this session: we’re not done yet. There’s more to learn, more to improve, and more to share.

Triple-A, we’re ready for round four.

 

EMS1 | From the ED to the edge: How Dr. Darria Long found her rhythm — and how EMS can find theirs

Written by Rob Lawrence on . Posted in Annual Conference & Tradeshow, News, Press.

From the ED to the edge: How Dr. Darria Long found her rhythm — and how EMS can find theirs

For many of us in EMS, the term “crazy busy” is often thrown around like a rite of passage. It’s shorthand for a culture of overdrive: another shift, another code, another unfunded mandate, another denied claim. But what if “crazy busy” isn’t just a schedule problem — it’s a warning sign?

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EMS1 | Gen Z, AI and the loneliness epidemic: The 5-M blueprint to future-proof your EMS crew

Written by Rob Lawrence on . Posted in Annual Conference & Tradeshow, News, Press.

EMS1 | Gen Z, AI and the loneliness epidemic: The 5-M blueprint to future-proof your EMS crew

Named one of Forbes’ Top Futurists, Heather E. McGowan has advised Fortune 500 boards, high-growth start-ups, universities and governments on how to adapt “at the speed of possibility.” A two-time bestselling author (“The adaptation advantage” and “The empathy advantage”), she specializes in translating big, fast-moving trends (e.g., technological disruption, demographic shifts, AI augmentation) into practical strategies leaders can act on today.

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A Message from AAA President Jamie Pafford-Gresham

Written by Jamie Pafford-Gresham on . Posted in AAA HQ, Annual Conference & Tradeshow, Medicare, Stars of Life.

Happy New Year from Our New Association President

 

Dear Fellow Members,

I am saddened to begin the New Year with such grim and shocking news from Louisiana and New York. I am sickened and heartbroken—as I know you are—by the terror attack that struck New Orleans this weekend as well as the mass shooting in the Bronx. Our hearts ache for the victims and all those whose lives have been shattered by these senseless acts of violence. We also offer our deepest gratitude to our fellow first responders who selflessly rushed toward danger to provide skilled care and comfort in the midst of these tragedies. May their example galvanize us as we work in concert in support of EMS.

Despite these tragedies, as we ring in 2025, I am excited to begin my two-year term as the president of the AAA. I am deeply honored and humbled by the outpouring of support I have received as we begin this 24-month journey together.

I say TOGETHER because this is about US and OUR profession, and I don’t plan to do this alone. I need your participation as we move forward to ensure the best outcomes for all of us in emergency medical services.

Decades ago, when I began working in the business office (which was the kitchen) of what was then my parents’ small Arkansas ambulance service, I never imagined that one day our family of Pafford companies would care for communities in four states, nor that I would have the opportunity to serve my EMS colleagues on the American Ambulance Association board.

I’d like to thank the outgoing AAA President, my friend, Randy Strozyk, for his hard work and leadership. Randy’s dedication over the past two years has enhanced unity and camaraderie among our leaders, members, and fellow EMS stakeholder organizations. I applaud his efforts and those of the larger board, committee chairs, and vice chairs. I am privileged to continue working with this extraordinary group of mobile healthcare professionals.

Too often, EMS—especially private EMS—feels like an unappreciated and misunderstood underdog. 2025 presents an opportunity to change that narrative. One of my cardinal rules at Pafford EMS is, “no whining allowed,” and another is if you complain about a challenge, be prepared to bring forth a proposed solution at the same time. We each know the incredible value we bring to our communities and patients. Together, our voices will be heard in Washington as we share data and stories highlighting the impact of the 24/7 on-demand mobile healthcare we provide.

I hope to approach my AAA presidency with the same sense of urgency with which we treat our patients. As a profession, we can work side-by-side to quickly and effectively secure the extension of the Medicare add-ons beyond the current March 31 expiration date, then collaborate on advancing additional key priorities including sustainable reimbursement, innovative payment models, and solutions to EMS’s challenging workforce shortage.

To accomplish these shared goals, we ask that AAA members treat our advocacy efforts with the same care, grit, and tenacity we demonstrate in our communities every day. On behalf of the board, I ask that you please respond quickly to requests from our government affairs team to write letters or to set meetings with members of Congress. AAA’s grasstops relationships are sterling and have helped the association punch above its weight for decades. However, I believe all politics are local and you are the secret sauce in our success!  Grassroots efforts rule the day in transitional times like these when every interest group is competing for dollars and attention. Nothing is guaranteed—we quite literally cannot advance ambulance advocacy without the active cooperation of every AAA member organization.

In addition to supporting you through lobbying, AAA proudly offers outstanding member educational opportunities. Learning and networking abound at the 2025 AAA Annual Conference & Trade Show. We can’t wait to see you—and a thousand of our mutual colleagues—in beautiful Lexington, Kentucky June 22–24. Speaker proposals are due January 31, and the full agenda will be announced in February. However, please don’t hesitate to register for the conference and book your hotel room today. From reimbursement to operations to human resources, AAA 2025 will offer informative, engaging executive-level content to help you keep service rolling. Additionally, thanks to the support of our exhibitors and sponsors, this year’s event will have fun extras including a welcome reception the night before the conference, trade show special events, and entertaining optional outings to visit Lexington’s famous racehorses and distilleries. You don’t want to miss it as we will roll out our southern hospitality and have a great time!

We also look forward to honoring the 2025 class of Stars of Life in Washington, DC November 3–5. Nominations will open in late summer for this year’s cohort of exemplary EMS professionals. We hope that your ambulance service will join AAA in celebrating your hometown heroes in our nation’s capital.

If you have not yet renewed your AAA membership for 2025, I encourage you to do so immediately—your dues power our ability to drive the policy that sustains EMS. As a friendly reminder, your membership includes complimentary access to dozens of webinars and e-books—log in to our website any time for on-demand education from Scott Moore, Brian Werfel, and countless volunteer leaders. Members also receive deep discounts on everything from medical supplies to uniforms to ambulances through Savvik Buying Group. Additionally, we are proud to support your team with counselor matching services and on-site critical incident stress management should the need arise. New for this year, the AAA mentorship match program will offer an exciting career development opportunity for staff of all levels. AAA delivers these resources and many others as part of a comprehensive member benefits package that we are confident pays for itself many times over. (If you need help updating your contact details or accessing your benefits, please contact hello@ambulance.org for assistance.)

Those of you I’ve had the pleasure of meeting in person know that state ambulance advocacy is a personal passion of mine. In the course of operating Pafford Medical Services, I have seen firsthand many times how strong state associations drive enhanced revenue for EMS as well as add might to state and federal lobbying efforts. If you are not yet connected to your state ambulance association, I encourage you to reach out today. For our part, AAA will continue to support state-level boards with resources, research, events, and connection opportunities through our State Association Forum network and State Association Leadership Excellence conference.

Last, but not least, I wanted to share with you that the board has initiated a strategic planning process for the association to ensure that AAA is positioned for continued success. Our trusted consultants at Davidoff Mission-Driven Strategy will be gathering candid feedback from members of all types and sizes. Your insights are essential to charting a course for 2025 and beyond. I thank you in advance for your participation in surveys and/or virtual focus groups that will take place in the coming months.

I look forward to collaborating with you to move EMS forward in the coming 24 months. Thank you again for your support and participation, and happy New Year!

Now, let’s get to work!

Jamie

Jamie Pafford-Gresham
2025–2026 President
American Ambulance Association

Register Now: EMS Focus Webinar

Written by AAA Staff on . Posted in Member-Only, Patient Care, Webinars.

EMS Focus
WEBINAR

Post-Crash Care – Innovations in Managing Patient Entrapment and Extrication

Hosted by NHTSA’s Office of EMS on Thursday, December 19, at 1pm ET / 10am PT

EMS clinicians respond to nearly 1.5 million motor vehicle crashes on the nation’s roadways each year. Of those, at least 55,226 involve patients trapped or pinned in vehicles in need of extrication.

In this webinar, experts will explore entrapment-related injuries and the specialized skills and training EMS clinicians need.

Panelists will review:

  • Current NAEMSP recommendations for entrapped patients
  • The latest research from the United Kingdom
  • Traditional extrication techniques and technology
  • Rapid extrication methods, self-extrication and the hazards of prolonged entrapment
  • Training and skills needed to manage entrapped patients and support patient-centered rescue throughout the extrication process
  • Patient communication and airway, injury and hypothermia management
Register Now

Panelists Include:

Nichole Bosson, MD, MPH, NRP, FAEMS, medical director, Los Angeles County Emergency Medical Services Agency, associate clinical professor at the David Geffen School of Medicine at UCLA; faculty member and EMS fellowship director in the Department of Emergency Medicine at Harbor-UCLA.

Tim Nutbeam, MB, ChB, Medicine, professor of emergency medicine and post-collision care, Peninsula Medical School, University of Plymouth, Great Britain; consultant in emergency medicine and prehospital emergency medicine.

Attendees will be encouraged to submit questions during any point of the discussion. The webinar and Q&A will last approximately one hour.

About EMS Focus

EMS Focus provides a venue to discuss crucial initiatives, issues and challenges for EMS stakeholders and leaders nationwide. Be sure to visit ems.gov for information about upcoming webinars and to view past recordings.

We are committed to providing equal access to this webinar for all participants. Persons with disabilities in need of an accommodation should contact nhtsa.ems@dot.gov to request an accommodation no later than Friday, December 13, 2024.

Sign up to receive the latest news from the Office of EMS, including webinars, newsletters and industry updates.

Contact Us

1200 New Jersey Avenue, SE
Washington, DC 20590
nhtsa.ems@dot.gov

EMS.gov | Commemorate National EMS Week

Written by AAA Staff on . Posted in Events.

EMS News

NHTSA’s Office of EMS
Thanks You for Making Your Communities Healthier
The Office of EMS (OEMS) at the National Highway Traffic Safety Administration (NHTSA) is honoring our country’s EMS clinicians during EMS Week. Thank you for delivering high-quality, compassionate care to your patients on our roadways and in homes, schools and businesses across the country. We celebrate your commitment to your profession and to the safety and health of your communities.

Please download this customizable certificate of recognition from the Office of EMS to help you recognize your team this week. And, watch or share this special thank you message from Gam Wijetunge, Office of EMS Director and active volunteer paramedic.

Today is EMS Education day. NHTSA remains committed to supporting the education of the EMS workforce, a key factor in recruitment and retention of capable clinicians. Learn more about NHTSA’s efforts in education: from the refresh of the EMS Education Standards in 2020, to the upcoming development of the EMS Education Agenda 2050, to collaboration with our partners at the Federal Highway Administration to educate clinicians about Traffic Incident Management to reduce secondary crashes.

Sign up to receive the latest news from the Office of EMS, including webinars, newsletters and industry updates.

Contact Us

1200 New Jersey Avenue, SE
Washington, DC 20590
nhtsa.ems@dot.gov
911.gov NHTSA DOT

POTUS | A Proclamation on National EMS Week 2024

Written by AAA Staff on . Posted in Events.

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        During National Emergency Medical Services (EMS) Week, we honor our Nation’s courageous EMS providers, who put it all on the line to deliver urgent, life-saving care to people across our country in times of great need.

Whether paramedics, emergency medical technicians, 911 and 988 dispatchers, or other first responders, EMS providers routinely work long hours away from loved ones to keep other families whole.  They risk their own lives and health, staring down storms, floods, or fires and rushing to rescue people in need.  For many Americans, they are a beacon of hope in some of life’s toughest moments and let us know we are going to be okay.  We have a duty to show up for them the way they show up for us.

That is why my Administration is working to get every EMS department in America the equipment and support they deserve.  During my first months in office, we passed the American Rescue Plan, investing billions of dollars to support EMS roles.  Today, we are working with State, local, Tribal, and territorial governments to keep EMTs on the job and to help them handle trauma and burn out.  We are working to get departments the resources they need to provide better training and equipment for EMS providers.  To help ease staffing shortages, we are also helping communities recruit and train more firefighters, who often provide emergency medical services as well.  We are fighting to ease the burden of student loans.  In all, we have cancelled debt for 4.6 million student borrowers, including for nearly 900,000 public service workers by fixing the Public Service Loan Forgiveness Program, which many non-profit or government EMS provider employees could be eligible for.

I have often said that courage lies in every heart, and the expectation is that it will one day be summoned.  It is summoned every day for America’s EMS providers.  They embody the best of our Nation — bravery, honor, and respect, never failing to answer the call to help others.  This week, we thank them and the unions that protect so many of our EMS providers and promise to always have their backs.

NOW, THEREFORE, I, JOSEPH R. BIDEN JR., President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim May 19 through May 25, 2024, as National Emergency Medical Services Week.  I call upon public officials, doctors, nurses, paramedics, EMS providers, and all the people of the United States to observe this week with appropriate programs, ceremonies, and activities to honor our brave EMS workers and to pay tribute to the EMS providers who have lost their lives in the line of duty.

IN WITNESS WHEREOF, I have hereunto set my hand this seventeenth day of May, in the year of our Lord two thousand twenty-four, and of the Independence of the United States of America the two hundred and forty-eighth.

JOSEPH R. BIDEN JR.

EMS.gov | EMS Day at the Museum and National Mall Event

Written by AAA Staff on . Posted in Events.

EMS News

Join Us for “EMS Day at the Museum” and National Mall Event to Commemorate EMS Week

It’s the 50th anniversary of EMS Week and to celebrate this momentous occasion, the Smithsonian National Museum of American History is presenting “EMS Day at the Museum.” This day of events will explore the history of emergency medical services in the United States.

Wednesday, May 22, 12 to 4 p.m.
Smithsonian National Museum of American History
1300 Constitution Ave NW, Washington, DC
First Floor West & Warner Bros. Theater

This special exhibit will trace the roots of EMS, beginning with field-care during Revolutionary and Civil War battles, to the very specialized care provided by modern-day emergency medical technicians and paramedics. Historical objects from the museum’s archives and vintage ambulances will also be on display. The exhibit will highlight Pittsburgh’s Freedom House Ambulance Service, one of the nations first ambulance services to offer emergency medical care, founded in 1967 and staffed by Black paramedics. The afternoon events will include a panel discussion about the life-saving medical care delivered by our nation’s EMS clinicians, featuring important figures in EMS, including John Moon, one of the Freedom House paramedics.

Learn More

The following day, Thursday, May 23, from 11:30 a.m. to 4 p.m., the 50th anniversary celebration will continue on the National Mall with the following events:

  • Antique ambulances on display
  • Hands-on Hearts CPR training
  • Stop the Bleed and tourniquet application training
  • Table demonstration of the new DC Fire & EMS Whole Blood Program
  • Presentations from national EMS organizations (1 p.m. – 1:30 p.m.)

Join representatives from the American College of Emergency Physicians (ACEP), the National Highway Traffic Safety Administration’s Office of Emergency Medical Services (NHTSA’s OEMS), the National Association of Emergency Medical Technicians (NAEMT) and the DC Fire and EMS (DCFEMS) Foundation as they host these two special events.

Sign up to receive the latest news from the Office of EMS, including webinars, newsletters and industry updates.

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1200 New Jersey Avenue, SE
Washington, DC 20590
nhtsa.ems@dot.gov
911.gov NHTSA DOT

EMS.gov Webinar | EMS Harm Reduction and SUD Treatment

Written by AAA Staff on . Posted in Operations, Patient Care, Webinars.

EMS Focus
WEBINAR

EMS Harm Reduction and SUD Treatment

Hosted by NHTSA’s Office of EMS on March 22 at 2 PM ET / 11 AM PT

According to the National Harm Reduction Coalition, “harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use.” This can include improving access to naloxone (Narcan) to prevent death from opioid overdose, providing sterile syringes to reduce the spread of HIV and hepatitis C, and fentanyl testing programs, among other types of help.

EMS clinicians are often on the frontline of addiction and the unintended consequences of both legal and illicit drug use and substance use disorder (SUD). In addition, drug use greatly impacts the larger context of our nation’s roads and highways through impaired driving and the resulting risks to the impaired driver, other drivers, passengers, bicyclists, and pedestrians. A 2022 NHTSA study of seven trauma centers around the U.S. found that nearly 56% of people injured or killed on roadways tested positive for one or more drugs, including alcohol. The most prevalent drug category was cannabis, and opioids made up 8.5% of cases at the trauma centers.

In this EMS Focus webinar, panelists will discuss:

  • Harm reduction and SUD treatment in the context of EMS care
  • Recent research
  • How innovation and intervention can drive overdose prevention in your community and reduction of other health risks, including traffic crashes that may be a result of impaired driving
REGISTER NOW

Panelists Include:

  • Kate Elkins, Emergency Medical Services/911 Specialist, NHTSA’s Office of EMS (moderator)
  • Gerard Carroll, M.D., EMS Medical Director, Cooper University Health Care; Division Head of EMS/Disaster Medicine; and Program Director, EMS Fellowship Program
  • John Ehrhart, Paramedic; EMS Manager, San Diego Health Connect; Co-Founder, California Paramedic Foundation; and Founder, Mission Critical Protocols
  • Simon Taxel, Paramedic Crew Chief and Public Safety Diver, Pittsburgh Bureau of EMS; Bloomberg Fellow, Johns Hopkins Bloomberg School of Public Health

About EMS Focus

EMS Focus provides a venue to discuss crucial initiatives, issues and challenges for EMS stakeholders and leaders nationwide. Be sure to visit ems.gov for information about upcoming webinars and to view past recordings.

We are committed to providing equal access to this webinar for all participants. Persons with disabilities in need of an accommodation should contact nhtsa.ems@dot.gov to request an accommodation no later than Friday, March 15, 2024.

Sign up to receive the latest news from the Office of EMS, including webinars, newsletters and industry updates.

Contact Us

1200 New Jersey Avenue, SE
Washington, DC 20590
nhtsa.ems@dot.gov

10/23 | US DOT Allies in Action Pedestrian Safety Month Webinar

Written by AAA Staff on . Posted in Webinars.

In honor of Pedestrian Safety Month throughout October, the U.S. Department of Transportation Office of the Secretary will host a webinar to highlight USDOT and National Roadway Safety Strategy Allies in Action efforts and resources to forward pedestrian safety. 

We hope you can join us!

Event: U.S. Department of Transportation Allies in Action Pedestrian Safety Month Webinar

When: Monday, October 23, 2023, from 1-2:30 p.m. ET

Where: Via Zoom (see registration link below)

Audience: Open to the public

Registration Link: Register now

 

Additional information on 2023 Pedestrian Safety Month and upcoming events can be found here and on the National Highway Traffic Safety Administration website.

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