Format: E-Book

Beyond the Annual Review: Rethinking Performance Management in EMS

AAA and Newton 360 White Paper Examines the Role of Performance Management in Employee Development, Engagement, and Retention

As the EMS industry continues to confront workforce shortages, employee turnover, and increasing operational demands, a new white paper from the American Ambulance Association (AAA) and Newton 360 examines an often-overlooked component of workforce stability: how EMS organizations manage, support, and develop their employees. 2026 Performance Management for EMS: A White Paper Supplement to the Employee Turnover Study draws upon data from 74 EMS organizations nationwide, along with established workforce and organizational research, to explore the current state of performance management in the ambulance industry.

The findings reveal important opportunities for improvement:

• 61% of responding EMS organizations reported having an annual performance management process.
• 40% of organizations evaluating their annual process did not believe it meaningfully improved individual or organizational performance.
•  18.1% reported having neither an annual performance management process nor a formalized ongoing feedback process.
• Only 43% reported linking compensation to demonstrated employee performance.

But the white paper goes beyond the numbers. It challenges EMS leaders to reconsider performance management as something more than an annual evaluation or administrative requirement. Instead, it explores how clear expectations, meaningful feedback, ongoing coaching, employee recognition, and professional development can contribute to a stronger employee experience and a more capable workforce.

The report also introduces a four-level Performance Management Maturity Framework, providing EMS organizations with a practical approach to assessing their existing processes and identifying opportunities for improvement. With actionable recommendations for EMS executives, human resources professionals, and operational leaders, this white paper offers a roadmap for moving from traditional performance evaluations toward a more continuous, developmental, and strategically aligned approach to workforce management.

The central message: Effective performance management isn’t simply about evaluating employees. It’s about helping employees succeed, grow, and see a future within their organization.

Discover what the research reveals about performance management in EMS—and how your organization can begin strengthening its approach to employee development and retention.