The American Ambulance Association is partnering with Newton 360, an ambulance industry partner and Human Resource support firm, to conduct our fourth annual industry turnover study. Our intent is to comprehensively collect and analyze ambulance industry employee turnover data so as to produce a report that provides useful and actionable data. We are inviting EMS organizations to participate in the study. The study will be conducted and managed by Dennis Doverspike, PhD, and Rosanna Miguel, PhD, who are associated with the Center for Applied Talent Analytics at John Carroll University. Each individual or organizational response will be strictly confidential.
The purpose of the study is to better quantify and understand the reasons for turnover at nearly every organizational level within the EMS Industry. Thank you very much for your time and support.
Laying the Groundwork for Reducing Employee Turnover
Why participate in the survey?
- Educate elected officials, municipalities, and healthcare clients. The insight gained from this survey can help influence the actions, practices, or decisions of officials regarding regulatory and funding policies at the federal, regional, or local level. Specifically, this important data can help validate the critical staffing challenges faced by the EMS industry. This year, we continue to have queries related to the COVID-19 Public Health Emergency (PHE), to better understand impacts of the PHE on EMS turnover and its related costs.
- This study is critical to gaining insight into combating staff shortages. The AAA / Newton 360 2022 Ambulance Industry Employee Turnover Study aims to yield the information that organizations need to identify and benchmark their turnover challenges. Over the years this survey has been conducted, it has generated the largest response to a turnover survey ever published for the private EMS industry.
- Participating organizations will have full access to the final report at no charge. The comprehensive results of the study will be shared exclusively with each participating organization. Shorter write-ups and summaries of the results may be shared at conferences or published in relevant periodicals or journals.
Before You Start
It is recommended you gather information about your employees and about turnover before completing the questionnaire.
In this survey, we will be asking about headcount (filled and open positions), number of employees leaving the organization, and reasons for employees leaving. We will be asking these questions for each of the following job categories: supervisor, dispatch, EMT, part-time EMT, paramedic, and part-time paramedic. Headcount refers to the number of filled and open positions for each job category at the end of 2021. Filled positions refer to the number of employees in each job category that were on payroll at the end of 2021. For each job category, the number of filled positions should be added to the number of open positions at the end of 2021 to determine the total headcount.
The survey can be accessed by following the link below. It will open on July 5th, 2022, and close at end of day, July 15th, 2022.
Scott Moore, Esq.
Workforce Dynamics, Inc.
(781) 236-4411 office
(781) 771-9914 cellular
AAA President Shawn Baird shared with @foxandfriends how the #EMS workforce shortage is impacting our communities. Congress must act to provide #heropay and training, and to cut red tape keeping military medics from serving at home! @NAEMT_ @NEMSMAnews https://t.co/sfHOLx3W7c
— AmericanAmbulanceAsc (@amerambassoc) October 12, 2021
Oct. 8, 2021, 12:53 PM EDT
By Phil McCausland
“Companies have had to close, consolidate or come up with new strategies to answer calls, said American Ambulance Association President Shawn Baird, who added that there is simply not enough EMS personnel to cover calls in many parts of the country, especially during the pandemic.”
October 1, 2021
The Honorable Nancy Pelosi
Speaker of the House
U.S. House of Representatives
Washington, DC 20515
The Honorable Kevin McCarthy
U.S. House of Representatives
Washington, DC 20515
The Honorable Charles Schumer
United States Senate
Washington, DC 20510
The Honorable Mitch McConnell
United States Senate
Washington, DC 20510
Dear Speaker Pelosi, Majority Leader Schumer, Minority Leader McConnell & Minority Leader McCarthy,
Our paramedics and emergency medical technicians (EMTs), as well as the organizations that they serve, take on substantial risk every day to treat and transport patients that call 9-1-1. But our nation’s EMS system is facing a crippling workforce shortage, a long-term problem that has been building for more than a decade. It threatens to undermine our emergency 9-1-1 infrastructure and deserves urgent attention by the Congress.
The most sweeping survey of its kind — involving nearly 20,000 employees working at 258 EMS organizations — found that overall turnover among paramedics and EMTs ranges from 20 to 30 percent annually. With percentages that high, ambulance services face 100% turnover over a four- year period. Staffing shortages compromise our ability to respond to healthcare emergencies, especially in rural and underserved parts of the country.
The pandemic exacerbated this shortage and highlighted our need to better understand the drivers of workforce turnover. There are many factors. Our ambulance crews are suffering under the grind of surging demand, burnout, fear of getting sick and stresses on their families. In addition, with COVID-19 halting clinical and in-person trainings for a long period of time, our pipeline for staff is stretched even more.
The challenge is to make sure that the paramedics and EMTs of the future know that EMS is a rewarding destination. Many healthcare providers have extensive professional development resources, but that simply does not exist for EMS. COVID-19 has put additional pressures on the health care system and added another layer of complexity to the emergency response infrastructure.
HRSA EMS Training Funding
Fortunately, there are immediate and long-term solutions. Although the provider relief funds are essential and helpful to address the challenges of the pandemic, we need funding for EMS that addresses paramedic and EMT training, recruitment, and advancement more directly. The Congress can provide specific direction and funds to the Health Resources and Services Administration (HRSA) to help solve this workforce crisis. Those funds can be used to pay for critical training and professional development programs. Some of our members have already begun offering programs and would benefit from additional funding support from HRSA. Funding public-private partnerships between community colleges and private employers to increase the applicant pool and training and employment numbers through grants could overcome the staffing deficit we face.
Paramedic and EMT Direct Pay Bump
In addition, more immediately targeting funds for EMS retention could address the shortage we are experiencing day to day. To help ambulance services retain paramedics and EMTs, we request funds through HRSA to be paid directly to paramedics and EMTs. These earmarked funds could be distributed to each state with specific guidance that the State Offices of EMS distribute the funds to all ground ambulance services using a proportional formula (per field medic).
COVID-19 Medicare Reimbursement Increase
With capitated payments by federal payors, there are limited funds to transfer into workforce initiatives. Increasing Medicare payments temporarily would be meaningful to compete with other employers and other jobs. This could help infuse additional funds into the workforce and create innovative staffing models that take into account hospital bed shortages and overflow.
Congressional Hearings on EMS Workforce Shortage
The workforce shortage crisis facing EMS spans several potential Committees of jurisdiction. This critical shortage is particularly felt in many of our rural and underserved communities. As Congress moves on the steps we have outlined above, we also urge you to organize hearings in the appropriate Committees to develop long-term solutions and focus the country’s attention on these urgent issues.
Thank you in advance for continuing to ensure that our frontline responders have the resources necessary to continue caring for our patients in their greatest moment of need, while maintaining the long-term viability of our nation’s EMS system.
Thank you for your consideration. Sincerely,
American Ambulance Association
National Association of Emergency Medical Technicians
Please share this email and survey link with EMS education providers in your area! If your ambulance service operates its own training program, please also complete the survey on its behalf. Thank you for helping us gather this critically important data!
Dear Education Partner/Collaborator,
As a leader in Emergency Medical Services and a member of the American Ambulance Association, the Association leadership is trying to better understand the current challenges regarding the new and current workforce. One of our goals this year is to better understand the impact that Covid-19 has placed on education institutions offering programs in emergency medical services.
Therefore, I am requesting your help in completing a short survey and answer five short questions through the link below to help gather data and try to determine the short- and long-term effects we might expect because of any potential disruption in the graduation or completion of future students entering the field of EMS?
We appreciate your time and effort towards helping us better understand the future of our EMS workforce and begin building more solutions to try and recruit and retain our workforce for long term sustainability. If you have any questions, please feel free to reach out to me directly or contact the American Ambulance Association’s CEO, Maria Bianchi at firstname.lastname@example.org.
Thanks for considering.
EMS Service Name
Scrolling through Facebook, I regularly notice EMS providers seeking feedback from friends and colleagues. Someone will post, “Hey, I’m moving to this city. Does anybody know some good ambulance services that are hiring?” Plenty of people will respond, “This is a pretty good place.” Others share warnings such as, “Don’t work for Provider X.” Word of mouth can be valuable for any EMS. What current and former employees say about their positive work experience is a major benefit to recruitment and retention. In order to ensure a top-notch service to customers and to attract top-tier employees, recruitment and retention must be at the top of the to-do list. This is important for both public and private EMS departments. With negative word of mouth, unless somebody is desperate to get a job, “Provider X” in the example above won’t receive a second look from applicants. While some services use salary as a major recruitment and retention tool, it’s not the only way to stand out. There are various low-cost strategies to employ when it comes to recruiting and retaining employees.
Moving on up
Opportunities for advancement are one attractive benefit. In a fire service, providers often begin their tenure as a fire service paramedic. They can take a test to become a paramedic lieutenant. If a space opens up, a person can test to be a paramedic captain or eventually paramedic chief. In private ambulance services, the organizational structure is often different. Provide an infrastructure for improvement is of the utmost importance. For many professionals, that upward mobility is gained through education. Offering more knowledge benefits both parties and has an impact across the continuum of care. The advanced education benefit allows providers to offer better care and to communicate better with colleagues in other healthcare disciplines about a patient’s care. This builds loyalty among employees toward a service that continues to invest in their skills.
Some organizations may avoid providing education while on the clock. Advanced planning ensures coverage while expanding the team’s skills. Work with your team to determine the most convenient time and day for the provider and the EMS to obtain educational opportunities.
An EMS department can offer a number of educational opportunities — starting with all the necessary courses to maintain certification — to expand a provider’s knowledge.
Some of the options include the following:
- Tuition reimbursement for college
- Flight paramedic, critical care or tactical paramedic certifications
- Critical care continuing education
These certifications make providers, and the service they work for, stand out above the crowd. Think of the added benefit of saying, “All of my paramedics are critical care paramedics.”
To recruit or to retain
So what comes first – recruitment or retention? That depends on the needs of an individual service. If a service, for example, is 10 people short, filling those spots is paramount. If there aren’t any open spots, concentration turns to keeping the providers you have satisfied and offering the best service possible. These providers are valuable because they are most familiar with your area, contracts and how your service does business. Whether recruitment or retention is the goal, the following perks may help candidates choose your organization over competitors:
- Free uniforms
- Recognition awards, dinners, picnics and other company events
- Colleague referral programs
- Discounts for services and products, such as gym memberships, travel, etc.
- Tax breaks for EMS volunteer hours (in some states)
While some services rely on a quick increase in salary as their only tactic, recruitment and retention is impacted by much more. Finding and incorporating multiple ways to value your providers and their contributions is the most beneficial path to follow.
Founded in 1971 in with just eight staff and two vehicles, Acadian Ambulance has grown over the years to more than 4000 employees with a fleet of 400 ground ambulances, helicopters, fixed-wing airplanes, and van and bus transports. Their territory has expanded from Lafayette Parish, Louisiana, to stations spanning large swaths of Louisiana, Texas, and Mississippi.
How does such a large and varied service feed their talent pipeline? In addition to many other strategies, Acadian is leading the industry in its efforts to engage young adults in EMS through its High School Champions program, a division of their National EMS Academy.
To learn more about the ins-and-outs of the program, AAA caught up with Porter Taylor, Acadian’s Director of Operations. Taylor has been in EMS for 29 years, since he joined Acadian Ambulance as a college sophomore. “I love making a difference in people’s lives. When I was working on a unit it was the patient, and now, almost 30 years later, it is the employees that I love helping.”
Establishing High School Champions was not a linear path. Initially, Acadian would send medics to career fairs and school functions to introduce the field and promote its National EMS Academy (NEMSA) as an opportunity after graduation. “There are a lot of technical grants out there, and a critical staffing need for EMS in general. We wanted to create an avenue for educating students about the benefits of becoming EMTs to support our staffing needs long term,” said Taylor.
Although these medic visits were effective, Acadian wanted to expand the fledgling program’s scope and reach. He began visiting area high schools and meeting with school boards and directors more than a year ago to build relationships and explore opportunities. The partnerships he built added another facet to the High School Champion initiative wherein Acadian continues to promote NEMSA, coupled with an effort to get the schools to incorporate an EMT program as an elective prior to graduation. “[I wanted] to introduce them to our company and our support of this technical career path. My goal was to let the teachers and technical program directors know that Acadian has jobs for their students upon the successful completion of the program. Once students turn 18, Acadian will be able to offer them a rewarding position with good pay and benefits and with continuing education opportunities.”
Acadian Operations Manager Justin Cox was instrumental in the implementation at Livonia High School, a recent addition to the program. In concert with his professional know-how, Cox had a personal connection to the school—his thirteen year old daughter attends Livonia.
Collaborating with the administration, Acadian now works with schools like Livonia to introduce EMS career paths at the end of high school, a time when students are making key choices about their futures. Students can start the EMT training program as an elective prior to graduation and take the national certification exam upon turning 18. Students spend 2-3 hours 3 days a week, during their junior and senior years preparing. “It is a joy to work on this program,” said Taylor, “It is a privilege to help young people make a career choice that is full of rewards.”
- Related: The Advocate’s “High school program focuses on career awareness“
Does your service have a great program that is making a difference in your area? Let us know in the comments section below, or email email@example.com.