Underfunding, burnout, and staffing reductions have been perennial problems that have plagued the emergency services industry. Covid-19 has unfortunately exacerbated these long-term obstacles to employee retention. Back in 2018, the American Ambulance Association conducted a study into EMS retention rates. The study found that the EMS industry has a higher-than-average turnover rate, as high as 25% for full time employees and up to 30% for part time employees. “A 25-percent turnover rate means 100 percent turnover in an organization’s staffing every four years,” noted EMS 1 in a review of the study.

To effectively confront the staffing crisis, EMS companies must find creative ways to maintain their staffing levels and keep new recruits on the job. But in an industry with such high turnover rates, it is a difficult challenge to meet. In 2007, EMS World published a strategic framework based on some of the practices utilized in American hospitals.

EMS Staffing Crisis Solutions

One of the first steps from this piece was for employers to stay engaged with their new recruits. “Hospital studies recommend meeting with new employees every two to three months to make sure they’re receiving adequate support and guidance. These meetings also open lines of communication with the manager to discuss any areas of concern that arise.” The key to this approach is giving new hires a mechanism to address concerns and grow confidence with their position.

Another sound strategy promoted in this piece is to emphasize educational opportunities to staff. Examples used in the EMS World piece include one hospital who gives nurses a paid day off for educational programs every four weeks, and another that provides paid time off and tuition coverage to nurses five days a year. “Taking this proactive stance toward education in EMS would yield the same results, giving EMTs and paramedics more say in departmental decisions because of their “expert” knowledge and increased satisfaction with their current workplace,” the piece argues.

Additionally, giving staff an active role in the governance of their workplaces can help build a feeling of ownership in their role. The example used in this suggestion is the concept of “magnet hospitals.” These hospitals use mechanisms such as nursing counsels, giving staff a hand in the direction of their roles. “These systems allow employees to participate more in the decisions that affect them through additional responsibilities that provide creative challenges, such as clinical career ladders or work groups created to solve departmental problems.”

These systems ultimately work towards building community, ownership, and advancement which give staff incentive to stay in a position, rather than look for new work opportunities. These suggestions and others can also be found in a real-world success story going on in Harris County Texas.

Success Story in Harris County Texas

While much of the industry struggles to maintain staff, Harris County Emergency Services District 11 has been inundated with job applications and currently enjoys a staffing rate of 110%!

In a press release reacting to the success of his organization’s staffing efforts, Harris County ESD11 EMS Chief Executive, Doug Hooten, said “We have had tremendous interest, and based on that, I expect to be able to put together a highly qualified team of emergency medical services people who will be ready to respond and provide the very best care to those who need us.”

Hooten also joined the EMS One-Step podcast with Rob Lawrence in which he discussed some of the tools he has used to find staffing success. One of them being, of course, competitive pay. Another aspect of his strategy has been flexible scheduling. EMS World pointed to the success this practice has had in hospitals. “Both flexible and self-scheduling are significant ways to increase worker satisfaction. These methods go beyond simply letting an employee pick the schedule that is best for him from existing options; they allow employees to self-determine…” Wooten also credited his success with providing employees with a Doggy Day-Care!

What organizations can take from both the advice of the EMS World article and the example of Harris County is to be open to new ideas. The constraints put on the EMS industry are numerous, and not every solution advocated here will work for every organization. But with some vision and a little creativity, EMS organizations can make progress towards improving their staffing situations and making the experience for the staff they already have a positive one, which in turn can lead to higher retention.

Image Credit: Photo by Jay Heike on Unsplash

Much of the country is just now waking up to the dire state that fire departments are in currently. Article after article is appearing in local, state, and national news about firefighter staffing shortages, emergency first responder recruiting, and fire station brownouts. The San Diego Fire-Rescue Department “was forced to take multiple engines and special units out of service, under an emergency brown-out, due to lack of personnel”.