Stepping Up: It's Time to Make a Difference

My years as a paramedic in the field were fantastic. I truly enjoyed helping people, knowing I was making a difference in my patients' lives and even saving a few.

When I stepped into a management position, I was concerned about losing that one-on-one interaction with my patients. Would I find supervision as rewarding? What I found was I had an even greater impact on patient care, albeit indirect. As a paramedic in the system, I impacted only the patients I saw in a shift. A supervisor has the ability to impact care for every patient for the entire shift.

The supervisor ensures the crews have everything they need to care for their patients and holds the system accountable to the performance expectations established by management. Managers impact the care the entire department provides by developing an effective strategic direction; implementing sound policies and procedures; hiring the right people; ensuring clinical competence; and managing the budget to purchase and maintain the right vehicles, equipment and supplies to do the job.

Each step you make from field provider to supervisor to manager requires new competencies. All of these skills will help your agency accomplish department-specific goals and objectives within the environment we live. But what is the next step? What about changing the environment and changing the rules. With more than 800,000 EMS professionals responding to 36.6 million EMS responses each year in the U.S., imagine the impact your voice can have. Advocating for EMS issues and the EMS profession can be game-changing and improve care across the board. Getting involved in national EMS associations can help elevate the entire profession, improving the quality, effectiveness and efficiencies of EMS systems. National associations can establish standards, share innovations from best practices, and develop and track benchmarks you can use to measure your agency.

On January 1, 2013, I became the President of the National EMS Management Association (NEMSMA). Our strategic plan describes NEMSMA as “a professional association of EMS leaders dedicated to the discovery, development and promotion of excellence in leadership and management in EMS systems. NEMSMA will research, discover, develop and promote best and most promising practices in EMS leadership, management, and administration through example, education, and advocacy.” NEMSMA’s vision blends best management policies and procedures with leadership character and competencies. This approach can educate new and seasoned EMS leaders and advocate for continual improvement by modeling excellence and creating/adopting best practices. Former President Gary Wingrove was successful in getting NEMSMA a seat at the table for national policy discussions. President Skip Kirkwood helped develop NEMSMA products, including the Field Training and Evaluation Program course and a soon to be released textbook about managing ambulance services.

As I take the reins, my plan is to build upon this success and help NEMSMA make a difference in the EMS profession. I plan to accomplish that in several ways:

• Engage the membership. There is too much work for just a few dedicated individuals to tackle if we want to make a difference. We need active members to participate in committees and projects and see them through to fruition.
• Partner with other associations. Many other national associations are doing great work. It makes sense to partner with agencies to create synergies and accomplish more and better products rather than each organization working in silos and performing duplicative work.
• Partner with EMS media outlets to tell the EMS story, portray leadership challenges and highlight best practice solutions.
• Engage our federal partners and Congress in meaningful conversation about the state of EMS, what help is needed, and what they can do to help EMS and the patients we serve.
• Develop additional management and leadership tools and products for EMS leaders to use on a daily basis.
• Offer educational opportunities in management and leadership topics. The leadership core competencies phase of the NEMSMA EMS Leadership Agenda for the Future will be completed in 2013 and will serve as the foundation for educational offerings and management tools.

With the healthcare reform movement, EMS is facing a watershed moment. This is our opportunity to better integrate EMS into the healthcare delivery system. As a paramedic, I knew I was practicing medicine and providing healthcare. I also knew I was making a difference in my patients' lives. If you are concerned you may not have the same level of gratification as you move up within your organization, fear not. There are many rewarding opportunities where you will have significant impact on patient care and the potential to save many more lives than ever possible seeing one patient at a time. When the opportunity arises, step up in your organization and join the national conversation. You, your community, and your patients are worth the extra effort. Do not leave the future of your profession up to others. Get involved and help shape the EMS profession of tomorrow.

Troy M. Hagen, MBA, EMT-P, is CEO of Care Ambulance Service in Orange, CA. He previously served as director of Ada County Paramedics in Boise, ID, and has more than 23 years of EMS experience. He is president-elect of the National EMS Management Association and an EMS World editorial advisory board member.