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Keeping the Best – EMS Retention Project of Virgina 

By  Robbie MacCue

Recruitment and retention is one of the hottest topics in EMS today. Virtually every EMS organization is dealing with some challenge in this area. Common explanations are “Young people don’t want to volunteer” or “People are too busy these days”.  These so called explanations are not supported by the research.

In 2005 the Virgina Department of Health & Office of EMS created a 37 page research report on the status of their EMS systems as well as recommendations. Their report, “Keeping The Best – How to Leverage Retention of Virginia’s EMS Professionals”, has industry survey based research, recommendations and highlights some retention principles.

Virginia EMS Report - Life-Cycle of Retention Model

The “Life-Cycle Retention Model” is particularly interesting, it very accurately outlines certain pitfalls (or retention barriers as the report details) that create a “revolving door”. When I use that term, it usually conveys an accurate description of an organization’s membership. So much effort is invested in bringing people into the organization and less effort is focused on keeping existing members from leaving.

The inadequate orientation or “on-boarding” process can take a very excited member and cause them to disappear within the first year. If members are not given clear steps & checklists to follow, they will become confused, frustrated and tend to leave or distance themselves from the organization. As Lisa Giruzzi says, “A confused mind does not act”, the more clarity you can bring to your on-boarding and orientation process and the sooner a member can feel that they are making a difference or feel connected, the more likely they are to stay.

When new members do complete their orientation and become actively involved contributing members, certain issues can quickly derail that person. So much of the leader’s effort is invested into bringing that member to a certain level of medical training, it’s usually the case that very little effort is put into giving people the distinctions of how to deal with interpersonal conflict. Many states do not have programs that give the leadership tools to help deal with those issues.

I love the saying, “To a hammer, everything is a nail”. We must give our leaders and our members (which are the future leaders), tools to deal with these interpersonal conflicts that are bound to come up in any organization. These are not unique to just EMS organizations, they typically plague many workplaces as well.

View the EMS Workforce Retention Research page for Virginia DOH EMS.

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Robbie MacCue


Robbie is the cofounder of the EMS Leadership Academy, host of the EMS Leadership Summit, and paramedic captain in Albany, NY where he serves in the Special Operations Division for ground rescue, flight, & tactical medicine. He performs international medical flights with North America's largest fixed wing Air Ambulance service. For more than 14 years, Robbie served as President of a non-profit EMS organization advocating for increased funding and raising the bar of excellence. In addition, Robbie is an American Heart Association advocate who is passionate about empowering others to save more lives. He has taught physicians, nurses, and other medical providers Advanced Cardiac Life Support at medical schools and hospitals throughout Manhattan. Robbie has undergraduate degree from Rensselaer Polytechnic Institute, and a MBA from Case Western Reserve University and provides business consulting that combines his love of technology with healthcare.

Robbie MacCue

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