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EMS Insights From VFIS: Bridging the Gap Between Management and Operations

Don Cox

Content sponsored by VFIS, the largest provider of insurance, education and consulting services to emergency service organizations such as fire departments, ambulance and rescue squads.

Management and operational members have very different roles within the fire and EMS sectors, and their day-to-day responsibilities are equally varied. Although some operational members have achieved promotions as supervisors and are a critical aspect of management, their duties are different than those of managers.

Managers often focus on making strategic departmental decisions, while supervisors direct the members and day-to-day operations of an organization. Despite these distinct functions, communication is key between the two roles. Their ability to effectively relate to and support each other is critical to achieving unified missions and producing consistently safe and successful working environments.

To effectively accomplish this, it is important to start at the top. It is management’s critical duty to ensure that their supervisors are following established best practices and safety protocols, and also to consistently listen to and learn from these members. Supervisors should be aware that the color of their shirt isn’t the only thing that differentiates them from their staff, and should be able to fully grasp the importance of their role as a leader.

Effective Leadership

If an ambulance is in a collision and the driver is found to have not been wearing his seat belt, responsibility ultimately lies with the organization’s management and operational supervisors. Harvard faculty and leadership consultants Ronald Heifetz and Marty Linsky discuss this in their book Leadership on the Line, which focuses specifically on the differences between technical problems and adaptive challenges faced by managers.1 Applying what they discuss in the book (especially because there are still many documented cases of responders not wearing seat belts), let’s look more deeply at the example.

To help encourage seat belt use, we’ve enacted and modified laws and policies; implemented standard operating procedures; and created technologies with alarms, flashing lights and transmission interlocks. These initiatives were designed to provide a solution to the technical problem at hand. Though money and resources have been used to help increase the use of seat belts, violations continue, leaving us to wonder what might more effectively put a stop to these types of occurrences.

Adaptive Change

Heifetz and Linsky discuss a tactic called adaptive change and indicate that it “depends on having the people with the problem internalize the change itself.” In other words, to attempt adaptive change in this scenario, both management and operational supervisors should focus on changing members’ attitudes, values and behaviors regarding seat belts. This tactic is intended to more effectively lower the number of continued violations and therefore decrease injuries and fatalities as well.

This adaptive-change tactic certainly encourages greater communication and cooperation between management and operations personnel. Taking the concept of this tactic even further, one might consider focusing on greater communication with the medics who are often in the backs of these ambulances attending to patients. Have these individuals also been taught the importance of taking the proper steps to secure themselves?

Only in recent years have we challenged ourselves to find better ways to establish and ensure a safer environment for our personnel and patients. It is well known that managers want their responders to be safely secured; however, executing this vision typically falls more on the shoulders of operational supervisors than they realize. By employing adaptive-change tactics, managers and supervisors, with a common vision, can help create greater change within their organizations and develop a culture that puts safety above all else.

Fostering Greater Understanding

Another key element to bridging the gap between management and organizational operations is developing a greater sense of understanding. At times managers can be so removed from the day-to-day duties of crews that they lose touch with what these personnel are actually experiencing in the field and therefore may be unaware of new safety issues that need addressed.

A tremendous safety concern today is the opioid crisis and its associated exposure risks. These incidents seem to be increasing at a rapid pace. Overall concern for those working in emergency services is no longer just about the increase in overdose incidents but also about the protocols of naloxone (or Narcan) administration. Responders face new challenges and hazards with components like carfentanil and a variety of other fentanyl-laced counterfeit pills.2

While management focuses on addressing these types of organizational safety issues, it’s equally important that responders thoroughly document and communicate their response details to keep managers informed regarding incident scenes. This will give management a more complete picture of problems and allow them to approach potential solutions in a more informed way.

Lifelong Learning

Effective managers often focus on continuing education and training as a part of their job responsibilities. This commitment to lifelong learning fosters better management and is of critical importance in an industry where best practices and response tactics can change so rapidly.

Not only should management professionals practice continued learning, they should work to inspire the same practice among their supervisors and operational staff. Though it’s easy to assume this responsibility should fall on the organization’s training officer, management must keep in mind that these officers only meet with responders on a periodic basis. While they assess performance in the field to verify competency, additional focus should be placed on training throughout the year.

Managing professionals can also take advantage of “seizing the moment” when they are able to highlight real-world learning opportunities that move their team toward accomplishing their mission. At times nothing can replace the amount of learning that can take place during these real-life situations.

As managers and industry personnel unite to identify problems, analyze future options and solutions, and implement adaptive changes, their organizations become stronger and more successful. Together we can work to build a stronger bridge and greater communication between management and operations and work more effectively and proactively than ever before.


  1. Heifetz RA, Linsky M. Leadership on the Line: Staying Alive Through the Dangers of Leading. Boston: Harvard Business School Publishing, 2002.
  2. Centers for Disease Control and Prevention. Influx of Fentanyl-laced Counterfeit Pills and Toxic Fentanyl-related Compounds Further Increases Risk of Fentanyl-related Overdose and Fatalities. Health Alert Network,

Don Cox is a retired fire chief/paramedic who has served in the fire service in Florida, Wisconsin and Iowa. He earned a master’s degree in adult education, holds Chief Fire Officer and Chief Training Officer designations, is a National Fire Academy Executive Fire Officer and is currently an education specialist for VFIS.


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