The EMS Manager's 7 Keys for Success

The EMS Manager's 7 Keys for Success

This article is the second in a series of three focusing on common pitfalls that may trip up EMS leaders. In keeping with the National EMS Management Association’s officer competencies, lessons will be divided into those for supervisors, managers and executives. Find Part 1, for supervisors, at

While organizations may vest an enormous responsibility in their front-line supervisors, the ability of managers to coordinate activities, resolve conflicts and work across traditional boundaries is critical to agency growth and success. Unfortunately, certain common traps can ensnare even the most seasoned manager. Here’s how to navigate them.

1. Don’t Let Your Boss Get Blindsided

A famous political maxim is “Always be the bearer of your own bad news.” An important corollary to that is that you have to watch your boss’ back. Your boss has to trust you, as you are essentially acting as an arm of your chief officer(s) by managing functional areas and keeping their span of control reasonable. That trust is built on competence, consistency, integrity and, most of all, communications.

If you’re going to be successful in watching your boss’ back, you’ll have to develop your own trust relationships. If your staff trust you, they will come to you with issues before those issues become problems. They will share critical intelligence with you because they know you can keep something in confidence or will act when it’s appropriate. This trust goes all the way down the line to every employee and provider in the system, not just those who report directly to you.

The worst thing that can happen is that your boss finds out something that you knew about, or should have known about, via an external source. This demonstrates that you do not have the pulse of your organization, and it limits or removes the time you otherwise might have had to gather further information, develop a consistent message and, most important, for your boss to control the flow of information up to his or her boss!

Of course this does not mean you should inundate your boss with information. An essential part of your job involves triaging the stuff that gets up the chain of command—what can you act on immediately and not even bother the boss with; what can you handle but should let him or her know about right away; and what you need to get clearance on before you act.

Knowing these levels of authority and using them to effectively keep your boss in the loop is essential for a good manager.

2. No ‘Second Opinions’

One of the most common occurrences in EMS agencies, especially in larger departments, is that employees will shop around for an opinion. They will go to one supervisor or manager with an issue, and if they don’t like the answer they get, they’ll simply go to another one. If they don’t like what mom says, they just go ask dad!

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Like in a family, this ends up being divisive. It creates conflict between mom and dad, and it can yield inconsistency that can damage operations and create human resources problems. In a family, it’s fairly easy to prevent this from happening. In an organization it’s much more challenging.

The solution to this is regular, ongoing and detailed communication between relevant personnel, but this is easier said than done. Communication should be both horizontal (for example, between different supervisors on other shifts or around parts of a larger system) and vertical (up and down the chain of command). There is no magic bullet for this, as each system has different structures and needs. You can use a daily operational huddle, where everyone on shift spends 15 or 30 minutes getting on the same page and raising any issues. You can use a reporting system that lets you track issues from shift to shift and makes a record for retrospective analysis. You can have regular meetings or conference calls among functional units to share information.

In the end this issue is best addressed by awareness and constant vigilance. Always be on the lookout for someone “playing” you in this way, and you can take a few steps personally to help prevent it from happening. First, slow down in your decision-making. We have a natural instinct to try to resolve issues as quickly as possible and move to the next fix, but in doing so we often skip steps and fail to get the best outcome. Ask why something is happening and if someone else has been involved in the process. Then take a few minutes to validate the information you have. Check the records, pick up a phone and call someone or send a quick e-mail inquiry. If you have to make a snap decision and it turns out you got played, don’t let that go unaddressed. Make sure you close that loop with the other supervisor or manager involved and go back to the employee and ensure it never happens again. 

3. Lateralize Yourself

It’s extremely common for leaders to fall into the trap of staying in their own domains. They end up in a silo or get “ivory tower” syndrome. Maybe you’re overworked, so it’s all you can do just to get your own work done. Or perhaps you have a colleague who’s not pulling their weight, and if you look over the fence into their area, you’ll get sucked into doing their work in addition to yours.

The most successful managers work diligently to break down the silo walls and know what’s going on in other functional areas. This is very hard work, as it requires additional effort to work outside your comfort zone. Often other managers will see this as threatening and might not want to share their toys in the sandbox. The key to solving this issue, as discussed above, is regular communications. If you share your toys, people are more likely to share theirs in return. Give information, look for collaborative solutions and remember that the goal is a department that excels.

4. Vary Your Communication

Everyone has their strengths and weaknesses, and that extends to their methods of communication. Some people excel at written communications, while others are skilled at public speaking. Some people prefer e-mail or telephone calls or memoranda. In fact, some people are terrible at communicating and prefer to keep their heads down and not be noticed. This is not, unfortunately, a recipe for long-term leadership success.

You should learn multiple ways of communicating, because your employees have different ways of consuming information. If you’re a verbal rock star, preferring to talk to people face to face or via telephone, you’re going to miss an entire segment of the population with whom you can’t make personal contact. Similarly, if your preference is to shoot off a quick e-mail, there are large numbers of people who skim those without really processing the information or just delete them without ever reading them. Remember the marketing rule that people do not retain a message until they’ve heard it three times. If you’re concentrating on one form of communication over others, you’re not getting your message heard.

Finally, with written communications have a second person proofread every single thing you send out to both general and “important” audiences. Nothing destroys your credibility faster than having a spelling or grammatical error in your e-mail or letter. It’s also extremely helpful to have someone watch your back for tone and for sensitive topics you might have missed. Have a trusted source help you with this process—it will improve your communication, help break down those silos and prevent you from being embarrassed.

5. Learn How to Manage Time

In hiring employees I believe the single most important quality to look for is a strong work ethic. You can teach people the skills of a job, but you cannot reach them how to be a hard worker. Similarly, once you reach the manager level, the most important skill you can learn is time management. You can learn or develop the functional skills you need to do your job, but not if you don’t have enough time to get the job done.

The first part of time management is to learn how to budget time. Learn how long it takes to get things done, and make sure you have enough time to make them happen. Set deadlines knowing how long it will take to accomplish tasks. Calculate travel time to and from meetings, including walking, so you’re not late. And be realistic about your expectations, as you’re only hurting yourself if you underbudget.

Next, develop a system for managing your calendar and ongoing tasks. There are countless systems for this, from pen and paper to extremely advanced electronic systems. Figure out what works for you and make sure it works with the technology in your system. Don’t keep a paper calendar nobody else can see if your department expects you to put all your appointments in Outlook so people can send you invites. The most important part of your system is that it has to be with you where you work. If you have a paper planner in your office, it’s not going to do you any good at a meeting out of the office. If you have Outlook on your desktop computer but cannot access it remotely, it presents similar issues. Look for interoperable solutions, but those you can use wherever you’re working.

Finally, protect your time as much as you can. There are constant, regular erosions of this precious resource in the workplace. People will invite you to meetings you don’t need to attend or schedule meetings where a phone call or e-mail might suffice. They will schedule meetings at times that interrupt your normal workflow and limit your productivity. But you can also have self-inflicted wounds when it comes to time management: Distractions to answer e-mails or telephone calls while working on a project will derail your activity, and it takes longer to get back on task than to keep working in the first place. Try to limit the periods where you answer e-mails and only answer calls during productive periods when it is absolutely essential. And try not to let people interrupt you indiscriminately. An open-door policy is a must for an effective leader, but there’s nothing wrong with telling someone you’re in the middle of an activity and will get back to them at a specified time.

6. Never ‘Fire and Forget’

In our 24/7 work environment, as we try to protect our valuable time, get the job done and still manage to have a work-life balance, it’s easy to fire and forget. Part of this is related to being a good manager. We want to empower our employees to make good decisions within their authority, and we’re always cautioned against second-guessing or micromanaging.

A natural tendency of these combined factors is to give people tasks and assume they’ve accomplished them. It doesn’t always work this way. They have competing pressures and varying degrees of effectiveness, and sometimes they drop the proverbial ball. Part of being a manager is actually managing, and this involves staying on top of the people who work for you and making sure their jobs are actually getting done. Of course this itself is a balancing act, as you don’t want to overmanage.

Try to use objective, definitive tools to accomplish this. When you delegate a task, establish clear goals and realistic deadlines for any waypoints you have to reach. This is another place where your time-management system must be utilized to make sure you don’t miss a deadline or let a critical task get pushed further and further off the priority list until it’s simply forgotten about. 

E-mail is a double-edged sword for communications, but there are times when it can be very useful, and task management is one of them. Establishing responsibilities, goals and deadlines in an e-mail, distributing it and archiving it for later reference will help make sure everyone’s on the same page and give you something to refer back to should it become necessary.

The key point in managing, at every level, is accountability. Everyone in an organization, from top to bottom, should be held accountable for his or her actions and to some reasonable objective standard. Remember, you set an example in this area, and so do the people above you. If they’re not following up or are letting projects fall by the wayside, then the people down the chain of command will see this and model their behavior accordingly.

7. Manage Your Boss

The term “managing your boss” is fraught with danger, but it’s the final key to success. Each person has strengths and weaknesses, preferences for how they work and manage time, and their own special set of needs to be successful. As a manager you should pay special attention to all of these elements in the person to whom you directly report.

If you can anticipate your boss’ needs, imagine how much more successful he or she will be. If you know your boss is always late to meetings, help them manage their schedule so they can get out the door on time. If you know your boss hasn’t read their e-mails yet today but there’s something critical they need to know, pick up the phone and call them. This can extend to numerous other areas, even to the point of having a cup of coffee ready at a meeting to make sure your boss is fully engaged. 

Now to the dangerous part: Never “play” your boss. You can’t ever shield them from information you don’t want them to know, try to steer their decision-making or isolate them from what’s happening below them. This is extremely common; unfortunately so when your direct boss is less than effective in their role. But if you get caught doing this, your trust relationship will be irreparably harmed. Earlier we discussed how important this trust is.

If your boss finds out you’re trying to manipulate them, consider your trust bank balance reset to zero.


Information is your friend. In fact, the common thread in all these keys to success is that they require good information, and that the information be communicated where and when it’s most effective. Remember that one point, and you will dramatically improve your success.

Finally, consider that your role is to be the link between large areas of an organization and the top brass. One of the common titles used is “chief of staff,” and you have to decide how you want to emphasize these words. Are you going to be the chief of staff or the chief of staff? The most successful servant leaders focus on the staff, and the authority of being a chief comes naturally. If you focus on being the title of chief, you will never have the respect of your staff.  

Matthew R. Streger, Esq., is a member of the EMS World editorial advisory board and a member of the law firm Keavney & Streger in Princeton, N.J. He has over 30 years of experience in EMS in a wide variety of roles and locations.

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