Avesta Partners with AAA for EMS Industry Turnover Study

Avesta partnered with the American Ambulance Association (AAA) to complete a survey on the EMS industry turnover. Identifying the industry standard for turnover is the crucial first step to then effectively measuring the reduction of EMS employee turnover by implemented methods. Avesta’s President, Greg Lawton, has long focused on reducing EMS turnover and stated “everyone believes their region is the toughest in which to recruit (EMTs and paramedics). The turnover problem is across the board.” With the new benchmark of EMS turnover, the study then focused on causes of voluntary retention and methods to practice in reducing voluntary turnover that can be executed nationwide. Avesta is proud to have participated in this original study and looks forward to the continued partnership with AAA, Dr. Dennis Doverspike and the Center for Organizational Research at the University of Akron.

The project was managed by Dr. Dennis Doverspike, Avesta’s lead Industrial/Organizational Psychology consultant and his research team at the Center for Organizational Research at the University of Akron.

For an excellent summary of the study by Greg Friese, Editor-in-Chief at EMS1.com, click here.

Knowing the high turnover problem exists for many industries, Avesta has focused their software and services on providing employers the tools to reduce employee turnover. To learn how Avesta can help your company reduce turnover, click here.

Attracting and Maintaining Top Talent

Next year, two out of five EMTs and paramedics who currently work for your competitors will look for another job; yet, finding skilled EMS clinicians is becoming remarkably difficult. This is because EMS organizations of all sizes are competing for a limited talent pool.

It doesn’t help that paramedics are becoming more specialized and are practicing their profession in a variety of settings. Whether it’s a private ambulance company, fire department, community medicine facility or hospital, recruitment competition is fierce.

Avesta is tuned into the EMS industry and can help you aggressively attract the most qualified EMS clinicians.


Understanding the motivations of the folks that you are recruiting.

When it comes to recruiting millennial EMS clinicians, it’s important to realize many experienced EMTs and paramedics are not actively looking for a job. However, they are eager and willing to change employers for the right opportunity.

Our experience at Avesta demonstrates that compensation, although important, is not the only key to attracting qualified millennials. This finding was further reinforced by a Gallup Poll conducted in 2017, which identified “opportunity to learn and grow” and “quality of management” as essential elements to an organization’s branding message when it comes to appealing to today’s young professionals.

In other words, pay is important but cannot normally be used as a differentiator in EMS recruitment campaigns. There needs to be a focus on equipment, clinical protocols, experience supervision teams, and a caring organization.

Are you an organization that is willing to try new strategies to attract talent?

Do you have the best leadership? Do your paramedics get the opportunity to participate in the development of your clinical program? Do you have a plan for work-life balance? Can you articulate a plan for helping EMS clinicians advance in your organization?

Understanding what EMS Clinicians want is half of the challenge. The other half is creating a high performing EMS recruitment strategy. Trends from our referral database suggest there are primarily two ways to find top EMS talent:

  1. Employee referrals – If a paramedic or EMT is happy with the organization they work for, they will bring friends with them. Recognition and retention within your organization should be a highlight that makes you stand out.
  2. Employ an aggressive, high-touch recruitment campaign – Recruitment of qualified talent is similar in context to your organizational sales and marketing strategy. The recruitment strategy must include several different approaches that are all tied together with a common theme.

Over the past eleven years, Avesta has worked with hundreds of EMS providers to create recruitment best practices, for example:

CandidateCare (Recruitment & Applicant Tracking Software):  Avesta’s CandidateCare software is the leading recruitment, selection, and hiring solution in the EMS industry. The program has processed and vetted over 1.5 million applications for EMS jobs.

CandidateCare recruitment properties:

  • Get access to thousands of job boards.
  • Increase engagement with branded career portals job seekers can explore on any device
  • Provide recruitment metrics and reporting
  • Manage recruitment process and documents

Social Media Automation: Start the conversation with passive candidates early. You can instantly link any open position to LinkedIn, Facebook, or Twitter. We simplify social recruitment with pre-built integrations with your corporate social profiles. In addition, you can track social media engagement.

Referral Data Tracking:  Tracking which job boards, social media sites, and campaigns attract your best candidates can help make better use of your recruitment budget. Avesta can build tracking pixels into your online recruitment campaigns to fully automate referral data tracking.

Employer Brand Development:  Nurture candidate relationships to reduce time to fill. Millennial EMS candidates normally conduct research on potential employers prior to applying for jobs. Your organization has a story to tell, and your employer brand has a significant impact on how passive candidates see your organization.  Avesta can assist you with a brand development campaign to enhance recruitment.

Job Board Online Optimization: Avesta can help you optimize the online range of your open positions. We integrate with key job boards such as Indeed and Zip Recruiter. Additionally, our software is built for mobile devices, ensuring that your job postings and applications format and scale to fit phones and tablets when opened through any job board. Finally, our staff can add comprehensive branding campaigns for your organization to most job boards.

You can also outsource all parts of your EMS recruitment through Avesta.

Recruitment Process Outsourcing (RPO):  We understand the discipline required for successful candidate sourcing in the competitive EMS market.  Avesta’s team of experienced EMS Recruiters and HR Support Specialists can provide additional, aggressive support to enhance your current recruitment resources.  Our team can identify and contact potential candidates, conduct application reviews, and administer online video-based interviews that include screen-sharing and recording. Furthermore, they can administer conditional offer letters or assist with the post-offer process.  Our method is customizable and scalable to meet your specific recruiting needs.

Predicting Safe Workplace Behavior

There’s never a good time to get clobbered while driving through an intersection. Unfortunately it happens far too often to ambulances and medical transportation vehicles. As managers in EMS, we prefer that our days be productive and free of accident investigations. Common sense and experience tell us that nearly all accidents are preventable. However, truly effecting change and creating a safer EMS work environment requires a focus on the attitudes and behaviors that lend themselves to accidents.

Sticking with the intersection accident theme, let’s think about the skills, abilities and behaviors that might help a driver change the outcome of an advancing accident. Research provides us with four information processing variables: visual and auditory attention, perception style, choice / reaction time and safe behavior (Arthur and Doverspike, 2001). The combination of the first three variables allows the driver to perceive the problem and then form an adequate response (Traffic Accidents; Causes and Outcomes, Bartley, 2008). The fourth indicator (behavior) guides the choice to circumvent a potentially dangerous situation. For example, a driver might avoid an accident by simply deciding to reduce speed prior to entering the intersection.

Removing high-risk behaviors from the equation will reduce the possibility of accidents. A behavior-based safety approach contends that both safe and at-risk behaviors can be altered through reward and punishment. The caveat, however, is that employees must first have the motivation and a safety-mindset to avoid risky behaviors. Values, motivation and personality traits define a person and determine whether they will choose to avoid risk. These traits remain relatively stable throughout life. According to researcher Paul T. Costa Jr., there is no evidence that our overall personalities change as we grow older. “What changes as you go through life are your roles and the issues that matter most to you”. Hence, it is nearly impossible to hire a person with high-risk behavior and change them. The best training programs in the industry are lost on individuals who are highly like to engage in high risk activity.

Fortunately, we can design programs to measure and predict which personality traits are a good fit for a particular job. This includes traits that lend themselves to a high propensity for safe behavior. To achieve this, we rely on the science of Industrial-Organizational (I-O) Psychology. I-O Psychologists are focused on the scientific study of employees, workplaces, and organizations. More importantly, their work provides empirical data to help support better hiring decisions and job performance by isolating and validating key behaviors that lead to success on the job.

I-O Psychologists initially direct their attention to relevant job-requirements through job analysis, which includes interviews and direct observation. For the purposes of this discussion, the focus is on key behaviors relative to an EMT job. Through job observation, we gain an understanding of the risks associated with the job. For example, we know that 79 percent of an EMT’s time is dedicated to driving. Or, on average, once during every eight hours of duty, an EMT will pick up a patient weighing at least 250 pounds (Avesta Physical Ability Study, Doverspike and Weber, 2012).

Next, the I-O Psychologists delve into the behaviors associated with job tasks and risks. Notably, they seek to understand the traits of incumbent EMTs who are most likely to achieve success by avoiding job-specific risks. From this over-simplified explanation of process, come the parameters of validation and the measurement of behaviors that allow us to predict job performance. In terms of predicting a safer EMS workplace, the focus centers on conscientiousness and compliance, predictors of work ethic and workplace rule compliance. Also, safety orientation, defined as the tendency to think and behave in ways that promote safety and prevent accidents from occurring (Avesta EMSI Validation Study, Whitaker, Whitaker and Weber 2007).

EMS organizations are routinely adding behavior-based screening and selection tools to their pre-hire process. The ultimate goal is to identify individuals who possess those behaviors most likely to fit the job. In addition to creating a safer work environment, this makes for a more legally defensible employee engagement process.

Training dollars are better spent on those employees that fit the job and possess an interest in safety. Effective recruitment and retention processes can effectively manage risks and control costs by screening out individuals who are most likely to exhibit unsafe behavior. Ultimately, who would you rather hire; the driver who habitually slows down prior to entering an intersection, or the person who shoots through the intersection in order to arrive on scene a few seconds earlier?

– Greg Lawton, President, Avesta

How Staffing Assessment Tools Work

Avesta helps clients build a consistent “compensatory” hiring and selection process. Our programs are intended to provide hiring managers with a measurable due-diligence process. A compensatory process includes a combination of three basic data elements about each candidate: Experience: what have they done? Motives: what do they want to do? Talents and Competency Do they possesses the ability and behaviors to “fit” the job.

Assessment tools can be broken into three general categories:

• Drug Screens, Background Checks and Physical-Abilities Tests measure very specific things about candidates’ history or personal characteristics. As a result, their effectiveness is limited primarily to jobs in which criminal history, drug use, and the ability to perform physical functions are significant employee-performance issues.

• Qualifications Screens and Knowledge Tests are good for measuring highly objective or “visible” things related to experience and motives such as education or salary expectations. It is relatively easy to build a 15-minute qualifications screen to “screen out” candidates who lack the minimum requirements for a job. However, qualifications screens are not effective for identifying less visible characteristics related to things such as problem-solving, honesty, leadership, or customer service. These measures are also relatively easy for candidates to fake.

• Talent Measures, Culture Fit and Values Inventories, Job Simulations, and Structured Interviews can effectively measure less visible candidate characteristics that influence job performance such as interpersonal style, motivation, and analytical skills. These assessment tools are good for “selecting in” candidates who not only can do the job, but also are likely to do it well. These tools are also among the most difficult to build and tend to require at least 30 minutes or more to complete. In addition, their complexity makes them susceptible to poor design and misuse. These tools should not be used unless a company is willing to spend the time and resources to ensure that they are used correctly.

The needs and goals of an organization determine which assessments to use:

Increasing Job Performance — If they are appropriately matched to the job, talent measures designed to assess work style and ability are usually the best predictors of job performance. Structured interviews and job simulations are also effective but require more time and resources from recruiters and/or hiring managers.

Increasing Tenure — Culture fit and values inventories tend to be the most effective for predicting tenure. Well-designed qualifications screens can also predict tenure, particularly for less complex entry-level jobs.

Increasing Staffing Efficiency — Qualifications screens tend to provide the highest level of return in terms of efficiently processing candidates. This is particularly true when they are integrated with a candidate-management or applicant-tracking system. Web-based talent measures can also be effective for rapidly evaluating candidates.

Decreasing Counterproductive Behavior – Personality tests, background checks, and drug screens tend to be the most effective for screening out candidates who are likely to engage in counterproductive behavior such as theft, drug use, or workplace aggression.