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Management of EMS


Management of EMS Cover


Synopses & Reviews

Publisher Comments:

Bruce E Evans, NREMT-P

Jeff T Dyar, NREMT-P


Management of EMS


EMS Management for the Fire Service brings value as a single source for the unique challenge of the management of Emergency Medical Services within the Fire Department, both for officers currently practicing as well as a training resource.


The career development model of the National Fire Academy, and the model curriculum of the Fire Emergency Service Higher Education (FESHE) group, industry leaders in fire service education and training, served as a basis for this important text. Being leaders in the field and having years of meaningful hands-on experience and a passion for EMS, the authors bring a real-life approach to this text.   This text covers all the elements of EMS management from core competencies such as strategic planning, training and education and fleet management to the legal, financial, and ethical aspects of good EMS management. Retaining its value beyond the EMS management class, groups of chapters from this text can also be used in other FESHE courses on QI/QA, Safety, and EMS Systems.


Features include: 

  • Text is built around the model curriculum of the Fire Emergency Services Higher Education (FESHE) of the National Fire Academy.
  • Offers coverage for accrediting agencies including CAAS.
  • Protocols and examples are covered in every chapter, along with a related story of a successful event. 
  • Includes steps to achieving the Malcolm Baldridge Award, the government’s highest award for quality.
  • Key Terms emphasize core concepts and provide clearer understanding.
  • Review Questions challenge the reader to remember key points.
  • Internet References provide web links and additional resources thatimprove usefulness of the text for the reader. 

Visit for Other Titles of Interest:

Bennett, Fire Service Law (0-13-155288-0)

Bruegman, Fire Administration I (0-13-118320-6)

Edwards, Fire Service Personnel Management, 2e (0-13-117766-4)

Politano, Public Information Officer (0-13-171923-8)

Wong/Olson, Multicultural and Diversity Strategies for the Fire Service (0-13-238807-3) 


Management of EMS offers a solid resource to help readers learn how to fearlessly take on the unique challenges of EMS Management, including the strategic planning needed to create comprehensive and successful EMS Management programs. 


Teaching and Learning Experience

  • Provides protocol and examples, along with real-life stories of success
  • Offers a solid resource for frontline EMS supervisors


Management of EMS utilizes the career development model of the National Fire Academy and the model curriculum of the Fire Emergency Service Higher Education (FESHE) group, to provide both officers and students alike with all of the elements of EMS management from core competencies, such as strategic planning, training and education, and fleet management to the legal, financial, and ethical aspects of good EMS management. Years of meaningful hands-on experience and a passion for EMS, enable the authors to bring a real-life approach to this text. Retaining its value beyond the EMS management class, groups of chapters from this text can also be used in other FESHE courses on QI/QA, Safety, and EMS Systems.

About the Author


Bruce Evans is the EMS Chief at the North Las Vegas Fire Department in Las Vegas, Nevada.  Mr. Evans is an NFPA Fire Instructor III and coordinates the College of Southern Nevada’s Fire Technology programs teaching various fire and EMS topics.  Bruce has over 25 years experience in a variety of EMS settings.  Bruce is an adjunct faculty of the National Fire Academy in the EMS, Incident Management, and Terrorism Training programs.  He holds a Masters degree in Public Administration, Bachelors degree in Education, and Associates in Fire Management.  Bruce is a certified faculty for the International Public Safety Leadership and Ethics training with Phi theta Kappa.  Mr. Evans publishes the bi-monthly column EMS Viewpoints in Fire Chief Magazine and is on the editorial board of for the Journal of Emergency Medical Services.  He is also a board member for the Cyanide Treatment Coalition.           

Table of Contents

Table of Contents




Chapter 1: Government Structure and EMS

The Beginning of EMS

            The History of Prehospital Emergency Medicine

            Federal Initiatives

The EMS System

            The EMS Agenda for the Future

Federal Government and EMS

Department of Transportation/National Highway Traffic Administration

Office of Domestic Preparedness

Health and Human Services

Federal Communications Commission

State Organizations and Activities

State Initiatives

State EMS Offices

County and Local Governments

            Other Government Interactions

Professional Organizations

            Management Organizations

            Unions and Labor Groups

            Trade and Advocacy Groups

            Physicians Groups

            Aeromedical Associations

            Standards Setting Organizations

            Accreditation Agencies with EMS Interest

            Provider Associations

            Lobby Organizations


Chapter 2: Strategic Planning for EMS

Benefits of Strategic Planning

            Setting the Stage for Strategic Planning

Overview of a Strategic Plan

            Balanced Scorecard

            Contingency Model of Strategic Planning

            Planning Processes

            Clearly Defined Mission and Vision


SWOT Analysis

            How to Use a SWOT Analysis

            Internal Characteristics: Strengths and Weaknesses

            External Characteristics: Opportunities and Threats

            Clearly Defined Goals and Objectives

Costing Out Planning Process

            Economies of Scale

            Work Load Indicators

            Capital Expenses

            Operating Expenses

            Facility Cost

            Capital Equipment Cost

            Personnel Cost

            Problem Research Techniques

            Who Is Involved with the Problem or Budget Item?

            Project and Program Management

Tools for Strategic Planning

            Critical Path Method


Strategic Plan as a Living Document

            Business Plan

            Strategic Quality Planning at the State of Regional Level

            State and Regional Vision

            Strategic Quality Planning Structure

Chapter 3: Manager to Leader

Origins of Management

The Role of Management

            Values Statements


            Managing Power

Management Defined

            Basic Management Skills

Management Processes

            Employee Needs, What Employees Want

            Increase Supervisor/Subordinate Communication

            Foster a Supportive Work Environment

            Delegate Tasks When Appropriate

            Institute Sound Performance Appraisal and Coaching Programs

Motivation and Building Teams

            Foundations of Motivation

            Team Building and Participation


            What is the Same? What is Different?   

            Leadership Defined

            Establishing Vision for the Organization

Leadership Styles



            Managing E-mail

            Communicating with People

            Conflict Resolution

            Ethics and the Leader

Succession Planning



Leadership Failures

            Why EMS Leadership Fails and Why EMS Teams Fail

Chapter 4: Injury Prevention and EMS

Introduction to Injury Prevention

            History of Injury Prevention

            Injury Prevention Programs

Databases and Injury Prevention

Science of Injury Prevention

            Public Health Model

            Epidemiological Model

            Haddon Matrix

            Access, Interpret, Use, and Present Injury Data

Framing an Injury Problem

            Finding Data to Define the Injury Problem

            Federal Cost Tracking


            The Spectrum of Prevention

Putting It to Action

            Injury Prevention Leadership

            Implementing These Strategies at the Community Level

            Funding Strategies

            Collaborative Approaches

Best Practices in Injury Prevention

            Safe Communities

The EPIC Medics Story A Local Paramedic Initiative

Frisco Fire Safety Town Project

Seattle Bike Helmet Program


Evaluating Injury Prevention Programs

Time to Implement

Chapter 5: Marketing and Customer Service

Introduction to Customer Service

Customer Relations

            EMS Service Benchmarking

Public Information, Education, and Relations (PIER)

            The Importance of Public Education

            Applying a Fire Protection Model to Injury Prevention

            Interacting with the Media

            Handling a Crisis

            Media Mitigation

            Types of Media Available to EMS       

            Life Safety Education Program

            Community Relations and Citizenry

Image Building Programs


            Citizen Relations

            Celebrate with the Community

            Planning Special Events


            Developing a Marketing Plan

            Assessing Customers

Resolving Customer Complaints

            Complaint Databases

            Internal Customer Service Programs

            Creating and Environment of Sharing and Helping

Chapter 6: Risk Management and Safety

Defining Risk Management

            Risk Management Process

Identifying Risks

            Identifying and Measuring Risk

            Near Miss Reporting Systems

Methods of Managing Risk

            Analysis of System Failure

            Conducting an Investigation


            Successful Programs

            Crew Resource Management

            EMS Near-Miss Program

            Psychological Applications

FDA Equipment Failure and Medication Reactions

Infection Control

            Laws, Standards, and Regulations

            Guidelines for Responding to Infectious Disease Exposures

OSHA Standards for Occupational Injuries and Illness

            What is an Occupational Disease?

NFPA 1581 Consensus Standard

            State or Local Legislation that Protects Workers

Building an Infection Control Program

            Components of the Plan

            Infection Control Officer

            Infection Control Training

            Equipment Needs

            Decontamination Areas

Occupational Exposures


            The chain of Infection

            Modes of Transmission

            Defining an Exposure

            Reporting Exposures

            Documenting Exposures

Post Exposure

            Occupational Exposures

Reporting Requirements

What are the Privacy Issues?

Components of an Infection Control Program

EMS Safety

            Safety Education

            Why Safety?

Top Five Injuries for EMS Workers

            Back Injuries

            Exposure to Infectious Diseases

            Injuries Sustained on Highway Operations or Scenes

            Vehicle Crashes Responding to Code 3, Lights and Siren

            Assaults on EMS

Chapter 7: EMS Human Resources Management

The EMS Workforce

            Human Resources Activities for Staffing

            Generational Bridges

            Motivation Tools for Different Generations

Job Analysis and Design          

            Methods of Assessing Job Standards

            Job Descriptions and Specifications

            The DACUM Process


            Disparate Impact

            The Griggs Decision



            Written Exams

            Physical Abilities Test


            Psychological Resources

            Academic Predictors for Health Care Workers

Assessment Center Process

            Meyers Briggs

            Background Checks

            Medical Exams

            Drug Testing

Employee Satisfaction and Retention

Legal Issues in Human Resources


            Fair Labor Standards

Collective Bargaining

            What are Mandatory Subjects of Bargaining?

            Grievance Procedures and Discipline

            Conflict Resolution

            Fact Finding/Non-binding Arbitration


Performance Appraisal and Incentives

            Building a Performance Appraisal

            Conducting Appraisals

            Problems Affecting the Performance Appraisal Process

            Rating Errors

            Performance Appraisal Process Errors

            360 Degree Evaluations

Sexual Harassment

            Ethics and Conduct

Employee Safety

            Workplace Violence

            Preventive Practices

            Identifying Problem Situations and Risk Factors of Current Employees

            Employee Assistance Programs

Chapter 8: Management of EMS Education

EMS Education and the Manager

History of EMS Education

The Future Framework of EMS Education

            National EMS Framework and Practice Blueprint

EMS Education Agenda for the Future

            National EMS Core Content

            EMS Scope of Practice

            National EMS Education Standards

            National EMS Program Accreditation

            National EMS Certification

            Paramedic Education Program Accreditation

Current Curriculums

            Pre EMS

National Standard Curriculums

            1998 Paramedic Training

            EMS Instructor Education

            Emergency Vehicle Operations Course

Inservice Training

Refresher Training

            EMT Intermediate Recertification

            Paramedic Recertification

Continuing Education

Continuing Education Programs

            Pediatric Education

            Trauma Continuing Education

            Medical Continuing Education

Accredited Education

Design of EMS Training

            Active Learning

            Creative Ideas for EMS Training

            Distributive Learning

Management Efforts toward EMS Education

            Evaluation of Training

            Maintaining EMS Education Records

            Attending Committee Meeting

            Maintaining Clinical and Teaching Experience

Psychomotor Education

            Skills Performance

            Preceptor Programs

Training to the Affective Domain

            Affective Domain

            Core Values Training

            ICARE Program

Leadership Training Programs

            Not-for-Profit Leadership Training

            Federal Leadership Training

            Other EMS Leadership Training Programs

            Academic EMS Management Programs

Chapter 9: Financial Management

Financial Requirements and Billing

            Marginal Costing


            Medicare Part B

            Scheduled Transfers

            Future Medicare Changes

            Billing Third Party Payees

            HMO Contracting

Financial Policy


            EMS Budgets

            Economies of Scale

Costing Out Service

            Cost Per Response

            Calculating Unit Hours

            Calculating Unit Hour Utilization

            Benchmarks of Unit Hour Utilization

            Seasonal Variations

            Estimating Delays for Ambulance Service                     

            Managing Unit Hours

            Determining Number of Personnel

            Subsidy Price Tradeoff

Funding Mechanisms

            Ambulance Membership Programs

            Non Transport MVA Reimbursement

            First Responder Fees

            Future Reimbursement Issues

            Billing Service

            Foundation, Associations, and Non-profit Structures

            Financial Reports

Chapter 10: Medical Practice

Medical Leadership

            Medical Authority

            The Role of the Agency Medical Director

Physician Organizations for EMS

Physician Involvement

            Support of Medical Directors

            The Medical Director’s Role in 911 Communication Center

Relations with the Medical Director


Online and Off-line Medical Control


            Protocol Development

On-line Medical Control          

            On-line System Design

            Offline Medical Direction


            Affiliation and Ethical Constraints

            Physician Providing Quality Leadership

            Other Sources of Information

            Medical Incident Review

Situations Requiring Immediate Involvement

            Unrecognized Esophageal Intubation

             Inappropriate Medical Care and Inappropriate Withholding of Medical Care

          Substance Abuse among Medics

Chapter 11: Fleet Management

Fleet Management and Equipment

          Fleet Management

          Verifying and Maintaining Check List

          Ambulance Specifications

          Ambulance Types, Classes, and Configurations

          Specification Processes

          Procurement Process     

          Ethical Considerations and Bidders

          RFP Construction

          Scoring and Evaluating Bids

          Vehicle Inspections

          Training and In-Service

Monitoring Cost in Fleets

          Vehicle Costs    

          Cost Tracking Software

          Calculating Unit Hour Cost

          Cost Per Mile

Medical Equipment

Vehicle Maintenance

          Vehicle/Equipment Failures

          Planned Maintenance

          Preventive Maintenance

          Corrective Maintenance

          Replacement Considerations


          Training and Certification

          Accident Reports


Chapter 12: Career Development and Staff Focus

The Need for Professional Development

          Professional Development

          IAFC Officer Development Handbook

          The National Highway Safety and Traffic Administration and the Baldridge Criteria

          Malcolm Baldridge and Professional Development

Education Opportunities

          Collegiate Education

          EMS Model Curriculum

          University Programs

          Skills Acquisition


          Job Experience and Rotations

Personal Skills

Key Concepts

          Entering a New Position

          Stabilize Personal Issues

Liaison Activities 

          Internal Customers

          Government Relations


          National Outreach

          The Personal Career Path Plan


          Finding a Mentor

          Mentorship Experiences

Community Relationships and Citizenry


Succession Plans

          How Succession Planning Helps

          Succession Planning

          Why Do People Often Put Off Succession Planning?

Chapter 13: EMS Quality Management

Quality in EMS: A Necessity

History of Quality Improvement in EMS

          Total Quality Management (TQM)

          Six Sigma

          EMS Quality Improvement

          Justifying Quality Improvement

          Comprehensive Quality Management

Implementing Quality Improvement Programs

          Building a Successful Program

          Service Audit

          Establishing Goals

          Identify and Develop Standards of Care

          Objectives and Performance Indicators

          IAFF Performance Indicators

          State EMS Performance Indicators


          Cardiac Arrest Outcomes

          Sentinel Events

          Develop CQI Programs/Processes

          Quality Assurance

          QI Process Steps

          Expanding Knowledge

          Full Integration and Monitoring

          Baldridge Criteria

          JCAHO Accreditation

          Human Resource Needs

          Provider Feedback and Access

          Linking Results to Education


          What Causes QI Efforts to Fail?

          QI and the Law

Chapter 14: Incident Management

History of Incident Management for Emergency Medical Services


          The History of the Incident Command System

          Variations on the Theme

National Incident Management System

          Types of Command Teams

          Elements of an Effective Incident Management System

          Business Management Techniques Applied to Incident Management

          Factors that Affect Incident Management

          What is NIMS ICS?

          ICS Management Characteristics

          ICS Command Staff

          Unified Command

          General Staff

          Area Command

          Divisions and Groups

NIMS ICS Applied to EMS Incidents

Air Operations at EMS Incidents

          Designate Landing Zones (LZs)

          Helispot Manager

          Helibase Manager

          The Difference between NIMS ICS and FIRESCOPE/NIIMS ICS

          ICS as Taught by the Department of Homeland Security

          Available NIMS ICS Training

          The Future of NIMS ICS Training

          Mass Casualty Terminology

Resource Allocation

Pre-Planning Special Events

          Incident Action Plans

          Meet with Involved Agencies

Chapter 15: Interagency Relations and Operations

Interagency Communication and Cooperation

Interface with External Agencies

          EMS Interaction within the Healthcare System

          Competing Emergency Service Interests

          Tiered or Dual-response Agencies

          EMS Interaction with Home Health

          Single Command with Assisting Agencies

          Hazardous Materials Response

          Unified Command and Area Command

EMS “All-Hazard” Approach

          Plan Components

          Resource Acquisition

          Mutual-Aid Agreements

Local Emergency Planning Committee Plans

          Regional Resource Response Plans

          State Emergency Operation Plan

          Interstate Resource Response Plans

          Federal Mutual Aid Initiatives

          Automated Resource Management Systems (ARMS)

          National Credentialing System

Disaster Condition

National Response Plan Assumptions

          The Plans Concept of Operations

Organization of Efforts

          National-level Response Structure

          Regional-level Response Structure

          Regional Operations Center

          Emergency Response Team

          Disaster Medical Assistance Team (DMAT)

          Metropolitan Medical Response System

Chapter 16: Data Collection and EMS Research

The Outcome and Research Challenge

          EMS and Research Agenda

          EMS Reports and Collection Techniques

          Integrated Information Management Systems

Domains of EMS Research

          Types of Research

          Research Methodologies

Data Tools

          Central Tendency

          Uses for Measures of Central Tendency

          Measures of Dispersion

          Data Entry and Data Quality

          Data Collection Tools and Trends

          Longitudinal Data

The National Data Collection Efforts

          Uniform Data Set

          Hospital Collection of EMS Data

          Federal Coordination of Health Care Research

          National EMS Information System

          EMS Outcomes Project

          Trauma Registry

          Motor Vehicle Crash Data

          Cardiac Arrest Data

          Airway Data

          Special Project Data

          Managing GIS Systems

          Automatic Vehicle Locators

Research Outcomes

          Literature Reviews

          Research Tools and Techniques


          Types of Voting

          Run Chart


          Bar Charts

          Pie Charts

          Cause and Effect Diagram


          Pareto Diagram

Ethics and Research

Chapter 17: Legal and Labor Relations

The Law

Legal Applications

          Federal Legislation and EMS

          UMC Quick Core Stuff

Ambulance Diversion

          Privacy Law

          Lawsuit Progression

State Laws


          Right to Provide Service

          Immunity from Liability   

          Fair Labor Standards

Labor Relations

          Landmark Legal Cases

Collective Bargaining

          Arbitration and Mediation


          Due Process and EMS Performance

          Garrity Rule

          Physician Prerogative

          EMS Pay Differentials

Legal Trends in EMS

          Civil Rights

          First Amendment Rights

          Communication Litigation

          Vehicle Accidents

          Medical Malpractice

Ethics in EMS

          Ethical Decision Making

Chapter 18: EMS Management of Communication Centers

History of Emergency Medical Dispatch

          Types of Centers

          Certification Standards


          Role of Communication Centers

          Components of the Communication System

Diversity and Disability

Management of Communication Centers

          Selection and Evaluation

          Case Law

          System Status Management

          Quality Improvement Processes

          Continuing Dispatch Education (CDE)

          Additional Training

          Case Study: Phoenix Fire



          Communication Unit Leader Position

          Communication System in Disaster Mode

The Future of the Communication Center

Chapter 19: EMS Special Operations

Importance of Special Operations

Emergency Medical Services Organization’s Components During Routine and Special Operations

Emergency Medical Services Preplanning

Managing EMS Special Operations

          EMS All-Hazards Approach

Mass Gatherings

          Pre-event planning matrix

          Event Public Health and EMS Surveys

          All-Hazards Approach Influences

          Plan Components

          Mutual-Aid Agreements

Disaster Condition

          Level of Care

          Main Concerns in Planning Medical Care


          Medical Access to Venue

          Medical Requirements

          Medical Teams

          Mobile Teams

          Medical Aid Stations

          Site Hospital

          Medical Equipment


          Ambulance Vehicles

          Other Medical Considerations

          Legal Issues


Contingency Plans

General Considerations

          Mass Gathering and Crush Load

          EMS Operations at Mass Gathering Events

          Mass Care and Special Needs Populations

Basic Red Cross Organization

          Shelter Operations

Minimizing Emergency Medical Services System Burdens

          Assignment of EMS Resources to Shelters

EMS Special Teams

          Tactical Emergency Medical Support

          Bike Teams and Alternative Response Programs

Protective Operations

          Causes of Assassinations

          Tactics to Counter Assassination Methods

          Organization of Protective Details

          Security for the Protectee in Residence

          The Command Post

          The Safe Haven

          Security Perimeters at an Office

          Hotel Security

          EMS Protection Levels

          Direct Contact with the President or VIP

          A Final Note Concerning Diplomats

          Helicopter Teams

          Medical Support of Hazardous Materials Operations

USAR and Technical Rescue

          Structural Collapse







































Product Details

Evans, Bruce E., Mpa
Prentice Hall
Loyd, Jason B.
Evans, Bruce E., MPA
Evans, Bruce MPA
Dyar, Jeffrey T., NREMT-P
Evans, Bruce E.
Bruce E. Evans MPA
Bruce Evans MPA
Evans, Bruce
Evans, Bruce T, MPA
Dyar, Jeff T.
Jeffrey T. Dyar NREMT-P
Dyar, Jeff
Bruce T Evans MPA
Dyar, Jeffrey T.
Fire Science
Fire extinction
Fire protection.
Emergency medical services
Edition Description:
Trade paper
Publication Date:
January 2009
Grade Level:
College/higher education:
9.8 x 8 x 1.1 in 1021 gr

Related Subjects

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Health and Self-Help » Health and Medicine » Medical Specialties
Health and Self-Help » Safety » Fire
History and Social Science » Law » General
History and Social Science » Linguistics » Specific Languages and Groups
Reference » Words Phrases and Language
Textbooks » General

Management of EMS New Trade Paper
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$102.25 In Stock
Product details 528 pages Prentice Hall - English 9780132324328 Reviews:
"Synopsis" by ,

Management of EMS offers a solid resource to help readers learn how to fearlessly take on the unique challenges of EMS Management, including the strategic planning needed to create comprehensive and successful EMS Management programs. 


Teaching and Learning Experience

  • Provides protocol and examples, along with real-life stories of success
  • Offers a solid resource for frontline EMS supervisors
"Synopsis" by , Management of EMS utilizes the career development model of the National Fire Academy and the model curriculum of the Fire Emergency Service Higher Education (FESHE) group, to provide both officers and students alike with all of the elements of EMS management from core competencies, such as strategic planning, training and education, and fleet management to the legal, financial, and ethical aspects of good EMS management. Years of meaningful hands-on experience and a passion for EMS, enable the authors to bring a real-life approach to this text. Retaining its value beyond the EMS management class, groups of chapters from this text can also be used in other FESHE courses on QI/QA, Safety, and EMS Systems.
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