Literature Review: Emergency medical systems

A study by Patterson (2010) investigated the mean annual rate of turnover and

mean annual cost of turnover of emergency medical systems (EMS). Patterson studied

a sample of EMS agencies (n=40) over a six-month period. The rates of turnover and

cost of turnover was weighted against the size of the roster. In this study, the overall

weighted mean rate of turnover was 10.7%. This rate of turnover was less than hy-

pothesized. Patterson (2010) utilized a modified version of the Nursing Turnover Cost

Calculation Methodology (NTCCM) to calculate both the direct and indirect cost of

turnover. Of the forty agencies sampled in the study, twenty-five reported turnover

during the six-month sampling period. The overall weighted cost of turnover for those

experiencing turnover was $71, 613.75.

Toby (2004) studied the effects of learning and job satisfaction on the motivation

to transfer learning and on turnover. This side provided compelling evidence to sup-

port the importance of job satisfaction and education on employee retention. Toby

(2004) investigated they impact of human resource development (HRD) on the retention

or turnover intent on information technology (IT) professionals.

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Specifically, the pur-

pose of the study was to investigate the relationship among organizational learning cul-

ture, job satisfaction, motivation to transfer learning to the workplace setting, and

turnover intentions (Toby, 2004). Toby (2004) cites several studies that evidence a di-

rect correlation between organizations that prioritize employee learning and develop-

ment with employee satisfaction and productivity.

Toby (2004) found that many factors influenced employee satisfaction. Mean-

ingful work and promotion opportunities were found to be strong facets to job satisfac-

tion, in addition to organizational learning priorities. It was found that pay, benefits,

and work conditions had a smaller impact on employee satisfaction than originally

thought. Toby (2004) identified supervisory communication and employee engagement

in problem solving as strong indicators of employee satisfaction. Employee empow-

erment made a significant impact on job satisfaction.Literature Review: Emergency medical systems

Interestingly, Toby (2004) found that intention to transfer or turnover was

stronger in employees when training was deemed mandatory. However, when man-

agers believe the training was important in the development of skills and techniques

directly related to employee jobs were more successful in transferring knowledge and

was better received by employees. Organizational learning culture has a significant in-

fluence on developing employee satisfaction and reducing turnover intention. (Toby,

2004)

Chapman (2009) investigated the correlation of the reasons of intent to leave

jobs between emergency medical technicians (EMT) and paramedics. Using the Na-

tional Registry of Emergency Medical Technicians (NREMT) database and the 2007

longitudinal EMT attributes and demographic study (LEADS), Chapman (2009) sur-

veyed EMTs and paramedics (n=1,334). 5,807 surveys were mailed with a 23% return.

Chapman (2009) found job satisfaction was not higher for paramedics than EMTs de-

spite higher pay. In fact, paramedics reported lower extrinsic job satisfaction. Para-

medics tended to require opportunities for advancement and higher quality supervision

than EMTs. (Chapman, 2009)

Patterson (2009) used the 2005 LEADS survey to take a secondary, cross-sec-

tional study of 1,854 respondents (30.8% response rate). 380 respondents (20%) were

excluded for exclusion criteria or missing data. The study revealed a few key indica-

tors for job satisfaction of EMTs and paramedics. Opportunities for advancement

tends to be highly associated with job satisfaction, in addition to education, overall

health, and type of agency. The study also found EMS professionals expressed more

dissatisfaction with pay and benefits than other allied health professionals. Patterson

(2009) noted the median annual income for EMTs and paramedics, in 2006, as $27,070,

42% less than the average median income among firefighters, nurses, physical therapy

assistants, police officers and detectives, and teachers during the same period.

Blau (2009) investigated a four-dimension of model of occupational commit-

ment, comprised of affective, normative, accumulated costs, and limited alternatives to

study intent to leave EMS. A sample of EMS respondents (n=854) revealed a strong

inverse correlation with job satisfaction and intent to leave. Blau (2009) states a gener-

al importance of pay, benefits, and opportunity for advancement to retention. Howev-

er, Blau (2009) explicitly cites “continuing education, including professional develop-

ment opportunities, will be important for the retention of EMS professionals.” A similar

study conducted by Blau (2011) identifies “better pay and benefits desire, lack of ad-

vancement potential, number of hours worked, lack of flexible schedule, and stressed/

burned-out items” are suggestive of “hygiene” factors related to intent to turnover,

while pursuing further education and lack of challenges as “motivator” factors. The

motivator factors suggest the presence of responders that are not unhappy with EMS,

rather they use EMS as a career strategy to career advancement. (Blau, 2011)

Career planning plays a major role in career satisfaction for those in EMS. (Car-

son, 1998) According to Carson (1998), goal setting helps to focus attention, direct ef-

forts, increase persistence, and allow for strategic development. Employers that prior-

itize career planning foster job and career satisfaction.Literature Review: Emergency medical systems

! ! References

Blau, G., PhD., Chapman, S., PhD., Pred, Robert S,M.A., PhD., & Lopez, A., PhD.

(2009). Can a four-dimensional model of occupational commitment help to explain

intent to leave the emergency medical service occupation? Journal of Allied

Health, 38(3), 177-86. Retrieved from http://search.proquest.com/docview/

211078622?accountid=12570

! Blau, G., PhD., & Chapman, S., PhD. (2011). Retrospectively exploring the importance

of items in the decision to leave the emergency medical services (EMS) profession

and their relationships to life satisfaction after leaving EMS and likelihood of return-

ing to EMS. Journal of Allied Health, 40(2), e29-32. Retrieved from http://

search.proquest.com/docview/887255408?accountid=12570

! Carson, K. D., Paula, P. C., Yallapragada, R., Langford, H., & Roe, C. W. (1998). Emer-

gency medical technicians: Is career satisfaction within their control? Hospital Top-

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accountid=12570

Chapman, S. A., Blau, G., Pred, R., & Lopez, A. B. (2009). Correlates of intent to leave

job and profession for emergency medical technicians and paramedics. Career De-

velopment International, 14(5), 487-503. doi:http://dx.doi.org/

10.1108/13620430910989861

! Choo, C. W. & Bontis, N. (2002). The strategic management of intellectual and capital

and organizational knowledge. New York, NY: Oxford University Press, Inc.

! Patterson, P D., Jones, Cheryl B, Hubble, Michael W, Carr, Matthew, Weaver, Matthew

D, Engberg, John,Castle, Nicholas. (2010). The longitudinal study of turnover and

the cost of turnover in emergency medical services.Prehospital Emergency Care :

Official Journal of the National Association of EMS Physicians and the National As-

sociation of State EMS Directors, 14(2), 209.

! Patterson, P. D., Moore, Charity G,PhD., M.S.P.H., Sanddal, Nels D,PhD.(c), M.S.,

Wingrove, G., E.M.T.-P., & LaCroix, B., E.M.T.-P. (2009). Characterizing job satisfac-

tion and intent to leave among nationally registered emergency medical technicians:

An analysis of the 2005 LEADS survey. Journal of Allied Health, 38(3), e84-91. Re-

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! Toby, M. E., Yang, B., & Bartlett, K. R. (2004). The effects of organizational learning cul-

ture and job satisfaction on motivation to transfer learning and turnover

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