Administration and Leadership, Columns

Supervising EMS Officers Display Clinical Performance Competencies

Issue 11 and Volume 41.

In this final installment of my series covering the National EMS Management Association’s Seven Pillars of EMS Officer Competencies, I’ll address the seventh pillar, Clinical Performance.

One might assume that clinical performance refers to providing clinical care, but this isn’t the case. The clinical performance pillar is related to the tasks, knowledge and skills a supervising EMS officer (SEMSO) needs in the domains of “quality and performance management” and “education and learning systems.”

The fact is, the minute a supervisor begins to provide direct patient care, supervisory responsibility is abdicated and he becomes simply another EMS provider.

There are times when a supervisor must step in and take over delivery of care, but these are extreme cases.

Unfortunately, when the most skilled clinician is the person who’s promoted to SEMSO and when there’s little or no education and training provided to prepare that person for their new and very different role, there’s a tendency to revert back to delivering clinical care rather than supervising those who should be providing that care.

By demonstrating competence in all of the behaviors articulated across the seven pillars, the SEMSO will be prepared for that role and less likely to fall back into old, comfortable habits.

Quality & Performance Management

A competent SEMSO must be able to provide oversight and leadership that supports the agency’s quality and performance management activities: collecting, analyzing and applying data to guide tactical and strategic decision-making processes.

The tasks included in this area are: applying principles of prospective, concurrent and retrospective performance management; in-taking, investigating and documenting operational or clinical complaints; and providing feedback concerning performance issues.

To demonstrate competence, the SEMSO will need knowledge in the following areas: the appropriate EMS-enabling legislation and the associated rules and regulations; HIPAA; crisis intervention; interviewing technique; agency policies and procedures; ALS and BLS treatment protocols; local and national best practices and how to apply them; reward, recognition, and incentive programs; and corrective action plans.

The skills and ability needed for success include: defusing situations using verbal or written communication; reporting finding of investigations in written documents; and communicating in writing and verbally in a manner that staff receive as working to common goals to improve overall clinical outcomes.

Education & Learning Systems

Competence in this domain involves ensuring adequate orientation of new members to the operation and that the agency’s field training program addresses new members’ and the agency’s identified needs.

The SEMSO must also ensure that members are meeting the organization’s education and training goals as well as statutory requirements for continuing medical education.

Education and training compliment quality and performance improvement; the two processes continue simultaneously with the goal of improved clinical performance and outcomes.

The knowledge, skills and abilities SEMSOs need related to education and learning systems include: principles of adult education; the ability to provide one-on-one and group instruction; use of technology in the learning environment; and the ability to adapt and adjust teaching styles and methods to various diverse audiences.


Clinical Performance is the last of the Seven Pillars. The first pillar describes prerequisites for becoming a competent SEMSO. The other five pillars are: Self Attributes, Leading Others, Task Management, Innovation, and Social Responsibility.

Individuals aspiring to become supervisors can use the competencies outlined and discussed over the past year as guidelines supporting preparation for the roles and responsibilities of a supervisor after promotion. EMS agencies can use the Seven Pillars to underpin education and training for officer and professional development. Individuals can demonstrate their competence by passing the SEMSO credentialing exam.

Individual and organizational efforts in pursuit of officer leadership and management competency will, over time, improve how EMS organizations provide the services the public needs and expects.

These efforts will also make employees happier. Organizations will have better leaders and managers and develop stability that allows organizations to grow efficiently, effectively and experience functional growth, successfully transitioning to EMS 3.0.

The Seven Pillars of EMS Officer Competencies are available for download at The NEMSMA website also has information for individuals who are interested in taking an EMS officer credentialing exam and organizations that would like to host an exam.