Graduate School of Business


Doctor of Business Administration (DBA)


MeLisa J. Rogers


EMS, Paramedic Shortage, Paramedic Attrition


Human Resources Management | Medicine and Health Sciences


This is a qualitative multi-case study on emergency medical services (EMS) paramedic shortages, their effects on ambulance responses, and the quality of patient care in the prehospital environment. A qualitative multi-case study was selected for this study because the nature of the methods’ design aligned with a systematic approach of life experiences (Creswell, 2015). Paramedics who participated in this study provided insight, from life experiences, as to why one prematurely leaves EMS; thus, creating a staffing shortage. The foundation of this study is the high staffing shortages of paramedics specifically in South Carolina (SC) and North Carolina (NC). Drastically reducing paramedic attrition is critical in reducing patient suffering, decreasing morbidity and mortality, and improving EMS key performance indicators. The conceptual framework for this study aligns with Fredrick Herzberg’s Two-Factor Theory of Motivation and Abraham Maslow’s Hierarchy of Needs. In conclusion, the findings from this study have shown that the number of ambulances that are unstaffed from the paramedic shortage has reached critical levels. Primarily, this review of the literature’s discovered themes has identified numerous challenges contributing to the increasing EMS paramedic shortages and their effects on patient care in the pre-hospital environment. Secondarily, the interview portion of this study solidifies the discoveries of the cited works and identifies further challenges through its semi-structured interview format. Thirdly, achievable data from previous studies, primarily from the South Carolina EMS Association, validate this study’s findings through triangulation; thus, instilling rigor on primary reasons for EMS paramedic shortages and their impact on patient outcomes.