What happened: In Cleveland, the local EMS union is urging city officials to add 11 positions in the 2025 budget to address staffing shortfalls. The request comes after positions were previously cut in a 2022 budget reduction. Despite city claims of EMS investment — highlighting new ventilators, a whole blood transfusion program and increased CPR training — the union argues that without enough personnel, these initiatives are at risk of stalling. The debate unfolded during ongoing city budget hearings, with the union pointing to persistent vacancies, difficult hiring conditions and a system strained by approximately 6% annual turnover.
| More: Cleveland EMS union pushes mayor for more paramedics, EMTs
Watch as Ed Bauter, MBA, MHL, NRP, FP-C, CCP-C; and Daniel Schwester, MICP, highlight the significance of this development, including:
- Prioritizing personnel over gear. While Cleveland has invested in equipment, Bauter and Schwester stress that no tool can replace trained clinicians. Without enough medics and EMTs, new programs like whole blood transfusion and advanced ventilation lack operational viability.
- The compounding cost of turnover. Annual staff turnover of 6% adds to the system’s strain. The hosts point out that failing to invest in working conditions, compensation and retention strategies can create a cycle of constant recruiting and red flags for prospective hires.
- Budgeting for outcomes, not optics. The duo argues that EMS systems must involve stakeholders in meaningful planning. Buying high-tech gear looks good, but without adequate staffing, it becomes what Bauter calls, “the heaviest paperweight in the city.”
The path forward: As Cleveland aims to innovate with new clinical capabilities, the city’s EMS system faces a fundamental challenge: without enough staff, even the best tools can’t deliver results. This situation echoes national concerns over recruitment and retention in EMS. Moving forward, stakeholders must balance capital investment with workforce development, ensuring that personnel — the true engine of patient care — are supported and sustained. Long-term success will depend on deliberate planning, honest evaluation of staffing needs, and the political will to prioritize people over purchases.
EMS1 is using generative AI to create some content that is edited and fact-checked by our editors.
