EMSARN Turnover Project
If your EMS agency would like to participate in EMSARN, please contact Dr. Patterson at pattersond@upmc.edu or 412-647-3183.
2010 Statistics on Turnover & Cost of Turnover in EMS
Below we provide current estimates of turnover and cost of turnover in EMS based on data collected from agencies in the 2010 EMSARN cohort. These estimates are based on participation from 4 agencies spread across 3 U.S. Census Regions. We report the estimated weighted annual rate of turnover and estimated weighted total cost of turnover and cost per termination. The reported statistics are based on data collected from January to June 2010 and are weighted based on size of agency workforce.
Figure 1: Estimated Annual Rate of EMS Turnover 2010
Figure 1 NOTES: The estimated annual weighted mean rate of turnover was 13.8% among 4 EMS agencies in the 2010 EMSARN cohort (Figure 1). This rate is slightly higher than the weighted mean rate observed in the 2008 turnover benchmarking study (10.7% --Patterson et al, 2010).
Figure 2: Estimated Annual Cost of Turnover Measures

Figure 2 NOTES: The estimated weighted median annual cost of turnover in the 2010 EMSARN cohort was $37,060.50. This amount is lower than the estimated weighted annual median cost observed in the 2008 turnover benchmarking study ($71, 613.75 -- Patterson et al, 2010). The estimated median cost per termination in the 2010 EMSARN cohort was $7,019.01. This amount is slightly greater than the median cost per termination observed in the 2008 turnover benchmarking study ($6,871.51 -- Patterson et al, 2010).Additional information about these statistics:Data were collected and statistics calculated using the exact same methodology described in our PEC publication.
The Cost of Turnover in EMS Project
Employee turnover affects all types of organizations, in all industries all across the U.S. According to the U.S. Department of Labor, the average annual turnover rate across all non-farm positions in 2007 was 39.7%.(1) These rates varied from 28.7% among all health and social assistant positions to 71.6% among all leisure and hospitality positions. Annual turnover rates for some organizations that employ nurses range from 23% to as high as 190%.(2, 3)
Employee turnover impacts a whole host of organizational factors, including financial.(4, 5) According to one study of nursing turnover, a hospital may spend as much as 1.3 times the nurse’s annual salary (or $88,006) to fill a vacated position.(5, 6) Turnover contributes to an unstable workforce which in turn threatens patient safety and care quality.(7)
Dr. Adidam describes turnover in this way: “High turnover sends a very clear signal that something is wrong somewhere in an organization.”
In 2008, we conducted the first-ever longitudinal study of turnover and associated costs. We convened a team of EMS researchers, health policy analysts, and labor economists to develop a methodology for calculating the cost of turnover in the EMS setting. For the first time, the EMS industry has objective statistics for the widespread problem of turnover. View our publication in the Prehospital Emergency Care Journal.
The specific aims of this EMSARN project include:
- To monitor the annual rate of EMT turnover and associated costs in EMS.
- To provide benchmarking data for comparison purposes.
FAQs
What is involved in participation?
An assigned representative from your agency would work with our team to collect data once each month depending on when your agency enrolls. The agency representative would use a secure Internet link to enter in data and answer a series of questions once a month. We're available to help when needed.
How much time is involved?
Time depends on the size of the agency and month of data entry. The first month requires the most amount of time. For larger agencies, the first month will take a little bit longer to complete. However, all subsequent months require very little time regardless of agency size.
What do agencies receive in return?
We provide all agencies with very detailed reports on turnover and associated costs. These reports will be compiled every six months and made available to agencies in print and electronic format.
Please contact us if your agency would like to participate in this EMSARN project. Contact Dr. Patterson at pattersond@upmc.edu or 412-647-3183.
If your agency has enrolled, please click this link to access the secure Data Entry Portal for the Turnover Project: https://www.crhc.pitt.edu/emsweb/login.aspx
Citations used for the Cost of Turnover in EMS Project Summary:
- Bureau of Labor Statistics USDoL. Job Openings and Labor Turnover Survey (JOLTS). http://www.bls.gov/jlt/#data. Accessed 08/18/2008.
- Bostick JE, Rantz MJ, Flesner MK, Riggs CJ. Systematic review of studies of staffing and quality in nursing homes. J Am Med Dir Assoc. 2006;7(6):366-376.
- Remsburg RE, Armacost KA, Bennett RG. Improving nursing assistant turnover and stability rates in long-term care facility. Geriatr Nurs. 1999;20(4):203-208.
- Price JL. The impact of turnover on the organization. Work Occup. 1989;16(4):13.
- Jones CB. The costs of nurse turnover, part 2: Application of the nursing cost calculation methodology. J Nurs Adm. 2005;35(1):41-49.
- Jones CB. Revisiting nurse turnover costs: adjusting for inflation. J Nurs Adm. 2008;38(1):11-18.


