Emergency Medical Service (EMS) providers face a host of significant challenges, including traffic congestion, increasing call volumes, hospital diversion (i.e., emergency departments at hospitals not allowing ambulances to deliver patients to them), and increasing transfer times at emergency departments. Many of these challenges can be attacked through an application of operations research techniques in conjunction with EMS expertise. The purpose of this article is to outline some of the key challenges and potential operations research based remedies, and to discuss in detail one such remedy that has various names including "system-status management" and "move up.