In a fast-paced pre-conference workshop, entitled: This Changes Everything: Future Operational Models for Public Safety, Mike Ragone and Guillermo Fuentes told attendees at the 2012 Pinnacle EMS Management Summit how public safety agencies are being challenged by taxpayer advocates like never before.
Ragone, fire service practice leader for Fitch & Associates, explained that the public has many perceptions of the fire service, many that are inflated or false, and discussed how efficiencies typically associated with the most cost-effective private agencies are now being expected of fire service agencies.
Fuentes, an EMS planner with extensive experience building modeling concepts that are known for accuracy and success in multiple countries discussed how municipalities are looking for transformational rather than incremental change, moving the conversation from, "What do we need?" to "What can we afford?"
The workshop focused on:
• What the real mission of public safety is in today's world;
• The right (and wrong) way to measure performance in an increasingly accountable environment;
• Why one size does not fit all;
• How to identify which operational model fits communities best;
• Why the "all-hazards" approach is in danger of becoming extinct.
Fire service agencies are traditionally slow adopters. For example, the medical priority dispatch system (MPDS) is an accepted call screening process that has 30 million dispatches flowing through it. The police priority dispatch system (the newest kid on the priority dispatch block) already has 5 million dispatches processed through it annually. However, the Fire Priority Dispatch System (FPDS) only has 300,000 dispatches processed through it.
Reliable measurements in the fire service that should be tracked:
• Call answer times;
• Turn out times;
• Drive times;
• Medication administration times;
• Transport times;
• Fire suppression times; and
• Return to service times.
Organizations should be agile to be able to adapt to all the changes occurring in the EMS/fire industry, economy and the national healthcare system.
The NFPA estimates show that most calls are not life saving. Instead they are:
Fire incidents: 4.7%
False alarm responses: 7.8%
Mutual aid responses: 4.2%
Other hazards (e.g., arcing wires and bombs): 2.3%
Kitchen sink calls: 13.9
Few agencies have performance based contracts with their 9-1-1 center.
Mutual aid calls are starting to disappear. For example, in July, Contra Costa (Calif.) Fire District capped its aid to East Contra Costa, where half of the fire stations were shut down. Contra Costa, fearing the neighboring district’s fiscal crisis will sap its own thin firefighting/EMS forces, placed a cap on the number of engines and manpower it will dispatch outside its territory.
The reality is that a cost benefit analysis is necessary to truly determine a department’s staffing needs.
The cost of response (to run a truck down the road: fuel, repair maintenance and capital replacement) is causing some progressive fire service agencies, such as Tualitin Valley Fire & Rescue in Tigard Ore., to use more economical vehicles to respond to lower acuity calls. (See http://www.tvfr.com/aboutus/dept/ems/index.aspx.)
SUV: $ 3.42/mile
Ladder Truck: $33.05/mile