Transcript Current EMS Deployment - San Francisco Fire Department

San Francisco Fire Department
San Francisco Fire Commission
EMS Configuration Project Report
October 14, 2004
Chief of Department, Joanne Hayes-White
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Goals of the merger
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Rapid paramedic response to reduce
response times
Assure adequate transport resources
Capitalize on economies of scale:
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Infrastructure
Training
Administration
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A little background
Emergency Medical Technicians (EMT)
 120 hours of training
 The ability to:
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Provide basic trauma care
CPR and Defibrillate with AEDs
Basic patient assessment and history
Administer oxygen and oral glucose paste
24 hours of Continuing Education / 2 yrs
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More background
Emergency Medical Technician – Paramedic
 1200 hours of training
 The ability to:
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Defibrillate / Pace slow heart rates / Cardiovert fast heart
rates
Intubate / Cricothyroidotomies
IV lines and over 40 drug therapies including:
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Cardiac arrest drugs
Asthma
Pain management
Anti-seizure meds
48 hours of Continuing Education / 2 yrs
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Critical Findings of Study
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Transition off 24 hour ambulance shifts
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Transition to 10 hr – “short shift” staffing
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Allows for peak period staffing
Transition to dynamically deployment
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Promotes fatigue / untenable work-loads
Allows for quick response / best possible coverage
42 Paramedic Engine Companies
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Providing high level of service to all neighborhoods
Eliminating the “triple dispatch”
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Critical Findings of Study
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Better job satisfaction for H3 FF/PMs
Focusing on diversity in recruitment /
retention
Retaining ambulances for training /
retention of PM skills
Redeployment of H2 FF/EMTs and H3
FF/PMs from ambulance to suppression
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What does that look like?
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What we have now
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Nineteen ambulances quartered in Fire
Stations– 24/7
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Two Dual H1 ambulances
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Staffed with 1 FF/PM and 1 FF/EMT
1 0600 – 1400 / 1 1400 - 0200
42 Engine Companies
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25 Paramedic Engine Companies
17 Basic (EMT) Level Engine Companies
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SFFD TODAY
25 Paramedic Engine Co.s / 17 EMT Level Engine Co.s
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The Goal
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42 ALS Engine Companies
AND
24 peak-period / 16 off-peak ambulances
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Staffed w/ 1 SF PM & 1 SF EMT
All 10 hr / dynamically deployed ambulances
OR
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20 peak-period / 14 off-peak ambulances
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Staffed w/ 1 dedicated PM & dedicated EMT
All 10 hr / dynamically deployed ambulances
4 24 hour ambulances quartered in fire stations
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Assess call volume / feasibility during transition
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SFFD
The Goal: 42 Paramedic Engine Co.s
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Why peak period staffing?
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Predictable and dramatic rises in call
volume
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Time of day / day of week
Allows the Department to be responsive
to requests for service
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Why dynamic deployment?
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Real time redeployment of resources in
response to call volume
Constant “chess game”
Requires aggressive fleet management
at ECD
Most efficient mechanism of resource
utilization
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How do get there and how long?
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Accelerate Hiring of Dedicated
Paramedics and Dedicated EMTs
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Defer hiring of H2 Firefighters
Match hiring to retirements
Over 12-18 months transition our 24
hour units to 10 hour units
Move FF/PM & FF/EMTs to suppression
assignments
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Reinforcing our commitment to EMS
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Ads 160-200 dedicated EMS professionals to
SFFD (overall increase of 29 FTEs)
Creates 70 paramedic response platforms
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42 Engines/24 ambulances/4 Rescue Captains
40% increase in paramedic units deployed
Provides career opportunities for dedicated
function paramedics and EMTs
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Proposed Timeline
Outreach & applications for Paramedics /
EMTs – 1/05 (rolling applications)
Testing beings – 3/05
First class enters academy (2 x 33) – 5/05
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Three / four week academy
Deployment of 1st SF ambulances – 6/05
Second class enters academy – 10/05
Final class enters academy – 4/06
Total deployment of system – 6/06
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Critical Link-Project Management
Project
Manager
Operations
Logistics /
Admin
Human
Resources
Training
ECD
Liaison
EMSA
Liaison
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Operations
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Logistics / Administration
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Human resources
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Training
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Liaison to ECD
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Liaison from EMS Section
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Oversight Committee
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Committee of eight members
Reports to Fire Commission
Members from:
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Emergency Physicians Association
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The numbers game -#1
Current staffing:
 243 H3 Firefighter/paramedics
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Nine (9) currently assigned to SFO
20 H1 Fire Rescue paramedics
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14 currently working
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The numbers game -#2
What it takes for 42 / 20:
 42 Paramedic Engine Co. – 189 H3 FTEs
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42 X 4.5*
Ambulance staff is projected on 20 / 24 hour
units – 200 (100 PMs / 100 EMTs)
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2 X 20 X 5**
* 48.7 hr. work week relief factor
** 40 hr. work week relief factor
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The numbers game -#3
What it takes for 42 / 20:
 42 Paramedic Engine Co. – 189 H3 FTEs
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Four 24 hour dual H3 Fire station ambulances – 36
FTEs
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42 X 4.5*
2 X 4 X 4.5*
Total 225 H3 FTEs
Dynamic Ambulance staff projected on 16 / 24 hour
units – 160 FTEs (80 PMs / 80 EMTs)
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2 X 16 X 5**
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Why a cushion of H3s?
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Training
Continue ongoing truck training
Absorb attrition from promotional
exams
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FAQs
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“Will this be an entry level rank into the Fire
Department?”
“I’m in EMT or PM school now. Will I be able
to apply?”
“Is their opportunity to be a career paramedic
or EMT?”
“Are there promotional opportunities for these
new ranks?”
“Who will represent these new ranks?”
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FAQs
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“Isn’t there a need for additional
infrastructure with this new ambulance
corps?”
“Can H3s and new paramedics / EMTs
work together?”
“Will these PMs and EMTs be second
class citizens?”
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Thanks for your attention
and ongoing support
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