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Welcome to my site and thank you for reading. After many times thinking, if only I had a blog, well-- here we are. This blog will feature writings on a variety of topics from roadside food, to leadership in the fire service; politics; culture- gay, straight, and indifferent, my experiences in Ohio, New York and beyond; and much much more. It's my hope that you will find it interesting and that it stirs at least some thought and discussion. I am certain you wont always agree, but that is what its all about right? Oh and one more thing: The views expressed on this site are entirely my own. They do not reflect in anyway the views or positions of my employer.



Wednesday, January 23, 2013

But Why?


There are certain trends that continue in the field of public safety in general and the fire service in particular.  Many of those traditions are positive, some are not.  Fortunately, for every one of those not so great trends, there is something greater and better that can normally overcome it.  For every arrogant officer, there is a servant leader—for every unmotivated “probie” that won’t lift a finger, there is a new hire that loves to learn and help—this is how we have survived, despite our lowest common denominators.

But of the negative traits, one of the most common laments in the firehouse and the dispatch center is that the fire service is far too reactive.  Often, persons of all ranks wonder why “we have to have something bad happen before anything can change.” 

Whether the efforts to improve firefighter safety after a firefighter fatalities or the change in dispatcher certification requirements after a tragic situation in Florida—the idea or the effort or the attempt to change almost always occurs only in the smoking debris of what once was presumed to an effective and stable organization—where problems are suddenly brought into the sunlight by a crisis or failure of incredible portions—totally unforeseen by most, but likely entirely anticipated by a few. 

The damage to the morale of the employees is severe, the damage to the reputation of the agency is scalding and the outcomes for a city, state, or county government can be financially devastating.  Not to mention the faith of the community in its public services can be shattered.  Our brothers and sisters in the private sector also know of this phenomenon—we hold no unique place in the annals of inept problem anticipation and/or recognition.  This week, it was published that the issues with the Boeing 787 Dreamliner, whose batteries have a nasty habit of catching fire, were documented in 2006.  A concerned employee wrote emails describing the problem—and was ignored and marginalized.   Read about it here:  http://www.nextgov.com/emerging-tech/2013/01/2006-battery-fire-destroyed-boeing-787-suppliers-facility/60809/ .   

But why does this happen?  Why, if everyone sees it, or if even one or two people see it, do we not fix obvious problems inside agencies that we claim to love—working with people we care about, doing a job we are passionate for? 

I think the answer lies somewhere in that caring, and in a lack of training for people to be effective managers and leaders.  But even more than that, it lies in a very simple concept:  Inertia.  From high school physics class hopefully you recall this Law—a body at rest tends to stay at rest—a body in motion tends to stay in motion.  You may also know that law from your experiences trying to hit the gym.  Don’t go for a couple of days—and watch your exercise routine go very quickly the way of the eight-track tape; Beta VCRs; and the Romney Presidential Campaign.  What we do, we tend to keep doing—unless something forces a change. 

Think about most public safety agencies and those that lead them.  They are perfectly happy with things as they are.  How often have you heard a variation of “one hundred years of tradition, unimpeded by progress” used to describe the fire service?   We have all said it.  But what does it really mean?

 It means that those inside most agencies, no matter how much they may complain about day to day issues—are perfectly happy with things just as they are.  For those in leadership roles; they are even happier.  For enacting change, or even considering it, is really hard work.  And when you work in public safety—where salaries and evaluations don’t depend on performance—there is no institutional reason to go anywhere but the same place as yesterday.  When you add in the fact that many agencies bathe in pride and honor and glory (whether overtly or subvert, deserved or not)— the ego decides that anything that challenges the perception that things are fine is not just wrong, but a threat.  Together, any interest in doing things differently is inherently unwanted.  Any voice from inside or outside that highlights an issue is a personal attack; and only the people in positions of power inside the organization—those with the most to gain from nothing—think they have the answers to any problem, or the right to ask any question. 

And that is where inertia comes in.  For an organization, the only thing that can change the direction of a hundred or thousand people moving in one direction, or not moving at all, is a very powerful force.  The only thing that can clear the cobwebs of inaction, or the stain of ignorance, is a tragedy.  It is not until something very bad happens that the light comes to bear on whatever issue or challenge was, to that point, mostly ignored. 

Far too often, a death of a civilian is not what causes change.  Sadly—routinely— it is the death of a member of the service.  The most significant shock that can happen to a department is what brings out the questions, calls out for answers, and pushes the agency into motion. 

The history of this pattern is long and extensive in the fire service.  How many firefighter fatalities did it take before we decided that Rapid Intervention Teams were a good idea?  How many vacant buildings have claimed firefighters, before people started asking—why?  In the 911 center, how many senseless citizens were lost due to preventable mistakes—before discussion began of certification and training and technology to allow dispatchers—require dispatchers—to meet basic standards? 

It doesn’t have to be this way.  History shows us so many great leaders who listened to information from all sources; who welcomed ideas and influence and support from all sides to chart a new way forward.  But many of them too, had problems along the way.  For many of them, however, they were already moving forward.  And the rule of inertia applies to them as well—and the power of those who fought Martin Luther King, or the US during WWII, or against all the innovators in the arts; science; sport—all of those who said “no you cant”; “that’s not your concern” “or “Mind your business” or “We have always done it that way”—all they succeeded in doing was pushing someone—or something—or some movement forward.  

So ask yourself, are you moving forward in your agency?  In your life?  Are you letting the forces that try to stop you push you forward?  Or are you letting that resistance hold you back.  Whether a fire department or a person striving for a degree—the facts are the same and the price to be paid for never moving, never growing, never learning is the same.  We owe it to our organizations to do better—we owe it those we serve not to accept that things must always be the way they are or were.  With the ever increasing diversity of people in the public safety field and the trends in education and training—the ideas to prevent the next tragedy will possibly come before things really get bad. 

Are you ready to listen?

Friday, January 18, 2013

CFD Fire/EMS: Solving the crisis before it starts


Columbus Fire EMS Delivery Model

Summary:          

The Columbus Division of Fire is experiencing a rapid increase in the volume of EMS Calls that it handles.  In outlying areas; the burden of these additional calls is frequently falling on automatic aid partners; while in the center portions of the City, EMS units are responding to upwards of 5,000 or 6,000 calls per year.  This type of volume is not sustainable.  It leads to increased response times; burnout of EMS personnel; and potentially less successful outcomes for patients.  This is despite the mid-90’s reorganization that resulted in Columbus transitioning to an all ALS system.  As a result of the single tier system, Columbus has a high percentage of medics to population, and, for many Medic units, the majority of calls they respond to are BLS in nature. 

Goals:

·         Match Service Delivery to Service Demand

·         Work to reduce excessive reliance on automatic-aid partners

·         Strive to maintain or improve response times—especially on critical EMS and Fire Incidents.

 

Potential Solutions:

The following efforts would help to achieve the above goals.  Although they will require a minimal investment in personnel, software, training, and equipment— they would result in significant improvements in response time and agency effectiveness.  Further, if CFD is able to handle more of its own EMS workload, an added benefit will be increased revenue.  If the CFD is able to bill for approximately 5,000 more EMS incidents per year, the increased funding will more than match the costs associated with these proposals.

1.       Third Firefighter (EMT) on outlying Medic Units at Stations: 5, 6, 26, 27, 28, 29, 31, 32, 33, 34 This will permit these Medic Units to respond to calls independently.  CAD can be programmed to support this functionality with ease. As a result, Engines will remain available for 2nd EMS runs in these areas, or Fires—preserving response time.

 

2.       When First-Due Engines are available, and are ALS equipped, preference should be given to dispatching Columbus Medic Units to Columbus incidents. (When there will not be a negative impact to arrival time for the first paramedic)  A potential time rule could be:  If CFD Paramedic Engine is responding and is the closest medic equipped unit a CFD Medic shall be assigned if it is within ten-minutes—no matter if an automatic-aid medic unit is available or not.  Exceptions shall be for Non-Breather; Cardiac Arrest, Unconscious.   This will help lessen the burden of City EMS incidents on Automatic Aid Partners.  [The new CAD will easily support this dispatch rule]

 

3.       Columbus Fire should deploy five (5) BLS units in the central portion of the city and the far north-side, staffed by two (2) Firefighter EMTs.  These units should be based at Stations 1, 6, 15, 17, and 18.  They will respond to BLS calls where they have an ETA of ten minutes or less or on special calls or to mass-casualty incidents.  Normally, they should not respond with an ALS unit or a first responder engine company.  The dispatch rule (easily accomplished in new CAD) should be:  For BLS calls, if a BLS unit is within ten minutes, it will be assigned… if not, then the nearest CFD Medic unit shall be assigned if it is within ten minutes, if none within ten minutes—then assign the nearest available medic unit regardless of department.

 

4.       CFD Should implement a medical-priority dispatch system as soon as possible- and enable the new CAD system to recommend the re-direction of medical units from calls of lower priority to higher priority.  This will ensure an adequate use of resources and reduce response times to higher priority calls.

 

5.       CFD should utilize Rescue and Ladder Companies to respond for Manpower requests, freeing up the ALS Engine Companies to respond to ALS incidents. 

 

6.       CFD Should consider redeploying Medic Units to match periods of peak activity, or consider staffing supplemental Medic units during period periods at key locations.  Hiring overtime personnel to staff additional medic units at key locations may be a beneficial cost to the department.  Analysis to determine peak periods and locations would need to be conducted to determine problem placement and benefit.

Conclusions:

Faced with an ever increasing workload and limited resources; but with a New CAD and other potentially beneficial technologies, the Columbus Division of Fire should implement creative and multi-faceted solutions to ensure that it is able to maintain or improve its effectiveness.  These solutions should help the CFD avoid the problems that have plagued EMS systems in other large cities, improve resource management, and thereby safe lives and be more cost effective.