Managing EMS Assists: A New Approach?

In my hometown of Columbus, the Fire Division utilizes Engine Companies to "chase" or first-respond for ambulances hundreds of times a day.  It was not always this way here, or in many other cities across the United States which have adopted similar approaches. Some claim this is the best use of their taxpayer dollars and others claim that it "gets the engines involved in EMS." Most can offer no effective rationale for the policy at all.  

This is especially problematic in a City where the response times are extended and the Engines are ALS. Dispatching both resources from the same station to the same call is a risky proposition.  The policy ensures that the response times for the second incident in that neighborhood will either be extended and/or "outsourced" to another department on Mutual Aid. It also wears out the apparatus faster-- as well as the firefighters who are on the rig. 

We must work smarter if we are going to ensure the public safety of our community and the effective use of taxpayer dollars. Here is just one possible idea of an approach that could work here in Columbus.  

Each CFD station is assigned a Pick-Up truck vehicle for random errands and tasks that do not require a fire apparatus-- such as inspections, hydrant duties, etc.  I would propose that Columbus implement an EMS pilot program with the (8) busiest stations which have an Engine and Ladder Company housed together. In these stations, both the engine and ladder would start the day with (4) personnel each instead of (3).  The 4th person from the Engine and the 4th from the Ladder would be assigned to the Station Truck to handle EMS assist runs; CO detectors; Lift Assists, medical alarms, and other minor emergency calls from 8am to 8pm each day. 

For the first three months, this unit would be "on the air" for the entire period-- monitoring the dispatch channel for runs where they can go in-place of a standard fire apparatus.  For the second three months, the unit would be created in CAD and assigned to incidents based on the results of the initial phase. 

At 8pm, this Station Truck would go out of service and the personnel would return to the Engine and Ladder Company to meet the mandated staffing of  (4) Firefighters on each company at night. 

This program would involve some expenses. Outfitting the Station Trucks with additional warning devices, caps or other storage compartments for the EMS gear, and other relevant tools may cost up to $25,000 per vehicle.  However, for the expenditure of $200,000 the City would benefit from: reduced wear and tear on apparatus; decreased response times; decreased effective force arrival time at fires; potentially improved EMS outcomes; potentially improved morale; and a host of other factors. 

With the continued increase in EMS call volumes seen by fire departments across the country and the ever increasing cost of fire apparatus and the related physical and mental strain on fire/ems professionals, the time has come to start thinking creatively about how to deliver EMS in the most effective manner possible.  This was one suggestion.  I encourage you and your community to come up with others.