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Pinnacle: Making Fire-Based EMS Work in a High-Performance World

Traditional models of EMS deployment and operations lead to inefficiencies, and leaders of fire-based EMS systems must learn how to better predict the impact of operational changes on revenue and costs. That’s the message attendees of the 14th annual Pinnacle EMS Leadership Forum heard from Steven Knight, PhD, a partner with the public safety consulting firm Fitch & Associates, in a seminar on the opening day of the conference in Orlando.

Knight, a retired assistant chief of St. Petersburg Fire and Rescue, was joined by fire chiefs from Polk County Fire Rescue and Orlando Fire Department who shared real-world examples of how their systems were taking a new approach to delivering EMS in an evolving market.   

Moving Away from the Traditional Model

According to Knight, most communities report high satisfaction with their fire-based EMS systems, but prioritize other emergency services. “Citizens believe they’re more at-risk for crime than fire emergencies,” he said, adding that city and county officials are faced with multiple priorities and fire departments may not be able to rely on the same funding they had previously.

Many fire departments are establishing more private-public partnerships for delivering fire-based transport services, Knight said. But whether their agencies are partnering with others or delivering comprehensive EMS response and transport services, fire leaders need to broaden their skill sets to make progress with this new model.

Learning from High-Performance EMS   

Traditionally, fire departments have differed from most private ambulance services in how they collect and analyze data, deploy resources and staff shifts.

Knight discussed how high-performance EMS systems typically use dynamic deployment strategies that “tailor staffing to meet the demand of services.” With stagnant or shrinking budgets and increasing demand, fire departments must consider these models and also use performance-based and quality measures to assess the health of their systems.

Considering Community Risk Reduction

Fire leaders need to embrace the concepts of Community Risk Reduction to ensure their organization is aligned with level of risk in the area they serve. That means using historical data as well as projections for the future to better assess the types of incidents occurring in their communities.

Currently too many fire departments justify decisions based on what they assume is happening and not what is actually happening. While that approach may have worked in the past, it’s no longer sustainable in today’s fire service, especially for departments hoping to provide the most effective EMS care in their communities. With that, Knight explained how it will be challenging for the current model to maintain long-term sustainability.

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