Commonalities of the approach to EMS by
our western brethren
Bend Fire & Rescue
By Alan Perry
Where I got my
information
I have visited Bend, Oregon on several occasions and found
it to be a beautiful community with many natural resources, a pleasant climate
and breathtaking vistas. In short a community I would love to live in. I came
across the Bend Fire & Rescue Deployment Plan for 2011-2013 while perusing
the department’s web site. It is a comprehensive and detailed document available
to the public prepared with the help of ICMA data, and the department’s
historical data to determine their compliance with NFPA 1710 . It is a document
used by the state government to assist departments with identifying their
circumstances and creating plans to help them remain viable.
About Bend Fire &
Rescue
Bend Fire and Rescue serves a population of approximately
100,000 in an area of 165 square miles much of which is sparsely populated. The
City of Bend has a population of 77,000. The annual call volume is around 8000
with 82% of calls being EMS in nature. Their staffing consists of 88 career
personnel, 4 part-time and 5 volunteers. The chain of command contains a Chief
several Deputy Chiefs including the Deputy Chief of EMS, a Battalion Chief for
each of the three shifts, a Captain for each of the five stations on each
shift, 6 engineers per shift and 6 ff/medics per shift. The department uses a
flexible staffing model were engines and ambulances are at each station, and
staffed based on the nature of the call. All-in-all, a very lean operation.
About us
Fire Departments in Southeastern Virginia tend to follow the
old school east coast fire service model. It is a well-tested institution known
for a strong and rigid structure which does a good job of protecting lives and
assets and the jobs of firefighters. We have enjoyed both public and political
support, supporting well-staffed and
well-equipped career departments in most major cities. The approach to
providing EMS service is widely variable ranging from only providing a first
response to being a primary EMS transport provider. In this mix there are also
widely varying degrees of support for the EMS mission ranging from treating it
as a necessary evil in order to maintain public support and funding, to
embracing it, making innovative changes that are needed and addressing public
education in EMS.
Common threads to our
approaches to EMS
The most common thread among fire departments that have taken
on EMS as part of their service mix is the high percentage of our total calls
that are EMS in nature. Of equal importance and contrast is that most
firefighters do not enter this career with the primary desire to transport the
ill and injured on an ambulance. Culturally I think this is a common thread
among fire-based EMS systems, one that creates the climate for poor attitudes
when making decisions and long-term plans for these systems.
Where we differ
A few highlights of the Bend Fire & Rescue program
jumped out at me as being very proactive and engaged in improving the quality
of their EMS system; They conduct monthly EMS case reviews with their two
physician advisors to include patient outcomes. EMS protocols are updated
annually, A service survey is sent out for every 15 EMS calls, They have an EMS
public education program even though it is limited to senior communities only
at this time. The concept of flex staffing maximizes the effectiveness of a
small staff allowing a smaller group of responders to handle a variety of calls
whether EMS or fire. Despite the staffing limitations the department has an
average response time within the city of 7:33. They have a dedicated training
staff and a training facility.
How can Fire-based EMS
improve
Bend Fire & Rescue appears to be doing well with the
resources they have available but are clearly pushed to the limit in their
current circumstances. Like many other departments they are having difficulty
with being fully forthcoming about the nature of the fire services relationship
with providing EMS. The financial data conveniently lumps both fire and EMS
operations costs under one heading and does the same with revenue, this
approach could be considered an attempt to minimize the higher operating costs
for fire services and the revenue produced from the EMS activities. Being open
and honest about these circumstances will better allow the management and the
public to make good decisions. Their portrayal is not unique, it is a common
tactic used in the fire service. We in the fire service, as public servants,
should be more honest with the public and ourselves, the lack of clarity will
affect our integrity ultimately. Fire-based EMS systems must look at our perception
of EMS and be certain that we are embracing it, constantly looking for ways to
improve upon it, and deliver the service as effectively and efficiently as
possible.
Link to Bend Fire & Rescue Deployment Plan
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