20 Tough Questions For the Fire Chief: Are You Prepared To Answer Them? Question 15

This question is a continuation of last month’s discussion about fire-based EMS. While it is widely considered a best practice by efficiency consultants to benchmark and compare your organization to others, this question implies, ironically, that such a...


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This question is a continuation of last month’s discussion about fire-based EMS. While it is widely considered a best practice by efficiency consultants to benchmark and compare your organization to others, this question implies, ironically, that such a comparison is irrelevant.

Perhaps the basis of the question is the notion that the decision to provide, or not provide, fire-based EMS transportation in any jurisdiction is uniquely individual to the community and not a decision that should be influenced based on what other communities are doing. To a great extent, this is true. However, it is worthwhile to look at like-sized communities that provide or don’t provide fire-based EMS transportation and to ask them why they do or why they don’t. It may also be advantageous to look at fire service organizations that have recently (say, within the past five years) started or stopped providing fire-based EMS transportation and seek to understand what compelled that decision.

Department’s mission

The decision to provide, or not provide, EMS transportation is one based on the mission of the fire department. For most departments, the mission includes a focus on protecting life and property and the prevention of injuries and loss (perhaps not in those exact words). EMS transportation is a logical fit and within the scope of purpose for many fire departments. However, that does not make the decision to start providing EMS transportation easy. In fact, the decision can be quite complicated. This article looks at a few of the factors.

Competition

If the fire department does not currently provide EMS transportation, someone is doing it and that someone is most likely a private EMS provider. As we discussed last month, the decision for a public agency to provide services that may otherwise be provided by a private entity is a policy decision to be made by elected officials and, hopefully, after great consideration to the benefits and detriments of doing so.

Where a private EMS agency provides the transportation services for multiple communities, the revenue it may lose if one community decides to have its fire department provide EMS transportation services could have a significant impact on its ability to provide EMS to the other communities. And while the elected officials are only required to do what is best for the community they are elected to represent, there is a humanitarian (if not ethical) obligation to at least give consideration to the broader impact of policy decisions. A policy decision to start providing fire-based EMS transportation that, in turn, causes the current provider of EMS transportation for multiple communities to go out of business could have a significant impact. It may be especially detrimental if the other communities did not know the change was coming or if the other communities are not in a position to provide their own fire-based EMS services.

Of course, this could provide an opportunity for the fire department to become the EMS transportation provider of choice for the region and serve the needs of other communities as well. This sort of cross-jurisdictional provision of services can quickly become complicated and very political, especially where neighboring community relations (or neighboring fire department relations) have historically been strained.

Quality of service

One of the key drivers in the decision for a fire department to implement transportation services should be a focus to improve the quality of service. However, to improve the quality of service, there should first be an assessment of the existing quality of service. That should include identifying what defines quality and then measuring the existing level of service to the definition of quality. It would be bad business to start transportation services only to find the quality of services declined as a result.

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