How Is Peak Load Staffing

The majority of non EMS/Fire related people believe that the EMS and Fire calls are sporadic. In reality there is a predictable trend where the call volumes are higher and lower. There are 3 concepts that I will discuss further, first, System Status Management. SSM is simply what its name implies, the management of a EMS/Fire system’s resources before and between calls. It is the process of preparing the system for the best possible response to the next EMS or Fire call. Second, the concept is of Unit-Hour Utilization. UHU is an equation to find out what percent of the time a specific unit is being used on a specific day.
Third, Peak Load Staffing will be discussed. PLS is a pretty simple topic to understand, For instance, Industrial areas and commercial office building usually have the highest call volume during the 9am-5pm business day when residential areas have a higher call volume after 5pm, lessen at night and start again around 6am the next day. The concept of PLS is to have more resources in the higher call volume times and areas. I work as a Paramedic for the Medical Express Ambulance Service (Medex) where both SSM and PLS are used. First, the concept of System Status Management.
Our 2 most northern posts at Medex are Swedish Covenant Hospital (northeastern chicago) and Resurrection Medical Center (northwest chicago). The dispatchers attempt to keep 2 ALS and 3 BLS ambulances around the hospital. However if all of our ambulances out of Swedish Cov. Hospital get dispatched, Our dispatchers will move a few ambulances from Resurrection over to Swedish Cov. to cover the area and decrease overall response times. There have been times where we have not been relocated to either hospital and had to travel more than 30-45 minutes lights and sirens to get to a patient.

If SSM had been implemented appropriately, that response time could have been greatly decreased. “UHU, or unit hour utilization, itself is fairly straightforward. It’s calculated by dividing the number of transports by the number of “unit hours,” with one unit hour defined as a fully equipped and staffed vehicle in your EMS system. If your system has 10 ambulances around the clock, there are 240 unit hours in a 24-hour period. If those 10 ambulances do 120 transports in 24 hours, you would calculate your system’s UHU as follows:120 transports/240 unit hours = . 5 UHU” (http://www. ems1. om/ems-management/articles/1365144-How-to-explain-UHU-from- UFOs-to-your-city-manager/) Back to personal experience at Medex for the implementation of PLS. On average, our Medical calls on the week days are nearly double that of which we get on the weekend. In addition, the number of calls during the day is cut in half at night. On average, I run 6 medical calls per 12 hour shift on a week day, 3 at night and 3 on the weekend. If you look at those numbers, if you were to staff the same amount of ALS and BLS ambulances on the weekend or at night as you did during the day, the UHU ratio would be extremely low.
On average, Medex has around 12 ALS and 24 BLS ambulances on the street during the week. For the weekend, they only have 6 ALS and 10 BLS ambulances on the street. This effectively reduces the running cost for the company but does not strain the line staff. The EMS and Ambulance companies utilize these three concepts quite effectively, however they can also be applied to municipal Fire/Rescue departments. Most people see the Fire Departments as a rigid system, The stations are where you sit. However this does not always cover the most amount of area.
For instance, town ABC has 2 fire stations both on the main road in town 5 miles apart. Both have 2 ambulances at each station, If both ambulances at one of the stations go our on a call. One of the towns regions around the station would experience a long ETA for an ambulance. However if one of the 2 ambulances sitting at the other station would go and cover the empty station until a unit cleared from a call, the ETAs would be greatly reduced. This system is partially implemented with the station coverage neighboring departments participate in.
The concept of UHU would be implemented in the Fire service more for evaluation purposes. This can help identify if addition resources are required, which units are near operational limits and which units are not utilized to their potential. Finally PLS is a topic which is not often used in the Fire service. This if properly implemented can reduce line staff strain, more adequately cover the areas required and save money. For instance, a town like Rosemont is primarily commercial business that are open 9-5 with very little residence on off hours and weekends. The majority of their Fires are 9-5 weekdays.
To have more staff on duty during those hours would simply make more sense and save the town money. The Ambulance services have less complications than the Fire services does implementing the above concepts. The Fire service provides a larger spectrum of services and has many different apparatus for different uses. In the ambulance service they only have ALS and BLS ambulances which can sometimes work for eachother. For instance, a ALS ambulance can run a BLS call easily. However in the Fire service, a ALS ambulance cannot have the firefighting capabilities of a Truck or Engine crew.
In addition, Ambulance companies have a plethora of resources that they can call on, to get another ambulance on the street is easy as calling a few people in since they have many spare ambulance that can be deployed if needed. The largest problem with the Firefighting side of this concept being implemented is that fires, sizes and resources needed truly is a sporadic event. Yes you can predict in the winter there will be more fires but the resources needed to combat a fire cannot be predicted as accurately.
The UHU is extremely variable as is the ability to effectively implement PLS on Fire Apparatus. For the 4th of july scenario shows the utilization of Peak Load Staffing by having more resources on duty for events and days shown to require more resources. City XYZ FD is using System Status Management to cover the high call volume areas between the hours required. The final example uses Unit Hour Utilization to most effectively distribute the resources. The three above concepts of properly applied to the fire service can greatly reduce strain on the staff and running costs.

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