The Default Solution is Always More

My wife announced that there wasn’t enough money in the checking account again. áThe obvious solution to her was that I simply needed to add more money to it each month and that the problem would then go away. áAny attempts on my part to question where the money is being spent is considered completely offensive simply on face value. áThere are so many details that I would just not understand. áAfter all, I simply need to know that we are talking about meeting the needs of our family. áHow could I even consider not addressing those needs? áDo I want a child to go without an education? áWithout shoes or food? áIt could happen she warns, if the funds are not provided. áOh, and I can’t reduce the family size either by letting any of the kids (or even my wife) go. áAlright, maybe I took that analogy to an extreme there at the end, but replace my wife with the fire chief or union leaders, my kids with union firefighters, and make me a politician or simply the public and the story is replayed all over the country and even across the world. á”If we don’t have more money, someone could die!”

I was thinking about this economic routine when I read the articleáCity asked to boost fire resources in wake of slowing response times. áI was prepared to blast it as another of the “how can you put a price on a life” stories. áBut to my surprise, “city administrators” in this case started discussing “restructuring” – they even got to specific issues by pointing out that it was “chute time” that was slowing down even though the actual travel times were improving. áHowever, the familiar refrain still finally appeared, the Alderwoman in this particular story “plans to bring forward a notice of motion asking the city to look at what she calls a general lack of resources within the department.”

While I cannot diagnose why the response time compliance in this specific situation went steadily down from 64.7 percent in 2007 to just 54.7 percent last year, I also cannot concur automatically that it is by default a lack of money. áEven the Deputy Fire Chief “expects a number of factors have played into the slowed turnout times since 2007,” before admitting “but he welcomes additional resources into the department, including more firefighters.”

Again, I admit that I don’t know all of the details surrounding the specific question in this next case askingáShould City Merge Emergency Operations?á But the first thing that struck me was that the city was looking to take over a nonprofit ambulance service in order to save money. áI understand that the city is a major contributor to this service and that the fire department attends one third of their calls yet the city is the one complaining of the duplication of effort. áThe assumption is that the entire amount of support currently being given to the volunteers would be considered savings and could mean a new fully equipped ambulance after a merger. áIt seems to me that the money that was being used for operations would still be needed even after the fact.

A final article I read on the topic wasáNew Toronto Fire Chief Says Merger with EMS Eyed. áIn this story, the City Fire Chief acknowledged that the existing fire model was broken saying “The status quo … is not an option. It just isn’t.” áPart of his initial attack of the problem was reducing the number of firefighters to save money while an official service review is conducted. áOnce that review is completed,á”every single truck in every single location” will be examined to determine the most “efficient” route forward. áIt was exciting to hear an administrator keeping the options (outside of the status quo) open. áBut the next line in the story asked about the recommendation of an accounting firm to merge with the more profitable EMS agency. áThen I began to hear that common refrain begin again when the chief respondedá”I’m not opposed to anything that improves service for citizens.” áHowever, he changed the melody a little by sayingá”You’ve got to build a model that fits this city. We need a ‘Made in Toronto’ solution.” áthere was no talk of “quantitativeáeasing” or government agencies “too big to fail.” áIt was, I hope, straight talk about finding real solutions in a bad economy. áIt may still be the money in the end, but let’s keep those options open until then. áAnd I hope more agencies look at “locally grown” solutions before defaulting to money or taking over EMS.

Oh, and just for the record, I would never really compare my wife to a union boss. áIt was just an analogy, Sweetheart.

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High Performance Emergency Medical Services (HP-EMS) systems provide effective clinical care promoting positive patient outcomes and community wellness while maintaining a focus on improving economic efficiency of the system.  This site is dedicated as a community seeking to increase agency performance by promoting useful information regarding the developing trends and improvements in the efficiency of delivering basic and advanced medical care in the field.

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Comments
daleloberger
EMS Deployment Community of Practice
A reader offered up this link to multiple fire department EMS analysis reports over time: https://sites.google.com/site/standardsofcoverfire/
2014-11-16 17:51:01
Rob Lawrence
Quick Thoughts from EMS World Expo 2014
In my High Performance EMS session I presented 'Robs 10 top tips' or Healthy Habits of High Performing Systems'. I majored on key elements of business practice, organizational performance and clinical excellence required in any high performing system, EMS or otherwise. My ten top tips were as follows: 1. Economic Efficiency. - money is getting…
2014-11-16 08:59:44
CJ Ewell
Is our success a sign of our failure?
A couple things- first, your discussion has nothing to do with schizophrenia and it does a disservice to your readers and the mentally ill to use this term inappropriately. Second, people need access to appropriate primary care options. Delivering these services in an expensive vehicle with a revolving cast of providers is a stop-gap, not…
2014-11-04 15:56:29
Phil Jordon
Impressions of the Ferno iN/X
John Staymose- You're only half correct on the weight issue. If you are lucky enough to work for an agency that has the Stryker lift system as well as the power cot, you do indeed enjoy having to do very little lifting. However, there are instances when your conclusion is erroneous. The major instance is…
2014-11-03 15:03:16
Laura Lant
Is our success a sign of our failure?
Interesting article, hit alot of points that are actual reality today - things realized but maybe not been focused on - I feel some of the issue is comunication and community education - we know what we do as providers and why we do it but does everyone else ? What is their actual perception?…
2014-11-02 07:48:53

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