Reconfiguration Update San Francisco Fire Department EMS Division
Collaborative Process Under the Direction of the Chief of Department, Deputy Chief of Operations, and the Deputy Chief of Administration –Department of Human Resources –Division of Training –Bureau of research and Planning –EMS Division: Admin., Ops, QM –H-3 Committee / PMs & Local 798
This Presentation Transition of Static to Dynamic Deployment Posting Locations Workload Transition Logistics Support Center Patient Care & Performance Management Challenges to Response times in the City & County of San Francisco What is next?
Project Goals Operate within County mandated response time guidelines Stabilize / equalize workload across static ambulances Complete Truck training Data Driven Measurable and Controlled changes Limit Risk exposure Fire / EMS Industry Best Practices
hour Ambulances
Transition of Static to Dynamic Deployment Static Deployment = Fixed facilities / stations Dynamic Deployment = System Status Management [SSM] SSM matches the Service Demand (calls) with Resources (ambulances/medical units) and moves these resources in the system/City to where the service is needed
Phase 1 Close Medics [24 hour]: Station 1, Station 3, Station 36 Add: Ambulances on 10 hour shifts Develop posting location in the center of the highest Demand for service Develop Business rules to assist dispatch with placing the ambulances where they are needed
Highest Call Volume Per Mile 2
Workload per District 11/06
Comparison of Nov 06 & Aug 07
Phase 4 Close Medics: 11, 21, 28 Add additional shifts Deploy a combination of 2 paramedic ambulances & 1 EMT + 1 paramedic ambulances Continue to monitor performance metrics
Static Layout Phase 4
Logistics Support Center 1415 Evans Street Best Practices for the Center –Sunstar – Pinellas County –AMR - Alameda County Nine Fuel / Supply Hubs at Firehouses Mobile Supply caches Performance Management –Section Chief EMS Operations –Captain –Lieutenants –Field RC’s –Quality Management
Patient Care Comprehensive Performance Management Program approved by the EMSA 1.Each new PM surveyed regarding course content 2.Surveyed a second time after 30 days regarding course content applicability 3.90, 180, 270 & 360 day skills testing Critical failures addressed with remediation 4.Paramedic Captain ride-a-long with performance narrative regarding each new member in a data base 5.Interview with EMS-1 regarding Division performance and career path forward
Good Reports From RC’s Field crews [suppression] they work with From their new colleagues in the ambulances From the Hospital staff EMSA Medical Director SFFD Medical Director Citizens at large Patients
SFFD Outreach Programs HOMETEAM –Work with Department of Public Health to mitigate Demand… while getting the patient connected with services Asthma Outreach –Healthy communities / dealing with illness as a child or young adult McMillan –Alternative transport facility / sobering center Mental Health receiving facility alternatives
What is Next? Continue with Performance Management Plan Continue Outreach Interoperable training with Firefighter paramedics and the new members Interoperable training with Private sector
Align DPH Policy & Planning for system implementation with SFFD Department of Public Health: Surge capacity & Mass Care –Planning, Policy –Patient tracking –Equipment specs & purchases w/HLS support –Interoperable exercises
Pinnacle 2007 EMS Leadership Conference 400 EMS Leaders Best Practices SFFD is On Track! –SSM –Mission driven, employee collaborative/transparent, & patient focused –Data validated process –Local and Regionally interoperable –Living process with constant monitoring and input
Intentionally Blank
Response Time Challenges Supply & Demand is the issue Supply –can be monitored and adjusted –Hospital diversion Demand –Difficult to predict sudden changes –Trend analysis ongoing –Workload monitoring daily –Hospital diversion –Working on Special programs Wellness programs Dispatch efficiencies Performance management at the street level
CHN VA PMC STF KSF STM UC RKD SFGH STL STN B - 10 B - 9 B - 8
Ambulance Destinations
Hospital Diversions in SFGH 19% UCSF 8 %
Location of the Hospitals