Eight-man shift improves ambulance response time
The eight-man shift has improved response times by the fire department’s ambulances and fire truck, reduced the frequency that “mutual aid” assistance from neighboring towns is required, and town officials like the way the first 18 months of the program have gone.
“The eight-man shift has worked out very well,” First Selectman Rudy Marconi told The Press. “We’re able to respond to calls more quickly and we’ve seen a definite reduction in the amount if mutual aid. What that means is we have fewer instances when we have to call other communities for assistance with an ambulance.”
“It has been a total success,” said Fire Chief Jerry Myers.
Had any problems with it?
“No, we really have not,” Myers said.
With the eight-man shift, the town’s adopted a requirement that staffing be boosted by calling in off-duty firefighters anytime a shift falls below eight men on duty — two each to man four vehicles, either fire trucks or ambulances.
“The eight-man requires that at all times we have eight men on duty, whereas in the past we staffed to eight, but were not required to have more than six,” Marconi said. “So, in situations of vacations or sick leave, it was possible we only had six or seven people on duty.”
The cost is figured at about $260,000 a year.
“It’s not inexpensive. It’s a couple of hundred thousand dollars,” Marconi said.
“Overtime increased. We knew it would,” Marconi said. “But it was better than actually hiring people. The cost was substantially more if we were to go out and hire new people to meet the eight-man minimum.
“Most critically, here, we’re actually improving the level of service we’re delivering to the people of Ridgefield,” he said.
Total overtime at the fire department was budgeted at $436,053 for the 2017-18 year, and as of the finance board’s last report — through the end of May 2018 — $423,235 or 97% of that had been spent.
For 2016-17 —when the eight-man minimum shift was adopted half way through the fiscal year, in January 2017 — overtime was $303,549 through the end of May.
So, the cost was about $120,000 more for a full year of the eight-man in 2017-18, as opposed to six months in 2016-17.
Myers said the overtime approach to staffing the eight-man minimum — devised by former Chief Kevin Tappe and the selectmen, who act as the town’s Fire Commission — does add cost, but makes fiscal sense when compared to the cost of adding more firefighters to the department’s roster of 37 positions.
The department has four “platoons” of eight firefighters each, working 24-hour shifts, and also two firefighters who work days only, 8 a.m. to 8 p.m., three days on, three days off.
“Economically, when you look at the overtime number, that’s a big number,” Myers said. “If you were trying to accomplish the same thing by hiring people, we’d have to have 10 people on each shift to match that. That’s just cost prohibitive for a town of our size.”
Shifts at six
The principal difference in operations is when off-duty firefighters are called in to work on overtime. It used to happen when the number of firefighters working a shift got down to six. Now it happens as soon as a shift falls below eight.
“They could fall to six,” Myers said of the shifts. “If they fell to five, we’d hire one — call somebody in — to bring it back up to six.”
Now, when a shift falls to seven, someone’s called in to bring it up to eight.
Chief Myers described the typical deployment of the eight-man shift, with fire engines and ambulances ready to roll — three at fire headquarters on Catoonah Street, and one at the Ridgebury firehouse.
“We have an engine at Ridgebury, and an engine at headquarters, each with two people on it. And we have two ambulances at headquarters, each with two people on it,” he said.
“So, the improvement from the six to eight-man minimum meant that we staffed the second ambulance all the time.”
With just six firefighters on duty, the department could staff only three vehicles at once. When a second ambulance call came in, some switching around was required.
“Prior to that, we’d have to shut down one of the engines, and have those guys move into the ambulance,” Myers said.
“With six people, we had to rob Peter to pay Paul. And if we shut down one engine to staff the second ambulance, then we only had two [firefighters] to go a fire — and that’s not enough to enter the fire.”
That’s due to what’s known as the “two-in, two-out rule.”
”We’ve got to have four, at minimum, to enter a fire,” Myers said.
The first two responding firefighters don’t go into a fire until the second two firefighters have arrived and are on duty outside the fire — “to rescue the first two if something goes wrong,” Myers said.
Statistics comparing the last two complete calendar years, 2016 and 2017, show improvements in the department’s responses. The eight-man shift began in January 2017, starting half way through the 2016-17 fiscal year to spread the cost increase over two budgets, making it in effect two half-steps up of $130,000 each, rather than a full-step of $260,000 absorbed all in one budget year.
In 2017, the fire department responded to 3,276 “incidents,” compared to 3,233 in 2016 — an increase of 43 incidents, or roughly 1.5%, that were 30% fire and 70% ambulance calls, according to Myers.
The statistics showed:
- The department’s “average response time” was 7:00 minutes in 2016, but down to 6:33 in 2017 — a 7% faster average response.
- Some 59% if calls were responded to in 7 minutes or fewer in 2016, and that was up to 64% of calls in seven minutes or fewer for 2017.
- A response time of 10 minutes or fewer was achieved 82% of the time in 2016, and 86% of the time in 2017.
- In 2016, “98 people had to wait more than 15 minutes for a transporting ambulance to arrive” and in 2017 that was down to 59 people waiting 15 minutes or more for an ambulance.
- Waits of 20 minutes or more for an ambulance were experienced by 48 people in 2016, down to 29 people in 2017.
- The number of calls where “there was not a full assignment available” to staff the responding vehicle was 20% in 2016, and down to 11% in 2017.
- In 2016, the town requested “mutual aid transport” from neighboring towns’ emergency services 62 times, and in 2017, that was down to 29 times.
The benefits can go beyond simple response time, as the larger shift better accommodates instances where more than one vehicle is sent to an emergency.
“A lot of ambulance calls you need more than two guys,” Myers said. “A heart attack, or a bad fall, two guys aren’t going to be enough. So if the call meets a certain criteria, we send one engine with the ambulance so they have the necessary help. We get better coverage.”
Having more paramedics or EMTs on scene can be critical.
“Because all the career guys are EMS-trained, either paramedics or EMTs, if we send an engine with the ambulance we can do some intensive on-scene stabilization of the patient before we start the transport,” Myers said. “We start I-Vs, we give them tests...
“In a worst case, we can break one of the guys off and send a third guy with the ambulance during transport,” he said. “We can send a third off the engine...
“A cardiac arrest, or a person who flat out is not breathing, we’ll send an extra person — because one person’s necessary just to ventilate them, and the other person looks for problems, administers medications, maybe has to do CPR,” Myers said.
“We’ll put a breathing tube in them and attach it to a bag-valve-mask ventilator.”
The eight-man minimum is popular with the firefighters who work the daily shifts, according to Myers.
“The pressure of working on the six-man alignment is very significant,” he said.
With only six men on duty, the two firefighters in the Ridgebury firehouse were often asked to scramble down to headquarters on Catoonah Street to cover for the two vehicles that are out on call.
And a standard deployment of two ambulances and two fire trucks, each with a two-member crew, works better than six firefighters manning one ambulance and two fire trucks.
“We weren’t fairly dividing the workload around the department,” Myers said. “Two guys were trying to do the work of four, because we were trying to make do with just one ambulance, whenever possible.”
Marconi said the firefighters appreciate it.
“When you come to work you know you’re going to be assigned to a specific piece of equipment and have that assignment throughout your shift, the full 24 hours, rather than in the past having to be on engine one, and then jumping into the ambulance to do an EMS call, rushing back to the firehouse to go on an alarm call,” he said.
“It certainly allows for a much smoother operation that I think has improved morale among the men and women in our department,” Marconi said, “as well as increasing the efficiency of the service and the level of service to the people of Ridgefield.”