Mara H. Gottfried On Jul 11, 2017
An outside study commissioned by the city of St. Paul, MN, has recommended that its fire department begin shifting resources from fire suppression toward emergency medical services.
July 11–An overwhelming percentage of calls to St. Paul firefighters are for medical emergencies, and the fire department needs “a paradigm shift” to best handle the workload, according to an outside study of the department.
Fires account for less than 5 percent of the emergency calls in St. Paul, and about half of 1 percent are structure fires. Meanwhile, demand for emergency medical services has been increasing 3 to 4 percent annually, much faster than population growth, and is likely to continue to increase, the review by TriData found.
“To meet the increasing EMS demand the city must add more resources — either through funding, or by shifting budget resources from (fire) suppression to EMS,” said the report, which St. Paul City Council members received Monday and will begin discussing Wednesday. “Increased medical demand is the No. 1 threat to maintaining services at the high quality they are now.”
Overall, the report said the city “is getting very good fire and EMS service from its fire department, and it is equitably delivered” among neighborhoods. The recommendations “are largely to increase efficiency in light of the burgeoning EMS demand,” according to the report.
One recommendation is to consider eliminating one of St. Paul’s three fire-rescue squads in order to reallocate staff to ambulances. The rescue squads respond to fires and to vehicle crashes to extricate people, and each also has specialty functions.
St. Paul Fire Chief Tim Butler said he does not believe that cutting a rescue squad is the best strategy, but he would be willing to sit down to discuss it with firefighters, union officials and the city’s leadership. The president of the union representing rank-and-file St. Paul firefighters said he does not support cutting a fire rig.
“Our effort has been pretty clear and historical along the way — we have asked for additional resources for EMS,” Butler said Monday. “We don’t think taking fire-suppression units out of service in order to enhance EMS is the correct answer.”
St. Paul allocated $100,000 for the study of the fire department’s deployment and staffing practices, and the final tab was $80,000. The report is intended to be a step toward helping the department craft a strategic plan.
City Council member Chris Tolbert, who pushed for the study, said it’s important to have outside eyes looking at how the department is doing, especially as St. Paul’s population has grown.
“It was clear that we have a great fire department and part of the reason we do this is to ensure it continues to be a leader,” he said. Tolbert said he wants to hear from Butler and firefighters about their reactions to the recommendations and which they think should be prioritized.
BEEFING UP MEDICAL RESPONSE
Ten years ago, the city also hired TriData to conduct a review of the St. Paul fire department. The Virginia-based company found then that medical calls amounted to 80 percent of the department’s business but that they were a secondary priority. The 2007 report suggested putting paramedic rigs at every station and shifting staff so they could be on medical and fire calls simultaneously.
Thirteen of St. Paul’s 15 stations have ambulances. Three of the ambulances are part of a “supermedic” program that Butler started.
All St. Paul firefighters are EMTs and 38 percent are paramedics. At 10 fire stations, there are four firefighters assigned to a fire apparatus and an ambulance. Whether it’s a medical or a fire call, all four crew members respond together. If an apparatus is responding to a call and the same station gets a medical call, an ambulance from the nearest station has to respond.
At the three stations with supermedics, two firefighters are added to the four-member team, allowing them to staff an ambulance and an engine at the same time. Adding the supermedics “have greatly improved service delivery,” the new TriData study said.
The report said the fire department has a fire rig and ambulance respond “to the same calls, thereby reducing the effectiveness of independent staffing for medic units.” Butler, however, said they do not respond to all of the same calls, unless it’s a fire or major medical emergency.
The current supermedics are stationed downtown, on East Maryland Avenue between Hazelwood and Kennard streets, and on Como Avenue near the Minnesota State Fairgrounds.
The study’s recommendations also include:
- Increasing the fire department’s efforts to recruit paramedics.
- Replacing a second fire engine at the West Side station with a supermedic unit.
- Upgrading the medic units to supermedics at the stations at Snelling and Laurel avenues, and Payne and Hawthorne avenues.
RESPONSE TIMES STUDIED
The study also looked at fire department response times. In general, most St. Paul fire front-line units have travel times of four to six minutes to 90 percent of incidents within the city, the report said.
Three of the department’s units exceed travel times of 6 minutes for 90 percent of their responses: a rescue squad at West Seventh Street and Randolph Avenue, an ambulance on Como Avenue near the Minnesota State Fairgrounds, and a ladder truck stationed at Edgcumbe Road and St. Paul Avenue. The three vehicles and their crews help in areas beyond where they are stationed and have longer travel times, the study noted.
But the report said the fire department’s “turnout” time, which is measured from when a call is dispatched to when a unit heading out, is too long — up to 2 minutes and 46 seconds for 90 percent of responses — and that they should aim to improve that. The national recommendation is that turnout times not exceed 1 minute for medical calls, and 1 minute 30 seconds for fire calls.
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