GFD - Independent Report

Final Report Fire/EMS Operations Germantown, Tennessee

Submitted by and reply to: ICMA Center for Public Safety International City/County Management Association 777 North Capitol Street NE, Suite 500 Washington, DC 20002 [email protected] 202-962-3607

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ICMA Background The International City/County Management Association (ICMA) is the premier local government leadership and management organization. Since 1914, ICMA’s mission has been to create excellence in local governance by developing and advocating professional local government management worldwide. ICMA provides an information clearinghouse, technical assistance, training, and professional development to more than 9,000 city, town, and county experts and other individuals throughout the world.

ICMA Center for Public Safety Management The ICMA Center for Public Safety Management team helps communities solve critical problems by providing technical assistance to local governments. The ICMA Center for Public Safety Managements’ areas of expertise encompass the following areas and beyond: organizational development, leadership and ethics, training, assessment of calls for service workload, staffing requirements analysis, designing standards and hiring guidelines for police and fire chief recruitment, police/fire consolidation, community-oriented policing, and city/county/regional mergers.

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Table of Contents
Executive Summary ............................................................................. 9 I. Introduction ................................................................................... 10 II. Overview...................................................................................... 11 III. Operations Analysis ...................................................................... 12 A. Evaluating Local Risks and Determining Resources ........................... 12 1. Risk Management ...................................................................... 14 B. Challenges Facing a Combination System....................................... 16 1. 2. 3. 1. 2. 3. 1. 2. 3. 1. 2. 3. 4. 5. National Trends in Volunteerism .............................................. 16 Planning for Future Participation .............................................. 18 Where are Volunteers Needed? ................................................ 19 Developing an Effective Performance Measurement System ........ 23 Program Logic ....................................................................... 25 Benchmarking ....................................................................... 29 Medical Transportation ........................................................... 33 Economic Factors Surrounding Policy Implementation ................ 35 Cost Factors .......................................................................... 37 Reducing Response Times ....................................................... 45 National Standards ................................................................ 46 Standards of Response Cover .................................................. 50 Risk versus Response Time Standards ...................................... 50 GFD Response Time Analysis ................................................... 51

C. Measuring Performance in an Emergency Service Organization ......... 22

D. Ambulance Transport Service ........................................................ 32

E. Fire Station Location..................................................................... 42

F. Organization and Deployment – Increased Fire Potential within Germantown ................................................................................... 52 G. Alternative Options for GFD Funding Allocations .............................. 54

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1. 2. 3. 4. 5. 6. 7. 8.

Data and Management Information Systems ............................. 54 Communications .................................................................... 55 Geographic Information Systems (GIS) .................................... 55 Computer Aided Dispatch (CAD) .............................................. 56 Global Positioning Systems ..................................................... 56 Wireless Data and Laptop Strategies ........................................ 57 Fire Prevention and Public Education ........................................ 57 Public Education .................................................................... 58

H. Recommendations ....................................................................... 61 Data Analysis Introduction ....................................................................................... 63 I. Aggregate Call Totals and Dispatches ................................................ 64 II. Workload by Individual Unit—Calls and Total Time Spent .................... 75 III. Dispatch Time and Response Time .................................................. 81 IV. Analysis of Busiest Hours in the Year ............................................... 96 Appendix I. Correspondence between Call Description and Call Type ....... 102 Appendix II. Workload Analysis for Administrative Units and NonGermantown Units ............................................................................ 105

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Tables Table 1. Call Types ............................................................................. 64 Table 2. Calls by Hour of Day ............................................................... 70 Table 3. Number of Units Dispatched by Call Type .................................. 71 Table 4. Annual Deployed Time by Call Type Including Mutual Aid Calls ..... 73 Table 5. Annual Total Deployed Time by Call Type for Calls within Germantown ...................................................................................... 74 Table 6. Call Workload by Unit and Station ............................................ 75 Table 7. Busy Minutes by Hour of Day ................................................... 77 Table 8. Engine and Truck Units: Total Annual Number and Daily Average Number of Runs by Call Type ............................................................... 78 Table 9. Engine and Truck Units: Daily Average Deployed Minutes by Call Type ................................................................................................. 79 Table 10. Rescue Units: Total Annual and Daily Average Number of Runs by Call Type ........................................................................................... 80 Table 11. Rescue Units: Daily Average Deployed Minutes by Call Type ...... 80 Table 12. Average Dispatch, Turnout, Travel, and Response Time of First Arriving Units by Call Type ................................................................... 82 Table 13. Average Response Time of First Arriving Units by Call Type ....... 84 Table 14. Number of Total Calls for the First Arriving Units ...................... 85 Table 15. Average Dispatch, Turnout, and Travel Time of First Arriving Units by Hour of Day ................................................................................... 87 Table 16. Average Response Time of First Arriving Units by Hour of Day.... 89 Table 17. Cumulative Distribution Function (CDF) of Response Time of First Arriving Unit for EMS Calls ................................................................... 91 Table 18. Average Response Time for Structure Fire and Outside Fire Calls by First Arriving Fire Units ................................................................... 92 Table 19. Average Response Time for Structure Fire and Outside Fire Calls by Second Arriving Fire Units ............................................................... 93

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Table 20. Cumulative Distribution Function (CDF) of Response Time of First, Second, and Third Arriving Fire Units for Structure and Outside Fire Calls .. 95 Table 21. Frequency Distribution of the Number of Calls .......................... 96 Table 22. Ten Hours with the Most Calls Received ................................... 97 Table 23. Unit Workload Analysis Between 10 p.m. and 11 p.m. on January 29, 2010 ........................................................................................... 98 Table 24. Unit Workload Analysis Between 10 a.m. and 11 a.m. on April 13, 2010 ............................................................................................... 100

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Figures Figure 1. Performance Measurement Systems ........................................ 24 Figure 2. General Program Logic Model ................................................. 26 Figure 3. Costs Needed to Support a New or Expand an Existing Program. . 39 Figure 4. Incident Development and Response Timeline and NFPA 1221 and 1710 Recommendations for Career Firefighters ...................................... 48 Figure 5. Incident Development and Response Timeline and NFPA 1221 and 1720 Recommendations for Volunteer Firefighters .................................. 50 Figure 6. Outcome for Heart Attack Victims Based on When CPR is Provided ........................................................................................................ 59 Figure 7. Non-canceled Calls by Type and Duration ................................. 66 Figure 8. Non-canceled EMS and Fire Calls by Type ................................. 68 Figure 9. Average Calls per Day by Month ............................................. 69 Figure 10. Calls by Hour of Day ............................................................ 70 Figure 11. Number of Units Dispatched by Category................................ 71 Figure 12. Busy Minutes by Hour of Day ................................................ 77 Figure 13. Average Dispatch, Turnout, Travel, and Response Time of First Arriving Units by Call Type ................................................................... 82 Figure 14. Number of Total Calls for the First Arriving Units ..................... 85 Figure 15. Average Dispatch, Turnout, and Travel Time of First Arriving Units by Hour of Day ................................................................................... 86 Figure 16. Average Response Time of First Arriving Units by Hour of Day .. 88 Figure 17. Cumulative Distribution Function (CDF) of Response Time of First Arriving Unit for EMS Calls ................................................................... 90 Figure 18. Cumulative Distribution Function (CDF) of Response Time of First, Second, and Third Arriving Fire Units for Structure and Outside Fire Calls .. 94 Figure 19. Unit Workload Analysis by Call Type Between 10 p.m. and 11 p.m. on January 29, 2010.................................................................... 99

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Figure 20. Unit Workload Analysis by Call Type Between 10 a.m. and 11 a.m. on April 13, 2010 ...................................................................... 101

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Executive Summary
The report provides an analysis and evaluation of various aspects of the city of Germantown Fire Department with emphasis on challenges facing combination type departments in light of decreased volunteer resources, feasibility of Advance Life Support program expansion, options for future funding allocations, and improvements to the strategic management processes. Peak load staffing solutions in the wake of increased demands brought on by increasing emergency medical responses has been in use in other departments for some time. Various approaches to increase volunteerism are employed by nonprofit organizations with great success. Supplementing volunteer membership with paid part-time employees is a natural transition for the combination department whose call volumes continue to escalate. Some recommendations challenge perspectives regarding deployment initiatives. Although ICMA data analysis mirrors the results of some GFD internal performance indicators, a different approach is taken with respect inferences made and conclusions drawn. The goal in these instances was to stimulate creative thinking and cost-effective measures for improving service delivery efforts. System service enhancements can be achieved in a modest fashion thereby re-directing funds to other deserving areas. Reconstructing performance objectives as a part of the development of a total performance measurement system will aid in accountability and monitoring goal achievement.

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I. Introduction
ICMA was retained by the City of Germantown, Tennessee to conduct a study of the Germantown Fire Department (GFD). The department is all risk providing Suppression, Emergency Medical Service, Hazardous Materials and Technical Rescue, Fire Prevention and Public Education, Emergency Management, and Community Emergency Response Team services. The organization has evolved over the years from an all-volunteer service to its present form of a combination fire department. GFD has enjoyed many successes on the road to improving the level of service provided to its citizens. It is a well-organized department with established well written and maintained standard operational procedures. These guidelines provide a significant measure of safety to both its emergency responders and the citizens of Germantown. It uses strategic management concepts to determine its future direction based upon continued environmental scans both internal and external - to identify challenges and opportunities. The department consists of a dedicated group of men and women, paid, volunteer and civilian which contribute to its delivery of exceptional service to the community.

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II. Overview
The project team conducted an on-site analysis mid-August 2010. Qualitative interviews were conducted with members of the command staff. All operational facilities were visited and less formal qualitative interviews transpired with facility personnel. A thorough review of literature was made examining the latest information regarding the subject matter. Observations made in the data analysis were used to make inferences as to operational strategies to employ for service delivery improvements. The study focused on the following key issues: What are the advantages/disadvantages associated with a change of EMS service delivery method from private to fire based transport? What organization and deployment methods are needed in light of a new mixed used neighborhood which will include an eight story building? What is the appropriate staffing, deployment, and equipment levels needed taking into consideration the possibility of additional fire station? What challenges are present in a ―combination‖ type department and what is the most effective use of its reserve component? What opportunities for continuous improvement exist and what are the key variables that should be tracked routinely to assist with budgetary and policy decisions. The Operational report will show tables and figures representing national standards for fire department response times; components of performance measurement systems; State of Tennessee census data; cost associated with program development; demand analysis data, and Cardiopulmonary Resuscitation timeline.

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III. Operations Analysis
A. Evaluating Local Risks and Determining Resources The City of Germantown Fire Department (GFD) Strategic Plan 2009-2014 identifies its number one core business as that of suppressing fires. Operating element number eight lists identifying fire risks and assessing community risks. The department has developed a business plan to identify the magnitude and scope of probable fire risks in the community, a plan that every fire department should conduct and periodically update. This risk analysis or assessment process enables the department to determine what assets within the community are at risk and what resources are available or needed to effectively deal with them. A universal tool that allows the entire community to be evaluated in relation to the risk of fire is the Risk, Hazard, and Value Evaluation (RHAVE) model, which the Commission on Fire Accreditation International developed as a way to classify individual properties in relation to protecting lives and property.1 The RHAVE software and documentation is available at no cost from the U.S. Fire Administration. The risk evaluation process enables a department to establish a fire risk score for every property and to categorize a property as one with either low, moderate, or high/maximum risk. Once completed, the risk ratings of individual properties can be aggregated to establish a risk level of low, moderate, or high/maximum for each geographic area of the community. These ratings are then used to determine the appropriate level of fire

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Managing Fire and Rescue Services, Third Edition, ICMA, 2002, p. 40.

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suppression resources needed (equipment, personnel, and apparatus) to be deployed for the initial arriving unit, the full alarm assignment, and any additional alarm assignments for each level of risk. The GFD has successfully developed a strategic plan. However, its business plan needs to be refined if the department wishes to achieve its goals. A business plan is the direct link between the operational planning of a department and the overall community’s agenda. Business planning is the process of arriving at a document that outlines how the organization will achieve its objectives in conjunction with the fiscal constraints set by the budget process. The document outlines the major tasks to be performed to a specified level of service (e.g., responding in a certain number of minutes in at least a certain percentage of calls or having a certain number of firefighters on scene within a certain number of minutes for at least a certain percentage of all reported working fires) and the cost associated with those tasks.2 The development of these targets or performances measures will be addressed later in the report. Miami-Dade County incorporated the strategic planning process into its management system in the early 1990s. This has evolved since then into a highly efficient and effective method for monitoring the performance of its departments. It is the department business plan, outlining performance measures, that makes it a highly effective accountability document. The GFD business plan was analyzed against a business plan recommended by ICMA in its book Managing Fire and Rescue Services (p. 175). Although the GFD plan does touch key areas such as customer identification, services analysis, history, mission, vision and broad goals, it fails to identify specific objectives and the action plans necessary to carry them out. Program

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Managing Fire and Rescue Services, Third Edition, ICMA, 2002, pp. 172-173.

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objectives should specify milestones to be attained within certain time periods. To do otherwise does not convey management commitment to achieve any particular results. Moreover, they provide little guidance for defining meaningful measures to assess performance. Truly useful objectives can be developed using the SMART convention: such objectives are specific in terms of the results to be achieved, measurable, ambitious but realistic, and time bound.3 The subject of performance measures is addressed in Section III-C of this report, ―Measuring Performance in an Emergency Service Organization.‖ 1. Risk Management After risks within the community are identified, appropriate control measures can be developed. The three generally accepted risk control measures are: Risk avoidance – making sure that the conditions giving rise to risk are eliminated or not allowed to arise. Risk transfer – moving the risk to another agency or an insurance company. Risk control - most commonly used by fire departments, this involves implementing measures to control the frequency and severity of losses and reduce the overall impact of community risks. With regards to risk management, this report will focus on all three risk control measures in some form or another. When looking at risk avoidance, naturally one thinks of fire prevention and public education. Effective measures to control risks take various forms. An ordinance that requires the installation of fire suppression and detection

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Measuring Performance in Public and Nonprofit Organizations, Poister, T. H. 2003, pg. 63

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systems is an example of a risk control measure, as is marking the exterior of abandoned buildings. The greatest potential for increasing the installation of home fire sprinkler systems is in new construction. Although a large percentage of current housing stock in Germantown is considerably aged, it is important to ensure that future residential buildings employ adequate control measures. The construction of multi-use buildings within the city should take advantage of all available measures to ensure the safety of occupants. Further, the use of these measures helps to bring down the cost of suppression forces needed to provide fire protection.

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B. Challenges Facing a Combination System The GFD operates a combination system fire department, which presents certain challenges not seen in fully-paid emergency service organizations. Generally, there are a number of factors that may cause a combination department such as GFD to assess its need for increased dependence on call or paid personnel. Overall call volume can be a major factor in a determining the need to increase paid staffing when the number of assigned volunteers is holding steady or dwindling in light of increasing call volume. Assessing when to evaluate the type of emergency service organization a jurisdiction chooses to operate is dependent on multiple factors, including rapid population growth, addition of new or different levels of service (such as the plan to implement ambulance transport within GFD), increased hazards within the response district, and changes in demographics. The most common change is rapid residential growth, often in the form of single family, two family, and multi-family structures. 1. National Trends in Volunteerism

Emergency medical services in the United States have depended on volunteer support for many years and the importance of volunteers cannot be overstated. Volunteers are of all ages, with the largest number between the ages of 30 and 45. At the same time, almost a quarter of the population under the age of 30 and over age 65 is involved in volunteer work. Each sex is represented equally among volunteers; almost one-half of all males and females are involved in volunteer activities. Both white collar and blue collar

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workers, as well as students and retirees are represented among volunteers.4 Prior to 1975 in Germantown, firefighters trained in first aid responded to calls for medical assistance. In 1975, three Germantown firefighters became licensed as Emergency Medical Technicians and the department placed a basic life support response truck in service. Thus, the GFD has a thirty-five year commitment to providing emergency medical treatment to citizens of Germantown. Volunteers have played a significant role in the advancement of service delivery not just in fire suppression but EMS activities as well. The key to any successful program is its leadership. Without the commitment of a manager to champion its cause, any program is destined to evaporate into nothing more than an ineffective nuisance – something that gives the appearance of being more trouble at times than its worth. The management of a volunteer program is no different. It is important that the GFD recognize the need for dedicated leadership and management responsibility for its volunteers. Simply assigning a volunteer to fill the management role creates issues of continuity of leadership. Likewise, placing it under the umbrella of an assistant chief’s responsibilities does little in the way of providing the close direction required to achieve established goals and objectives. A full-time, paid employee can provide the needed continuity of management and can represent the interests of volunteers, paid personnel, and the community at-large.

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Emergency Medical Service Recruitment and Retention Manual, Federal Emergency Management Agency, U.S. Fire Administration, (no date), pg. 3.

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2.

Planning for Future Participation

In order to be competitive in the marketplace of volunteerism, an organization must accept certain realities. Volunteer programs must be planned thoughtfully and managed well if they are to succeed. The combination fire department would do well to take lessons from the nonprofit agencies thatdepend primarily on volunteers in order to sustain their operations. Fire departments and EMS agencies alike must compete with other community organizations to attract the most capable and committed volunteers. According to the U.S. Fire Administration, here are the basic steps for recruiting and selecting EMS volunteers.5 Develop and implement a needs assessment based on the EMS organization’s current volunteer staffing, existing vacancies, and anticipated need for staffing, including daytime volunteers. Identify the skills, knowledge, and abilities needed and any specific certifications required. Prepare job certifications required. Prepare job descriptions based on tasks and responsibilities. Develop a plan and timetable for the recruitment of the various types of volunteer personnel and skills needed. Implement a system for evaluating potential volunteers that is compatible with applicable civil rights laws. The evaluation system used may be an existing system or a new system developed by the organization; however, the procedures employed in the system must be valid and reliable. Skill or knowledge tests, if appropriate or openended interview forms should be administered. Tests based on the performance of real tasks offer the most reliable information about the

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Emergency Medical Service Recruitment and Retention Manual, Federal Emergency Management Agency, U.S. Fire Administration, (no date), pg. 8.

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relative abilities of candidates for volunteer positions and are more easily shown to be valid if challenged in court. Rate or rank order the applicants based on established criteria. Select the candidates with the best qualifications. Develop a schedule compatible with current and anticipated needs for volunteers for bringing the selected candidates on board. Schedule follow-up contacts with qualified candidates placed on a waiting list. Implement an orientation and training program for new volunteers. Assess the progress of new volunteers and make recommendations as to changes needed in performance or training. As can be seen from the preceding list of tasks associated with recruitment and selection program, oversight cannot be haphazard. The success of an organization’s ability to provide the volunteers needed to assist in its operations will depend largely on its commitment to providing the resources required to achieve its desired goals. 3. Where are Volunteers Needed?

The GFD uses volunteers as paramedics, firefighters, and members of the Community Emergency Response Team. Of course, these jobs are not the only ones in which volunteers bring added value to the services delivered by emergency service organizations. For example, in Miami-Dade County, senior volunteers participate in a public education program to bring fire safety information to their peers in nursing homes, senior adult congregate living facilities, and at fire station open houses. In Germantown, people between the ages of 60 and 70 years make up about 22 percent of the population. This suggests the possibility of a fertile marketplace for volunteerism.

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The following list of volunteer recruitment and retention strategies can point the way for the GFD as it looks for ways to improve its recruitment and retention program. Additional information for each strategy can be obtained from the source of the list (see note).

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Volunteer Recruitment and Retention Strategies for Fire Departments6 Annual volunteer recognition event Availability of nonoperational opportunities Buddy system Clearly written job descriptions Competitive testing for promotions Encouragement of family participation Formal recognition system Free insurance Free meals during longdistance runs Free personal equipment and protective clothing Multilingual recruitment New, well-maintained vehicles Open house Out-of-town conferences Participation-based compensation Physical activities Piggybacking of recruitment activities Print advertisements Recruiter incentives Stipend (service account) for volunteers who meet minimum weekly participation requirements Targeted recruitment 24-hour central telephone access by prospective volunteers Vacancy announcements Volunteer EMT week Youth development programs Youth education

Free training Informal recognition system Length of Service awards program Mentoring Movie theater advertisement Welcome wagon

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Emergency Medical Service Recruitment and Retention Manual, Federal Emergency Management Agency, U.S. Fire Administration, (no date), pg. 47-48.

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C. Measuring Performance in an Emergency Service Organization The question of how to measure agency and program performance within a public organization is one of the big issues within the field of public administration today. Strategic planning and management has come to the fire service and is unlikely to go away. It is leadership and the proper and effective use of the right tools which will impact plan implementation. Performance measurement is the ongoing monitoring and reporting of program accomplishments, particularly progress toward pre-established goals. The need to continually assess performance requires the addition of new words and definitions to the fire service lexicon. Fire administrators need to know the different tools and consequences of their use.7 Administrative feasibility. How difficult will it be to set up and operate the program? Effectiveness. Does the program produce the intended effect in the specified time? Does it reach the intended target group? Efficiency. How do the benefits compare with the costs? Equity. Are the benefits distributed equitably with respect to region, income, sex, ethnicity, age, and so forth? Political feasibility. Will the program attract and maintain key actors with a stake in the program area? Performance measures are objective, quantitative indicators of various aspects of the performance of public programs or agencies. Different kinds of measures are used to track particular dimensions of performance, such as effectiveness, operating efficiency, productivity, service quality, customer satisfaction, and cost-effectiveness. Performance measurement refers to the process of defining, observing, and using such measures. The following is a

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Managing the Public Sector, Eighth Edition, Starling, Grover, 2008, pg. 242.

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step-by-step process for designing and implementing a performance measurement system.8 1. Developing an Effective Performance Measurement System

Performance measurement systems vary among types of agencies. Some systems focus primarily on efficiency and productivity within work units, and others are designed to monitor outcomes produced by major public programs. Still others track the quality of the services provided by an agency and the extent to which clients are satisfied with these services. Measurement systems are the principle vehicle for observing, reporting, and using performance measures. In addition to the management function, performance measurement systems consist of three components which pertain to data collection and processing, analysis, and consequent action or decision making as shown in Figure 1.

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Measuring Performance in Public and Non-Profit Organizations, Poister, Theodore H., 2003, pg. 3-4.

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Figure 1. Performance Measurement Systems

The following represents steps associated with implementation.9 1. Secure management commitment. 2. Organize the system development process. 3. Clarify purpose and system parameters. 4. Identify outcomes and other performance criteria. 5. Define, evaluate, and select indicators. 6. Develop data collection procedures. 7. Specify the system design. Identify reporting frequencies and channels. Determine analytical and reporting formats. Assign responsibilities for maintaining the system. 8. Conduct a pilot and revise if necessary (optional). 9. Implement full-scale system. 10. Use, evaluate, and modify the system as appropriate.

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Measuring Performance in Public and Non-Profit Organizations, Poister, Theodore H., 2003, pg. 22.

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2.

Program Logic

Public programs should be planned and managed with an eye toward specifying and achieving desirable results. If a program cannot articulate worthwhile results and provide evidence that its activities are producing them, continued support will or should be questioned. Any sound program design must be based on a set of assumptions regarding the services the program provides, the clients it serves or the cases it treats, its intended results, and the logic of how the use of resources in particular programmatic activities will be expected to produce these results.10 Figure 2 represents a pictorial view of the logic model.

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Measuring Performance in Public and Non-Profit Organizations, Poister, Theodore H., 2003, pg. 36-37.

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Figure 2. General Program Logic Model

The logic model clarifies what goes into a program, who its customers are, what services it provides, what immediate products or outputs it produces, and what outcomes it is supposed to generate. Once this has been done, the most relevant measures can be identified. For the most part, the type of measures include measures of output, efficiency, productivity, service quality, effectiveness, cost-effectiveness, and customer satisfaction.11 There are several studies, some of which date back to the 1970s, that highlight important performance measures for fire departments. The GFD has begun the process of measuring its performance, but more needs to be done. There have been many key changes in fire codes since the 1970s. This can have a profound impact on measures of fire department performance.

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Measuring Performance in Public and Non-Profit Organizations, Poister, Theodore H., 2003, pg. 47.

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Fire detection and suppression equipment is now required in most new construction. There are more requirements for nonflammable building contents, such as upholstered furniture and mattresses and bedding.12 The easiest and best way of applying quantitative performance measures to qualitative goal statements is to specifically identify target rates or percentages of each goal. Elected officials will then gain a better understanding of what it is the department is trying to achieve. For example, stating that the GFD’s ‖response time goal‖ is to reduce response time is a fine goal. However, an effective measure for this goal would be the percentage of time the department responds to fire incidents in five minutes or less. Another example of a qualitative goal statement might be to ―control fire spread upon arrival’‖ The department could use this measure: percentage of fires that did not spread beyond the area of origin after arrival of the fire department. The GFD collects the typical fire department data, such as response times, total inspections, code violations found, code violations corrected in ninety days, and response to structure fires by type. These statistics, although reflective of typical measures seen among fire service organizations today, should link department goals to specific target rates or percentages if they are to be used persuasively to justify budget requests to city officials. According to Schaemann and Swartz in Measuring Fire Protection Productivity in Local Government, The Urban Institute and NFPA, 1976, a large part of the fire service contribution to reducing loss can be measured by combining response time measures with measures of fire spread after

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Fire Service Performance Measures, National Fire Protection Association, 2009, pg.3

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arrival of the fire department. They also suggest analyzing the crash rate en route to or from fires to indicate if response times are being achieved at the expense of increased damage and casualties during response. Additional methods that may be used for measuring success are:13 Comparing fire incidence, casualty, and property loss rates over time both within the department and with the same rates of departments in comparable communities. Measuring the percent of fires confined to the room of origin. Measuring intermediate outcomes, such as ―number of preventable fires‖ (where ―preventable fires ―is defined as fires that could have been prevented if an inspector or other educational intervention had been performed). Measuring citizen satisfaction with fire department performance. (Public opinion of firefighters is generally quite high: thus any indication of dissatisfaction among citizens should be considered an indicator of possibly serious problems within the department.) Although responding to fire incidents, by definition, is the fire department’s primary mission and the majority of performance measure research focuses on this function, performance measures must be identified for each organizational function. They are especially important with regards to areas of service delivery. Below are examples of outcome measures for fire protection services.14

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How Effective Are Your Community Services: Procedures for Performance Measurement, Third Ed., ICMA, The Urban Institute, 2006, pg. 81-82. 14 How Effective Are Your Community Services: Procedures for Performance Measurement, Third Ed., ICMA, The Urban Institute,2006, pg. 82-83.

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Number of civilian (a) injuries and (b) deaths related to fires, absolute and per 1,000 population. Number of firefighter (a) injuries and (b) deaths per 100 firefighters. Direct dollar loss from fires (a) per $1,000 property protected and (b) per 100,000 population. Percentage of homes with working smoke alarms. Percentage of (a) homes or (b) businesses with working sprinklers. Average dollar loss for fires not out on arrival, by property type. Percentage of fires confined to room or area of origin (or a specified areas expressed in square feet). 3. Benchmarking

Benchmarking is the search for practices that lead to superior performance. Basically, it involves comparing performance across organizations to measure one’s own achievements and identify ways to improve. Unfortunately, most comparisons in the public sector focus on resources rather than on performance. The most common resource comparisons in the fire service are per capita costs, the number of firefighters per 1,000 population, and the number of firefighters assigned to each piece of apparatus. A primary difference between comparative resource analysis and benchmarking is the extent to which the latter focuses on methods for improving performance. Benchmarking seeks to identify best practices and then implement those practices to enhance performance. The following is an example of comparative data (taken from State of Tennessee fire department census data):

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Fire Dept. Germantown Shelbyville Barlett Millington Gallatin Collierville

Type MC MC MC MC MC

County Shelby Shelbywille Shelby Millington Gallatin Shelby

No. of Sta. 4 3 5 4 3 5

Paid Volunteer CA 67 37 94 47 57 64 25 18 30 30 9 0

P/C 0 0 0 0 0 15

MC = Mostly Career; Paid CA = Paid Career; P/C = Paid per call.

Whether initiated by a number of counterpart agencies or mandated by some higher level of authority, the benchmarking process usually proceeds through the following steps:15 Identify the measures to be used – what is to be measured and what those measures will be. Develop precise definitions of the operational indicators to be used by all participants, along with clear guidelines for implementing them and uniform procedures for collecting and processing the data and computing the measures. Collect and report the data on a periodic, often annual, basis. Use the comparative data to assess the performance of a particular agency or program, set targets for particular entities or more general standards for the field at large, or identify star performers and industry leaders and investigate leading-edge practices, as appropriate. There are challenges in the process that involve availability of data, reliability of data, reliability of comparative data, and variation in operating

15

Measuring Performance in Public and Nonprofit Organizations, Poister, T. H., 2003, pg. 239-240.

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conditions. These factors should not, however, deter an agency from embarking upon this worthwhile endeavor as a means of improving performance.

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D. Ambulance Transport Service The City of Germantown is considering the expansion of the GFD’s emergency medical services to include ambulance transport. The city currently participates with the cities of Arlington, Collierville, Lakeland, and Millington in a shared, intergovernmental agreement with Shelby County for ambulance transport services. GFD paramedics serve as first responders to all emergency medical calls for service, turning over advanced life support patients to Rural Metro, a private service contractor, for transport to an appropriate medical facility. According to a report issued by the GFD, two main problems exist with this method of service delivery. First, GFD expends resources without the possibility of cost recovery, and second, there is little to no control over the quality of service delivered once patient transfer occurs. Another issue not mentioned in the report but brought forward during the qualitative interview process, was that of time constraints. Legislative action at the state level could limit the city’s ability to implement transport service in the future. In a 2008 pilot study published by the U.S. Department of Transportation, National Highway Traffic Safety Administration, for the mid-Atlantic region, it was estimated that the fire department served as the primary emergency medical service transport agency for 31 per cent of the population of all systems surveyed. Of course, this means that fire departments served nearly 70 percent of the population with only primary first response. Why do so many fire departments not engage in transport services? The answer is not surprising. First and foremost, fire departments operating EMS transport need additional personnel, as time spent delivering patients to

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hospitals could otherwise erode effective fire company strength.16 This can be especially burdensome for volunteer and combination departments. Further, in addition to the human resources needed, the move to provide this level of service represents a significant cost outlay for facility renovations, equipment, and vehicle acquisitions, as well as maintenance considerations. 1. Medical Transportation

Fire departments across the country assume many different roles in performing medical transportation services. The most prevalent form of medical transportation by fire departments is emergency-only service using multirole personnel (sworn, uniformed firefighters with EMS training and certification). Less prevalent are emergency-only service using single-role personnel and the provision of nonemergency as well as emergency medical transportation. Emergency-only service using multirole personnel seems most compatible with the culture and strengths of most fire and rescue services.17 For purposes of this study, we will only examine the benefits and/or disadvantages of the emergency-only service role, which is the preferred choice of GFD. The fire department is uniquely suited to provide emergency transportation service given its preparedness in areas ranging from dispatching to vehicle maintenance and the advantages of station location and organizational discipline. From an economic standpoint, emergency ambulance service compared with nonemergency service requires a high state of readiness, increases vehicle wear and tear, carries greater potential for civil liability, and involves a higher percentage of uncollectible fees for service. Most

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Fire Protection Handbook, 20th Ed., National Fire Protection Association, 2008, Vol. II, pg. 12-72. 17 Managing Fire and Rescue Services, ICMA, 2002, pg. 30.

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private ambulance companies are not in a strong enough financial position to limit their services to emergency transportation, which is why so much of their resources are dedicated to nonemergency transports – where the higher percentage of revenues is received. Ideally, the ratio of billable to nonbillable transportation events will be two to one: two-thirds nonemergency and one-third emergency.18 Given this information, how could a local government – which has higher salaries and more generous fringe benefits than most private companies -provide emergency ambulance service on a competitive, cost-effective basis? Much depends on the demographics of the community, the payer mix, the prevailing reimbursement rates, and the effectiveness of the billing and collection processes. It is well documented that in most cases where the service is provided by the fire department utilizing multirole personnel, the marginal costs will be sufficiently low to allow the potential for full cost recovery. Furthermore, service charges for local government agencies can be lower than for private companies within the same geographic area.19 There are few if any current examples of government-operated EMS services of this type showing a profit margin. Recently, the City of Stockton, California made the decision to discontinue its ambulance transport service after operating it for nearly two years. Three ambulances and associated equipment were taken out of service, and there was a reduction in personnel. The original feasibility study undertaken by the department was favorable. It indicated better than average collection

18 19

Managing Fire and Rescue Services, ICMA, 2002, pg. 30 Managing Fire and Rescue Services, ICMA, 2002, pg. 31

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rates within the surrounding market area, as well as good comparative data among other fire departments providing the service. 2. Economic Factors Surrounding Policy Implementation

The GFD has researched the feasibility of implementing ambulance transportation services for the City of Germantown. In its document entitled, ―Emergency Ambulance Service, Business Plan for the City of Germantown,‖ it identifies various key indicators that serve to support its recommendation for the addition of this service delivery component to its core business functions. The following list of key indicators taken from that document, which are based on professional experience and judgment, offer the greatest advantages favoring service implementation. An aging population indicates a growth in the need for emergency medical services. During the next ten years, the majority of the baby boomer generation will reach 65 years of age. It is projected that between now and the year 2020, the growth rate in the number of persons over age 65 will be twice the growth rate for the general population. Germantown’s median age is 41.3 years, which is higher than the median age of the U.S. population, which is 35.5 years. Germantown is growing at a faster rate than the national average. The largest age group in Germantown is between the ages of 45 to 54 (21.7 percent of the city’s population). In four years, the largest group will be 55 and older. Germantown will need to provide medical (and other) services to seniors sooner and at a much higher rate than in many other communities.

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The number of medical responses the fire department makes to elderly residents is increasing. • The most common medical calls in Germantown associated with the elderly include respiratory problems, chest pain, cardiac arrest, stroke, diabetic emergencies, general illness, and falls. The socioeconomic environment in Germantown and the market area indicates a high potential for collecting revenue for services provided. The market area contains mainly third-party payers The vast majority of Germantown residents are well educated: more than 40 percent are college graduates and more than 22 percent have post-graduate degrees. This educational level indicates the probability that most residents have jobs or careers that provide medical benefits and/or they understand the need for comprehensive health insurance. More than 89 percent of the households in Germantown report annual salary and wage earnings. More than 81 percent of households in Germantown report annual earnings of $50,000 or more. More than 46 percent of households report annual earnings of $100,000 or more. The median household income in Germantown is $113,769. Per-capita income in Germantown is $44,021. At first glance, these factors provide a good argument for the sustainability of a fire department ambulance transportation service. However, there are other factors to consider.

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3.

Cost Factors

The cost concept that is most useful in examining new or expanded service is marginal cost. Marginal cost concentrates attention on the additional expenditures required to deliver a new service or expand an existing one.20 The business plan prepared by GFD outlines many of the programmatic costs associated with the implementation of an ambulance transport service. However, all costs associated with a new program or expansion of an existing one must be considered if an educated decision about program development is to be made. Cost projections and program objectives are used in choosing among possible programs before anything is implemented. The goal of the planners is to offer services that will justify the investment of funds. Some will argue that the expansion of EMS service within the fire department is a win/win situation for the department and community. No doubt many local governments have benefited, although not monetarily, from this expanded role for their fire departments. The enhanced reputation and goodwill associated with this service have been a selling point for many jurisdictions. At the same time, the idea that so many departments have moved toward this type of service delivery does not preclude the need to perform due diligence during the decision-making process. In this day and age of economic decline, government entities are scrutinizing expenditures closer than ever in order to keep costs down. There are various costs associated with undertaking a program, including:21

20

Costing Government Services: A Guide for Decision Making, Kelly, Joseph T. 1984, pg. 89. 21 Program Evaluation Methods and Case Studies, Fifth Edition, Posavac, E., Carey, R. 1997, pg.195-196.

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• Variable versus fixed costs: Cost borne to simply open an agency’s door. Incremental (marginal) versus sunk costs: Incremental costs are those that must be covered day by day in order for a program to provide a service-staff, salaries, or repairs. Sunk costs are those that have been expended already. Sunk costs do not determine future behavior, but incremental costs should. Recurring versus nonrecurring costs: recurring costs are those due at regular intervals, such as salaries, rent, utilities, and vehicle lease payments if that is what is used to acquire vehicles. The cost of purchasing equipment or vehicles is a nonrecurring cost if the equipment or vehicles are expected to last a number of years. Hidden versus obvious costs: Brings attention to the fact that some costs are not easily recognizable. Direct versus indirect costs: Those who provide the service and those who make it possible to provide the service, such as the city or fire department staff who provide administrative oversight for the private billing service company. Opportunity costs: Whenever money is spent to relieve one need, it cannot be spent to relieve another need; that is the opportunity cost. Figure 3 is a pictorial view of the costs associated with program development.

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Figure 3. Costs Needed to Support a New or Expand an Existing Program.

A few factors missing from the proposed business plan are contract administration, opportunity costs, discounting, compounding, future value, and present value. Contract administration can be calculated in one of two ways. The first is to choose a percentage of the contract cost. A range of 10 to 20 percent for contract administration is a rule of thumb, with the ratio dropping as the total dollar amount rises. The second is to use the staffing formula developed as a guide for federal agencies by the U.S. Office of Management and Budget (OMB), and which is based on the number of government employees needed to provide the service. For example, if government provision of the service takes 66 to 91 employees, then according to the OMB ratio four government employees would be needed to administer a private contract covering that same range of personnel.22

22

Management Policies in Local Government Finance, Fifth Edition, ICMA, 2004, pg. 369370.

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The factors of opportunity costs, discounting, compounding, future value, and present value fall under the category of the time value of money. Taking a closer look at opportunity costs, we begin to understand that even though the idea of expanding EMS service delivery sounds good theoretically, the decision to do so should be weighed against other department needs. After all, resources are limited and it is the responsibility of administrative and elected officials to make the best possible decisions when allocating limited resources. Hypothetically, what if funds used for this purpose were instead directed toward developing or enhancing a data and management information system (DMIS), toward increased staffing in Fire Prevention, or toward hiring a full-time volunteer coordinator? What about adding an additional compressed-air foam system equipped pumper? The decision not to expand into EMS transport is a difficult choice, but using these funds could generate tremendous resources to advance GFD service delivery by taking advantage of today’s technology and/or adding needed support staff. The wisdom of a resource allocation decision can be assessed by placing the decision in context and by considering the time value of money. Was it a good decision compared with some other option – including the option of investing these funds? A standard method of making such an assessment is to compare the ―return‖ or benefit from a project with the return on a conservative investment of an equal amount of funds. On that basis, the use of funds for a program with substantial revenue-generating or costavoidance potential would seem to have an advantage over a conservative investment of an equal amount of funds, which in turn would seem to have an advantage over nonrevenue-generating alternatives; but the time value of money comes into play in different ways.

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A dollar in the hand today is considered to be more valuable than a projected dollar to be received in the future for at least three reasons:23 It is a sure thing – the risk of nonreceipt is eliminated. The possibility of consumption today rather than tomorrow is highly prized (if owners must wait before gaining access to their resources, compensation in the form of interest payment is expected in return for deferred gratification). Inflation erodes the buying power of money. Our study will not attempt to compute any present or future values. This task is best left to finance experts within Germantown city government. In summary, the decision by public officials to spend financial resources eliminates the possibility of using those same resources for other purposes.

23

Tools for Decision Making, Second Edition, David N. Ammons, 2009, pg. 126-127.

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E. Fire Station Location The most effective way to improve outcomes for both fire and medical emergency response is to reduce response time. Excessive travel times may mean an increased risk to the public. Therefore, the basic deployment concept, or model, for a fire department calls for fire stations to be located so as to form an orderly network of stations from which emergency service is delivered. The network as a whole seeks to optimize coverage with short travel distances, while giving special attention to natural and man-made barriers that can create response time problems. When such barriers to optimum response times exist, some areas may require more fire stations.24 Fire station location planning must take into account a number of variables including: The importance of time in responding to fire and medical emergencies • Flashover (marks critical change in fire conditions) • Fire department total reflex time sequence (dispatch time, turnout time, response time, access time, and set-up time) • Emergency medical services. Prior to the gradual population growth to the northwest, the existing location of fire stations within the GFD response area has served to provide an effective deployment network for suppression and EMS resources. The impact this growth will have on overall resource deployment can be determined by analyzing historical response data and computer modeling. A computer database of local streets, roads, and thoroughfares can help the fire department planning staff by simulating responses from a proposed fire station site along all streets at various average miles per hour. The more

24

Managing Fire and Rescue Services, ICMA, 2002, pg. 121.

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realistic the average response speeds, the better the projected coverage area can be defined. This ICMA study is limited in its ability to provide this kind of station location analysis; however, computerized programs are available for this analysis, as are private consultants who specialize in such efforts. In an examination of the historical data extracted from the department’s computer-aided dispatch (CAD) system, unit workload was identified. Currently, engine 93 and truck 41 housed at station 3 are the busiest units within the GFD response area. Engine 93 has the largest percentage of EMS category calls (65.8) and the lowest percentage of fire category calls (33.8). Truck 41 ranks third highest among the remaining vehicles in the percentage of EMS responses. The following exhibit shows the call percentage by broad category of call during our study period. Station 1 2 3 4 Unit ENG 91 ENG 92 ENG93 TRK ENG 94 EMS 19.4 14.0 65.3 16.4 21.5
Fire Related

58.3 66.4 33.8 62.8 48.9

Given the above information, certain inferences can be drawn from which to make resource deployment recommendations. It is obvious that the city would be better served if station 3 could be supplemented with an EMS response unit, since the majority of its calls for service are of this nature. The type of unit (e.g., Basic Life Support, BLS, or Advanced Life Support, ALS, transport unit) would depend on the type of calls received. ICMA data analysis is limited to a broad categorization of EMS-related calls. Therefore, GFD would need to use its own resources to

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determine the level of service needed in the wake of this information. This strategy would also possibly bring about a reduction in EMS runs for truck 41, since number of runs per day for engine 93 average only 3.9. This report has already mentioned the additional wear and tear on vehicles with the implementation of transport service. Indeed, this is already being experienced as a result of the heavy use of a ladder truck for the delivery of this type of service. Increased maintenance costs are a result of this kind of deployment strategy. It should be noted that the information provided does not represent a trend analysis in that only a twelve-month period of data was observed. Another assumption that can be drawn from the data has to do with the issue of capacity. Capacity is the number of simultaneous calls for service or multiple alarms received by an agency and which would overwhelm its ability to meet the increased demand. ICMA data analysis shows the impact of simultaneous calls on department capacity to be insignificant. Our research indicates that only four out of six staffed units were busy during the peak workload hour of the period we observed, with only two units busy more than thirty minutes of the hour. Further, for the period studied, the hourly call rates were the highest between 8 a.m. and 6 p.m., averaging at least 0.42 calls per hour and the call rate was lowest between midnight and 6 a.m., averaging .13 calls per hour. Based on this information the following alternatives for modifications to deployment strategies are recommended for consideration (in order of descending priority):

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Add a peak load (8 a.m. to 6 p.m.) ALS unit to station 3, staffed by reserve members. Shift staffing could be condensed to only eight hours. Add a peak load (8 a.m. to 6 p.m.) BLS unit to station 3, staffed by reserve members. Shift staffing could be condensed to only eight hours. Add a peak load ALS unit to station 3, staffed with paid, on-call personnel during an eight-hour block time schedule. Add a peak load BLS unit to station 3, staffed with paid, on-call personnel during an eight-hour block time schedule. Using either peak load staffing and paid, on-call personnel are deployment methods that have used across the country for many years. These options offer flexibility and efficiency while increasing effectiveness. The unit demand analysis for the remaining stations shows near equitable distribution of calls among the two broad call categories – fire and EMS. Call volume does not require any recommended deployment modifications. A new station appears to be unjustified at this point in time. 1. Reducing Response Times

Essentially, each community must decide its desired response and travel times. There a number of factors that influence the selection of a specific response/travel time and all must be considered.25 These factors are: • What types of services are delivered by the fire department? Does the department deliver both fire and emergency medical services or fire service only?

25

GIS for Fire Station Locations and Response Protocol: An ESRI® White Paper, Jan 2007, pg. 8.

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• What is reasonable travel time for the community? • What is the size of the area being served and the type and amount of resources that are available? • What level of risk is the community willing to accept? There are several ways a community can establish a response/travel time standard.26 The use of historical fire and EMS response data. Demand for service. The level of care that the community wants to provide. The level of care that the community is able to afford. 2. National Standards

There are three National Association of Fire Protection Association (NFPA) standards that contain time requirements that influence the delivery of fire and emergency medical services. These are: NFPA 1221, Standard for the Installation, Maintenance, and Use of Emergency Service Communications Systems NFPA 1710, Standard for the Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Career Fire Departments NFPA 1720, Standard for the Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Volunteer Fire Departments. NFPA 1710 contains time objectives that shall be established by career fire departments as follows:

26

GIS for Fire Station Locations and Response Protocol: An ESRI® White Paper, Jan 2007, pg. 9.

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• Turnout time: One minute (60 seconds) for turnout time. • Fire response time: Four minutes (240 seconds) or less for the arrival off the first arriving engine company at a fire suppression incident and/or eight minutes (480 seconds) or less for the deployment of a full alarm assignment at a fire suppression incident. • First responder or higher emergency medical response time: Four minutes (240 seconds) or less for the arrival of a unit with first responder or higher-level capability at an emergency medical incident. • Advanced life support response time: Eight minutes (480 seconds) or less for the arrival of an advanced life support unit at an emergency medical incident, where the service is provided by the fire department. The standard states that the fire department shall establish a performance objective of not less than 90 percent for the achievement of each response time objective. NFPA 1710 does not contain a time objective for dispatch other than requiring that ―All communications facilities, equipment, staffing, and operating procedures shall comply with NFPA 1221.‖ For the purposes of NFPA 1710, the following definitions apply: Dispatch time: The point of receipt of the emergency alarm at the public safety answering point to where sufficient information is known to the dispatcher and applicable units are notified of the emergency. Turnout time: The time that begins when units acknowledge notification of the emergency to the beginning point of response time. Response time: The time that begins when units are en route to the emergency incident and ends when units arrive at the scene.

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Figure 4. Incident Development and Response Timeline and NFPA 1221 and 1710 Recommendations for Career Firefighters

Source: NFPA 1221 Standard for the Installation, Maintenance, and Use of Emergency Services Communications Systems and NFPA: 1710 Standard for the Organization and Deployment of Fire Suppression Operations, and Special Operations to the Public by Career Fire Departments.

NFPA 1720 contains a time objective for dispatch time by requiring that ―All communications facilities, equipment, staffing, and operating procedures shall comply with NFPA 1221, Standard for the Installation, Maintenance and Use of Emergency Services Communications Systems.‖ NFPA 1720 contains no time requirements for turnout time and response time. NFPA 1221 requires that 95 percent of alarms shall be answered within fifteen seconds, 99 percent of alarms shall be answered in forty seconds, and the dispatch of the emergency response agency shall be completed within sixty seconds 95 percent of the time. • After receipt of a call for assistance, the fire department will respond with the first unit to that location within three minutes.

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• After receipt of a call for assistance, the fire department will respond with a unit to the location, within four minutes, to 90 percent of area served. • After receipt of a call for a medical emergency, the fire department will respond with an engine company to that location within four minutes and an ambulance with six minutes.

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Figure 5. Incident Development and Response Timeline and NFPA 1221 and 1720 Recommendations for Volunteer Firefighters

Source: NFPA 1221 Standard for the Installation, Maintenance, and Use of Emergency Services Communications Systems and NFPA: 1720 Standard for the Organization and Deployment off Fire Suppression Operations, and Special Operations to the Public by Volunteer Fire Departments.

3.

Standards of Response Cover

Other guidelines for the deployment of emergency resources are the Commission on Fire Accreditation International’s standards of response coverage. The components of this resource were identified previously in this report. 4. Risk versus Response Time Standards

Some communities may choose to adopt several response time standards for various levels of risks in the community, or they may adopt one single response time standard for all risks. GFD has elected the latter. A risk refers to a location where the response may be made and the characteristics (e.g., fire potential, occupant exposure) at that location. Providing a single response time simplifies the station location study process; however, it does

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not negate the need to conduct a community hazard analysis and needs assessment. 5. GFD Response Time Analysis

According to the GFD business plan, the response time objective is five minutes within the city limits. ICMA data analysis indicates that for 90 percent of the time, response time is 7.3 minutes or less. Although still within the acceptable NFPA standard, this figure provides a more precise picture of where the community stands with regard to response time.

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F. Organization and Deployment – Increased Fire Potential within Germantown Preparation for potential fire operations prior to actual alarms requires preincident planning; staffing assessment; determination of apparatus and equipment needs; and training of emergency response personnel. With the construction of a mixed-use occupancy and a high-rise structure within Germantown, the development of new standard operating procedures and tactics and strategies will be needed. Pre-incident planning is conducted to allow firefighting personnel to view conditions within a structure or site, evaluate what these conditions are likely to develop into in the event of an emergency, and then develop strategies for dealing with potential problems. NFPA 1620, Recommended Practice for Pre-Incident Planning, should be reviewed by the department command staff prior to the development of a pre-incident planning program or updating an existing one. The following provides a summary of the steps involved in the process.27 1. Determine the priorities to address – that is, life hazards, firefighter traps, and critical infrastructure. 2. Decide what data are needed. 3. Develop a standardized information capture method, preplan form, and so forth. 4. Train collectors to gather information. 5. Perform visits and collect data. 6. Develop strategic and tactical plans.

27

Fire Protection Handbook, 20th Edition, National Fire Protection Association, 2008, Vol. II, pg. 12-302.

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7. Distribute copies to all potential users. 8. Train users on objectives. 9. Review the plan periodically (annually at minimum). 10. Revise as needed, redistribute, and retrain. Making the plan available to those who need it in an emergency is the last step in the pre-incident planning process. Information dissemination can be handled in a number of ways. Currently, the GFD uses both written documentation kept on field units and some limited storage within the CAD system as a means of getting the information to incident commanders. The CAD is by far the most effective tool for retrieving pre-incident planning information. Of course, the information within the system is only as good as the information that is put into it. Continual updating, at least on an annual basis, is required in order to ensure the safety of responding emergency personnel. The department should consider evaluating the effectiveness of the current CAD system to take advantage of available technology. Improvements in this area are not only critical to the safety of responding units, but also to reducing response times. The amount of information that can be amassed about a typical high rise building can be quite extensive. In many cities where the CAD systems have been developed or expanded, data entry issues have been resolved by requiring the property owners of certain ―target hazards,‖ such as high-rise buildings, to provide the information in a standardized electronic format. This can often be accomplished by using a commonly available electronic program that architectural or engineering firms use.28

28

Fire Protection Handbook, 20th Edition, National Fire Protection Association, 2008, Vol. II, pg. 12-307.

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G. Alternative Options for GFD Funding Allocations 1. Data and Management Information Systems

Fire and rescue service managers must have accurate information. They need it to make decisions, and they also need it to explain and defend their decisions to local government managers, budget directors, the media, and citizens. Like other agencies and public interest groups, the fire service must be prepared to make the case for its priorities. The number of problems a fire department faces is voluminous and the range of activities it engages in is broad. The GFD needs to able to handle the huge amount of information required to make intelligent and informed decisions. Even the smallest department can be confronted with a myriad of situations and require hundreds of material resources in order to deal with them. This is where access to a sophisticated method of managing data and information becomes important. Moreover, the proper use of good statistics can help managers identify potential problems, develop public education programs, and a build positive image of the fire department. Management information systems allow stored data to be manipulated and intermixed with advanced systems using computer models for decision making. Management information systems can also incorporate logic and information of experts to create ―expert systems‖ that imitate highly experienced advisers.29 This can be extremely effective in both the administrative and field environments. Hazardous materials incidents, disaster management, and EMS patient interventions are just a few of scenarios in which technology can be useful in improving the level of service provided.

29

Managing Fire and Rescue Services, Third Edition, ICMA, 2002, pg. 424.

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2.

Communications

Of all the areas in which technology can be applied to enhance public safety, communication probably provides the most ―bang for the buck‖ and also the greatest number of options. Some of the technology applications that affect communications are global positioning systems, internal communications systems (pagers, voice mail, e-mails), methods of geographically locating callers using cellular phones, and voice data logging systems. Because a new system that solves one problem may create new problems if it is unable to share resources with an existing system, it is wise to assemble representatives from all public safety entities to review any proposed purchases of technology, even though the purchase appears to affect only a single agency. For instance, an evidence tracking system for the police department might appear to affect only that department. However, if the fire department has a role in bombing or arson investigations, fire personnel may be involved in the collection or processing of evidence, or even have primary responsibility for arson investigations.30 3. Geographic Information Systems (GIS)

CAD can be interfaced with GIS, thus allowing various data to be presented in graphical form tied to maps of the community. For example, one can create a circle one mile in radius around a factory site and feed the telephone numbers of all residences in that area to an automated telephone calling system. This can then be used to provide evacuation information and instructions to the population at risk. GIS can also be integrated with enhanced 911 systems: when the location of the caller is overlaid with road closure information, emergency responders can be routed more efficiently.

30

IQ Service Report, ICMA, Vol.32/Number 1, January 2000, pg. 8.

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There are many other ways GIS can be used to improve service delivery in public safety operations. 4. Computer Aided Dispatch (CAD)

The CAD system in use for public safety purposes within the city of Germantown is a work in progress. The GFD lists in its business plan the objectives to be achieved in this area. It is important to understand the implications of changes to a system, especially as noted previously when multiple agencies are involved. Newer systems make it possible to transfer responsibility for status changes to the field units when those units are equipped with simple data status units, mobile data terminals, or mobile computers. Further, CAD systems can interface with enhanced 911 systems (systems that show the location of the caller) and with governmental computer systems. This interfacing allows access to vast amounts of information that, if properly managed, can be of assistance to emergency responders.31 5. Global Positioning Systems

Global positioning system (GPS) technology allows the user to establish, to a very high degree of accuracy, his or her location in three dimensions anywhere on or above the surface of the earth. The most common use of GPS in public safety is to locate mobile assets from a central control station. GPS technology can be used to track the movements of a receiver, or the vehicle on which it is mounted. The term ―automatic vehicle locator‖ is the term often used to describe this technology. It updates the location of receivers up to several times a second. The direction of travel and rate of speed can be tracked with high

31

Managing Fire and Rescue Services, Third Edition, ICMA, 2002, pg. 463.

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accuracy, and either transmitted to a base station or stored for later retrieval. Because units may be away from the station for various reasons during the course of a shift, GPS can have a significant effect on decreasing response times by enabling the dispatch of the closest unit to an emergency.32 6. Wireless Data and Laptop Strategies

A wireless system can connect a person in the field to the relevant database so that he or she can get information directly, instead of waiting for it to be read by a dispatcher. The technology can have a tremendous positive impact on the delivery of emergency services. Fire prevention code inspections can be completed with information inputted directly from the field, thus creating efficiencies and enabling the recording of more accurate information. The same is true with EMS patient reporting. Depending on the sophistication of the system, mobile data systems can enable field workers to bring up maps or diagrams of areas, floor plans, research the system for previous calls the area or address, and gather intelligence on the incident as they respond. 33 7. Fire Prevention and Public Education

There are a number of critical time factors that are within a fire department’s power to manage within the total reflex time sequence of every emergency. The United Kingdom released The National Plan in 2004, replacing earlier standards of coverage documents. The new report found that without prevention and mitigation, a fire department’s ability to have an impact on the level of safety for responders and the public would reach a plateau. Using the analysis of risk and looking at what strategic actions can

32 33

IQ Service Report, ICMA, Vol.32/Number 1, January 2000, pg. 11. GIS for Fire Station Locations and Response Protocol: An ESRI® White Paper, January 2007, pg. 11.

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be taken may not only prevent the incident from occurring, but may also minimize the severity when and if the incident ever occurs. At present, staffing within the GFD fire prevention section is minimal. The fire marshal has no additional human resource outside of himself to attend to the myriad responsibilities required of the functional area. It appears that all funding is allocated toward the suppression side of the equation, giving little emphasis to the importance of fire prevention and education efforts. This is not unusual among fire department organizations, given the limited resources available. However, if real progress is to be made in controlling the escalating cost of providing fire protection to our communities, adjustments in priorities must take place. Continued channeling of resources to control fire and medical emergencies after the fact is ineffective and highly inefficient. What was mentioned earlier in this report is worth repeating. Without prevention and mitigation, impacting the level of safety for responders and the public would reach a plateau. 8. Public Education

The delivery of EMS by first responders is also time critical for many types of injuries and events. If a person has a heart attack and cardiopulmonary resuscitation (CPR) is not started within four minutes, brain damage is likely to occur. Moreover, the victim’s chances of leaving the hospital alive are four times greater than if the victim did not receive CPR until after four minutes.

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Figure 6. Outcome for Heart Attack Victims Based on When CPR is Provided

Sixty-one million Americans have cardiovascular disease, resulting in approximately 1 million deaths per year. One-third of these deaths (300,000 – 400,000) are due to cardiac arrest, the sudden and unexpected loss of heart function. In 1999, every police officer in Miami Dade County was issued an AED and trained in its use. The City of Germantown, like many other cities across the nation, could benefit from the implementation of a comprehensive Automatic External Defibrillator Program. The operative word here is ―comprehensive‖.

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In 1990 one of the first studies was initiated to determine the effectiveness of putting AEDs on police cars. At the time the value of fully incorporating their use in the community at large was not considered. Since then, it has become a well-accepted fact that making AEDs accessible in as many public places as possible dramatically increases survival rate for out-of-hospital victims of sudden cardiac arrest. Public Access Defibrillation (PAD) Programs have been implemented using various funding methods across the United States. Grants at all levels of government are available for start-ups and some offer additional funding for maintenance once programs have been initiated. The business community has also contributed to the effort by not only providing opportunities for AED station placements, but providing financial funding as well. Training and public awareness play a key role in the success of a PAD program. Fire departments should assume the lead role in this initiative and aid in the administration the program, utilizing their association with local medical professionals and access to the business community. GFD has been forward thinking in this area, but the program should be expanded. The public should have access to CPR and AED training opportunities and police departments must have a strict protocol for the use of AEDs carried in their vehicles. Additionally and most important to the deployment of AED from police vehicles, is the cultural change within the police department that must occur for program success. A full commitment to assume the added role of becoming a medical first responder must take place. Communication center response protocols must also be changed to achieve improvements in survival outcomes.

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H. Recommendations Conduct community risk assessment and hazard analysis based on RHAVE model developed by Commission on Fire Accreditation and International. Modify Business Plan to include SMART performance objectives Consider FTE Volunteer Program Manager to lead and coordinate recruitment and retention activities. Implement lessons learned from nonprofit organizations on developing strategies to recruit and retain volunteers. Explore/identify areas within department where volunteers can serve, such as fire prevention and public education and administration. Implement part-time program to supplement Reserve Program staffing. Develop quantitative performance measures for all program areas that link goals to specific target rates or percentages. Establish benchmarking partnership(s) with comparable departments to determine ―best practices‖ as means toward self-improvement strategy. Expand feasibility study to include consideration of additional items associated with program expansion (marginal costs, contract administration, opportunity costs, discounting, compounding, future and present value). Consider opportunity costs associated with decision to implement ALS transport service. Implement paid part-time program to enhance staffing during peak load periods at Station 3 using various alternatives as determined by feasibility and ALS and BLS transport data. Reconsider need for additional fire station at this time.

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Data Analysis Report Fire/EMS Operations Germantown, Tennessee

Submitted by and reply to: ICMA Center for Public Safety International City/County Management Association 777 North Capitol Street NE, Suite 500 Washington, DC 20002 [email protected] 202-962-3607

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Introduction
Germantown’s fire department has four engines and three reserve engines, one aerial truck, one reserve hazardous material truck, one reserve brush truck, one reserve squad, one rescue unit, and two reserve rescue units for use during special events. These units are deployed in four stations. Every day, the fire department staffs one supervisor, one or two firefighters, and one driver in each of the four engine units; one supervisor, one driver, and one or two firefighters in the aerial truck; and one paramedic in the rescue unit. Our data analysis is divided into four sections. The first section focuses on call types and dispatches. The second section explores time spent and workload of individual units. The third section presents response time analysis. The fourth section presents analysis of the busiest hours in the year we reviewed. The data in this report cover all calls for service between July 1, 2009 and June 30, 2010. During this period, Germantown’s fire department received 2,669 non-canceled calls in the city of Germantown and 34 non-canceled mutual aid calls. As multiple units are often sent to calls, a total of 4,100 Germantown units were dispatched during this period. The total workload for the year for all Germantown units combined was 1,894 hours. Lastly, the average total response time was 5.1 minutes for both EMS and fire category calls in the city of Germantown.

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I. Aggregate Call Totals and Dispatches
In the year studied, Germantown’s fire department received 2,789 calls. Of these, eighty-nine were structure fire or outside fire calls within the city of Germantown and twenty-one were mutual aid structure fire or outside fire calls. There were 1,710 emergency medical service (EMS) calls within the city of Germantown and 8 mutual aid EMS calls. We categorized the calls based on the National Fire Incident Reporting System (NFIRS) call type code, as shown in Appendix I. Table 1. Call Types
Germantown Call Type Number of Calls 112 1,598 1,710 41 48 165 454 228 23 959 16 2,685 Calls per Day 0.3 4.4 4.7 0.1 0.1 0.5 1.2 0.6 0.1 2.6 0.0 7.4 Call Percentage 4.2 59.5 63.7 1.5 1.8 6.1 16.9 8.5 0.9 35.7 0.6 100 Mutual Aid Number of Calls 1 7 8 19 2 1 3 1 26 70 104 Combined Number of Calls 113 1,605 1,718 60 50 166 457 229 23 985 86 2,789 Calls per Day 0.3 4.4 4.7 0.2 0.1 0.5 1.3 0.6 0.1 2.7 0.2 7.6

MVA EMS Other EMS Total Structure Fire Outside Fire Hazard Alarm Public Service Good Intent Fire Total Canceled Total

Observations: Mutual aid calls were 3.7 percent of all calls. Of the 104 mutual aid calls received, 70 (67.3 percent) were canceled. In the city of Germantown, the department received 7.4 non-canceled calls per day. In the city of Germantown, EMS calls for the year totaled 1,710 (63.7 percent of all calls), or about 4.7 per day.

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In the city of Germantown, fire category calls for the year totaled 959 (35.7 percent of all calls), or about 2.6 per day. Calls for structure and outside fires combined averaged 2.1 calls per week. Of these, 19.1 percent were mutual aid calls. In the city of Germantown, alarm calls totaled 454 (16.9 percent of all calls), or about 1.2 per day.

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Figure 7. Non-canceled Calls by Type and Duration

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Observations: Of the sixty structure fire calls, nine lasted more than two hours, thirteen lasted between one and two hours, and thirty-eight lasted less than one hour. Among the nine calls that lasted more than two hours, seven were mutual aid calls. Of the fifty outside fire calls during the year, two lasted more than two hours, nine lasted between one and two hours, and thirty-nine lasted less than one hour. The two calls that lasted more than two hours were calls within the city. A total of 1,353 of EMS calls (78.8 percent) lasted less than one hour; 357 (20.8 percent) lasted between one and two hours, and 8 (0.5 percent) lasted more than two hours. In all, the department handled 500 calls that lasted more than one hour, an average of 1.4 long calls per day.

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Figure 8. Non-canceled EMS and Fire Calls by Type

Observations: A total of 110 structure fire and outside fire calls accounted for 11.2 percent of the fire category total. Alarm calls were 46.4 percent of fire category calls. Public service calls were 23.2 percent of the fire category total. Hazardous condition calls were 16.9 percent of the fire category total. Good intent calls were 2.3 percent of the fire category total. Motor vehicle accident calls accounted for 6.6 percent of EMS category calls. Other EMS calls were 93.4 percent of the EMS category total.

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Figure 9. Average Calls per Day by Month

Observations: Average calls per day ranged from a low of 6.5 calls per day in October 2009 and April 2010 to a high of 8.4 calls per day in January 2010. The highest daily average is 29 percent greater than the lowest daily average. Average EMS calls per day ranged from a low of 4.1 calls per day in August 2009 to a high in 5.4 calls per day in March 2010. Average fire category calls per day ranged from a low of 2.1 calls per day to a high of 4.0 calls per day (lowest in April 2010, highest in January 2010).

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Figure 10. Calls by Hour of Day

Table 2. Calls by Hour of Day
Two-Hour Interval 0-1 2-3 4-5 6-7 8-9 10-11 12-13 14-15 16-17 18-19 20-21 22-23 Calls per Day Hourly Call Rate EMS Fire Total 0.08 0.05 0.13 0.07 0.04 0.11 0.07 0.05 0.12 0.13 0.08 0.21 0.28 0.15 0.43 0.36 0.17 0.53 0.34 0.17 0.51 0.27 0.14 0.42 0.25 0.18 0.43 0.22 0.10 0.32 0.17 0.13 0.30 0.11 0.08 0.19 4.69 2.69 7.39

Note: Calls per day will equal the sum of each column multiplied twice since each row represents two hours.

Observations: For the period studied, hourly call rates were the highest between 8 a.m. and 6 p.m., averaging at least 0.42 calls per hour. The call rate was lowest between midnight and 6 a.m., averaging at most 0.13 calls per hour.

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Figure 11. Number of Units Dispatched by Category

Table 3. Number of Units Dispatched by Call Type
Unit Call Type MVA EMS Other EMS Total Structure Fire Outside Fire Hazard Alarm Public Service Good Intent Fire Total Grand Total Percentage One 29 1,318 1,347 12 29 56 247 212 11 567 1,914 70.8 Two 68 244 312 2 10 17 35 8 5 77 389 14.4 Three 12 40 52 25 8 64 172 9 6 284 336 12.4 Four or more 4 3 7 21 3 29 3 1 57 64 2.4 Total 113 1,605 1,718 60 50 166 457 229 23 985 2,703 100

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Observations: Overall, four or more units were dispatched to 2.4 percent of calls. On average, 1.3 units were dispatched per EMS call. For EMS calls, one unit was dispatched 78.4 percent of the time, two units were dispatched 18.2 percent of the time, and three or more units were dispatched 3.4 percent of the time. On average, 1.9 units were dispatched per fire category call. For fire category calls, one unit was dispatched 57.6 percent of the time, two units were dispatched 7.8 percent of the time, three units were dispatched 28.8 percent of the time, and four or more units were dispatched 5.8 percent of the time.

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Table 4. Annual Deployed Time by Call Type Including Mutual Aid Calls
Call Type MVA EMS Other EMS Total Structure Fire Outside Fire Hazard Alarm Public Service Good Intent Fire Total Canceled Total Germantown Annual Number Busy of Runs Hours 106 215 838 1,930 944 2,145 83 135 50 87 187 405 258 842 88 254 13 43 679 1,766 4 23 1,627 3,934 Mutual Aid Annual Number Busy of Runs Hours 2 3 14 8 16 11 234 76 2 2 3 2 1 3 1 1 241 84 9 71 267 166 Combined Annual Number Busy of Runs Hours 108 218 852 1,938 960 2,156 317 211 52 89 190 407 259 845 89 255 13 43 920 1,850 13 94 1,894 4,100

Observations: Total deployed time for the year, or total busy hours, was 1,894 hours. This is the total deployment time of all the units that were deployed on any type of call, including 267 hours spent on mutual aid calls. There were a total of 4,100 runs, including 166 runs dispatched for mutual aid calls. Fire category calls accounted for 48.5 percent of the total workload. There were a total of 300 runs for structure and outside fire calls, with a total workload of 369 hours. This accounted for 19.5 percent of the total workload. The average busy time for a mutual aid structure fire call was 184.7 minutes, which was five times longer than the average busy time for a structure fire call in the city of Germantown. Alarm calls accounted for 13.7 percent of the total workload. EMS calls accounted for 50.7 percent of the total workload.

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Table 5. Annual Total Deployed Time by Call Type for Calls within Germantown
Call Type MVA EMS Other EMS Total Structure Fire Outside Fire Hazard Alarm Public Service Good Intent Fire Total Canceled Total Busy Minutes per Call 29.7 26.1 26.4 36.8 34.3 27.8 18.4 20.7 17.9 23.1 10.3 24.8 Annual Busy Hours 106 838 944 83 50 187 258 88 13 679 4 1,627 Percent of Hours 6.5 51.5 58.0 5.1 3.1 11.5 15.9 5.4 0.8 41.7 0.2 100.0 Number of Runs 215 1,930 2,145 135 87 405 842 254 43 1,766 23 3,934 Runs per Day 0.6 5.3 5.9 0.4 0.2 1.1 2.3 0.7 0.1 4.8 0.1 10.8

Observations: The workload for calls in the city of Germantown was 1,627 hours. EMS category calls accounted for 58.0 percent of the total workload. The average busy time per EMS call was 26.4 minutes. Fire category calls accounted for 41.7 percent of the total workload. For structure and outside fire calls, a total of 222 runs were dispatched and the total busy time was 133 hours. The average busy time for a structure fire call was 36.8 minutes and the average busy time for an outside fire call was 34.3 minutes. On average, 10.8 runs were dispatched per day. Of these, 5.9 runs per day were for EMS calls.

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II. Workload by Individual Unit—Calls and Total Time Spent
Here we look at the actual time spent by each unit on every call. We report two types of statistics: workloads and runs. After the introductory table, we present run data and workload data for every unit, as well as the daily average for engine, truck, and ambulance units. Table 6. Call Workload by Unit and Station
Station Unit Type Engine HazMat Engine Rescue Brush Truck Engine Aerial Truck Engine Rescue Rescue Unit ID ENG91 HZ41 ENG92 RES41 BRT41 ENG93 T41 ENG94 RES42 RES43 Average Busy Minutes per Run 28.1 36.5 30.4 31.8 64.0 25.4 26.9 29.9 673.0 2.0 Number of Runs 597 39 500 307 19 1,428 599 514 1 2 Runs per Day 1.6 0.1 1.4 0.8 0.1 3.9 1.6 1.4 0.0 0.0 Busy Minutes per Day 46.0 3.9 41.7 26.8 3.3 99.4 44.1 42.1 1.8 0.0 Annual Total Busy Hours 280 24 254 163 20 605 269 256 11 0

1 2 3 4 Special Event

Note: Reserve engine ENG96 was dispatched one time and is counted as ENG91. Reserve squad SQ41 was dispatched eight times and is counted as ENG92. Reserve engine ENG95 was dispatched four times and is counted as ENG93. Reserve engine ENG97 was dispatched one time and is counted as ENG94.

Observations: Engine company ENG91 made 597 runs in the year studied, averaging 1.6 runs and 46.0 minutes of busy time per day. Engine company ENG92 made 500 runs over the course of the year, averaging 1.4 runs and 41.7 minutes of busy time per day. Engine company ENG93 made 1,428 runs during the year, averaging 3.9 runs and 99.4 minutes of busy time per day. Engine company ENG94 made 514 runs during the year, averaging 1.4 runs and 42.1 minutes of busy time per day. Hazardous material truck HZ41 was dispatched 39 times in a year.

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Brush engine BRT41 was dispatched 19 times in the year. Aerial truck T41 made 599 runs during the year, averaging 1.6 runs and 44.1 minutes of busy time per day. Rescue unit RES41 made 307 runs during the year, averaging 0.8 runs and 26.8 minutes of busy time per day. Special event unit RES42 was dispatched once and special event unit RES43 was dispatched twice during the year.

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Figure 12. Busy Minutes by Hour of Day

Table 7. Busy Minutes by Hour of Day
Two-Hour Interval 0-1 2-3 4-5 6-7 8-9 10-11 12-13 14-15 16-17 18-19 20-21 22-23 Daily Total EMS 2.3 2.2 2.3 5.1 10.1 11.7 10.6 8.9 8.6 6.4 6.6 4.2 157.9 Fire 3.4 8.7 2.6 2.7 6.5 9.5 10.5 7.6 8.5 5.6 5.1 4.8 151.3 Total 5.8 10.9 4.8 7.8 16.6 21.2 21.1 16.6 17.0 12.0 11.7 9.0 309.2

Note: Daily totals will equal the sum of each column multiplied twice since each row represents two hours.

Observations: Hourly busy minutes were the highest between 8 a.m. and 6 p.m., averaging at least 16.6 minutes per hour. Hourly busy minutes were the lowest between 10 p.m. and 8 a.m., averaging at most 10.9 minutes per hour.

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Table 8. Engine and Truck Units: Total Annual Number and Daily Average Number of Runs by Call Type
Unit ENG91 ENG92 ENG93 ENG94 BRT41 HZ41 T41 EMS 258 212 956 258 2 217 Structure Fire 38 34 44 29 2 43 Outside Fire 9 14 23 13 10 2 15 Hazard 85 55 80 54 30 84 Alarm 145 148 216 135 2 1 189 Public Service 54 32 98 18 3 45 Good Intent 8 5 11 7 6 6 Total 597 500 1,428 514 19 39 599 Runs per Day 1.6 1.4 3.9 1.4 0.1 0.1 1.6

Observations: Engine ENG93 was dispatched most often of all fire units. It made 1,428 runs during the year, averaging 3.9 runs per day. EMS calls accounted for 66.9 percent of this unit’s total runs. ENG91, ENG92, ENG94, and T41 each made between 500 and 600 runs, averaging between 1.4 and 1.6 runs per day.

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Table 9. Engine and Truck Units: Daily Average Deployed Minutes by Call Type
Structure Fire 8.4 10.8 9.8 7.9 2.1 7.6 Outside Fire 1.2 1.4 1.6 0.9 0.8 0.7 1.5 Public Service 2.8 2.3 5.9 0.9 0.3 2.3 Good Intent 0.5 0.3 0.5 0.3 0.3 0.3 Fire Category Calls Percentage 58.3 66.4 33.8 48.9 97.0 100.0 62.8

Unit

EMS

Hazard

Alarm

Total

ENG91 ENG92 ENG93 ENG94 BRT41 HZ41 T41

19.2 14.0 65.8 21.5 0.1 0.0 16.4

6.9 4.8 5.7 3.7 2.8 6.0

7.0 8.1 10.0 7.0 0.1 0.1 10.1

46.0 41.7 99.4 42.1 3.3 3.9 44.1

Note: Fire category calls percentage is the sum of average deployed minutes per day of all non-EMS calls divided by the total deployed minutes per day.

Observations: On average, Engine ENG93 was busy 1 hour and 39.4 minutes per day. EMS calls accounted for 66.2 percent of its daily workload. On average, ENG91, ENG92, ENG94, and T41 were busy between 41.7 minutes and 46.0 minutes per day.

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Table 10. Rescue Units: Total Annual and Daily Average Number of Runs by Call Type
Unit RES41 MVA 17 EMS Other 233 Structure and Outside Fire 24 Fire Other 33 Total 307 Runs per Day 0.8

Table 11. Rescue Units: Daily Average Deployed Minutes by Call Type
Unit RES41 MVA 1.7 EMS Other 17.2 Structure and Outside Fire 5.8 Fire Other 2.1 Total 26.8 EMS Calls Percentage 70.5

Observations: RES41 made 307 runs during the year, averaging 0.8 runs per day. On average, RES41 was busy 26.8 minutes per day. EMS calls accounted for 70.5 percent of its daily workload.

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III. Dispatch Time and Response Time
In this section we present dispatch and response time statistics for different call types and fire units. For most types of calls, we are mainly interested in the dispatch time and response time of the first arriving units. However, for structure and outside fire calls, we analyze the response time of the first and the second arriving fire vehicles (no rescue units). We use different terms to describe the components of response time. Dispatch processing time is the difference between the unit dispatch time and the call receipt time. Turnout time is the difference between the unit time en route and the unit dispatch time. Travel time is the difference between the unit on-scene arrival time and the unit time en route. Response time is the difference between the unit on-scene arrival time and call received time. A total of 335 calls have non-zero dispatch time, non-zero turnout time, and non-zero travel time. Out of those 335 calls, 204 (61.1 percent) were calls in June of 2010 and 96 (28.7 percent) were in May of 2010. We use those 335 calls to present the average dispatch time, turnout time, and travel time in Figures 13 and 15 and Tables 12 and 15. The average response time of the 335 calls was 5.4 minutes and did not vary much compared to the average response time of 5.1 minutes using all 2,651 calls. Thus, we report average response time using all 2,651 calls in the remainder of the figures and tables in this section.

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Figure 13. Average Dispatch, Turnout, Travel, and Response Time of First Arriving Units by Call Type

Table 12. Average Dispatch, Turnout, Travel, and Response Time of First Arriving Units by Call Type
Call Type MVA EMS Other EMS Total Structure Fire Outside Fire Hazard Alarm Public Service Good Intent Fire Total Total Dispatch Time 0.4 0.6 0.6 0.3 1.1 0.8 0.9 0.6 1.1 0.8 0.7 Turnout Time 1.1 1.1 1.1 1.2 0.5 1.1 1.2 1.3 0.5 1.2 1.1 Travel Time 3.0 3.5 3.5 3.4 3.4 3.3 3.6 4.7 6.8 3.8 3.6 Response Time 4.5 5.2 5.2 4.9 5.0 5.2 5.8 6.5 8.4 5.8 5.4 90th Percentile Response Time 6.5 7.8 7.7 5.9 5.4 6.6 7.4 9.9 8.4 8.0 7.7 Sample Size 18 211 229 3 3 22 60 17 1 106 335

Note: Figure 13 and Table 12 include only 335 calls that have non-zero dispatch time, nonzero turnout time, and non-zero travel time.

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Observations: The average dispatch time for all 335 recorded calls in the City of Germantown was 0.7 minutes. The average turnout time for all 335 recorded calls in the City of Germantown was 1.1 minutes. The average travel time for all 335 recorded calls in the City of Germantown was 3.6 minutes. The average response time for the 335 calls was 5.4 minutes and the 90th percentile response time was 7.7 minutes.

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Table 13. Average Response Time of First Arriving Units by Call Type
Call Type MVA EMS Other EMS Total Structure Fire Outside Fire Hazard Alarm Public Service Good Intent Fire Total Total Response Time 4.2 5.0 5.0 5.5 5.3 5.5 5.5 5.6 4.6 5.5 5.1 90th Percentile Response Time 6.1 7.2 7.1 7.3 7.8 8.0 7.4 8.4 8.0 7.8 7.3 Sample Size 111 1,588 1,699 41 47 165 452 224 23 952 2,651 Response Time of Mutual Aid Calls 5.4 17.5 16.0 13.7 14.5 26.0 10.1 26.9 14.3 14.7

Observations: The average response time for all 1,699 EMS calls in the City of Germantown was 5.0 minutes and the 90th percentile response time for all EMS calls was 7.1 minutes. The average response time for 952 fire category calls was 5.5 minutes and the 90th percentile response time for fire category calls was 7.8 minutes.

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Figure 14. Number of Total Calls for the First Arriving Units

Table 14. Number of Total Calls for the First Arriving Units
Unit ENG93 ENG94 ENG91 ENG92 T41 RES41 BRT41 HZ41 RES42 EMS 925 232 240 128 77 104 1 Structure and Outside Fire 42 22 16 15 6 4 4 Fire Other 345 163 115 152 80 8 2 4 Total 1,312 417 371 295 163 116 6 4 1 Percentage 48.9 15.5 13.8 11.0 6.1 4.3 0.2 0.1 0.0 Cumulative Percentage 48.9 64.4 78.2 89.2 95.3 99.6 99.8 100.0 100.0

Observations: Engine ENG93 arrived first on scene most often, followed by ENG94 and ENG91. The top three units, ENG93, ENG94, and ENG91, were the first units on scene for 78.2 percent of calls. For structure and outside fire calls, Engine ENG93 was the first unit on scene for 42 of 109 calls.

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Figure 15. Average Dispatch, Turnout, and Travel Time of First Arriving Units by Hour of Day

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Table 15. Average Dispatch, Turnout, and Travel Time of First Arriving Units by Hour of Day
Hour 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 Total Dispatch Time 0.7 0.4 0.4 0.9 0.5 0.6 0.4 0.4 0.8 1.4 0.6 0.6 0.9 0.7 0.3 1.0 0.5 0.6 0.4 0.7 0.3 0.4 0.4 0.7 0.7 Turnout Time 1.9 1.9 2.7 1.5 1.7 1.5 1.2 1.3 0.9 0.8 1.1 0.9 0.9 1.0 1.1 1.0 0.9 0.9 1.3 1.0 1.0 1.6 1.8 1.4 1.1 Travel Time 3.4 5.3 3.7 3.6 4.4 4.9 3.6 3.2 2.7 3.2 3.3 4.3 3.8 3.7 3.8 3.5 3.5 3.0 3.8 3.5 3.4 3.2 3.4 3.5 3.6 Number of Calls 4 5 6 10 6 8 10 13 18 20 25 20 28 24 16 22 22 25 19 5 6 10 6 7 335

Observations: Average dispatch time by hour of day was between 0.3 and 1.4 minutes for the 335 calls with all times recorded. Average turnout time was between 0.8 and 2.7 minutes. Between 8 a.m. and 6 p.m., average turnout time was no more than 1.1 minutes. Average travel time was between 2.7 and 5.3 minutes.

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Figure 16. Average Response Time of First Arriving Units by Hour of Day

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Table 16. Average Response Time of First Arriving Units by Hour of Day
Hour 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 Total Response Time 6.7 6.1 6.3 6.2 6.1 6.2 5.1 5.0 4.9 5.0 5.1 5.1 5.2 5.1 4.9 5.1 4.9 4.7 4.7 4.5 5.2 5.1 5.3 5.9 5.1 Number of Calls 55 38 39 36 46 40 66 81 150 161 198 187 181 188 145 154 161 147 126 104 113 99 80 56 2,651

Observations: Average response time by hour of day was between 4.5 and 6.7 minutes. Between 7 a.m. and 9 p.m., average response time was less than or equal to 5.2 minutes. Between midnight and 6 a.m., it was more than 6 minutes.

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Figure 17. Cumulative Distribution Function (CDF) of Response Time of First Arriving Unit for EMS Calls

Reading the CDF Chart

The vertical axis is the probability or percentage of calls. The horizontal axis is response time. For example, with regard to EMS calls, the 0.9 probability line intersects the graph at the time mark at about 7.1 minutes. This means that units responded to 90 percent of these calls in fewer than 7.1 minutes.

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Table 17. Cumulative Distribution Function (CDF) of Response Time of First Arriving Unit for EMS Calls
Response Time 1 min. 2 min. 3 min. 4 min. 5 min. 6 min. 7 min. 8 min. 9 min. 10 min. 11 min. >= 12 min Frequency 29 23 113 306 430 413 200 113 45 9 11 7 Cumulative Percentage 1.7 3.1 9.7 27.7 53.0 77.3 89.1 95.8 98.4 98.9 99.6 100.0

Observations: The average response time for EMS calls was 5.0 minutes. For 77.3 percent of EMS calls, the response time was 6 minutes or less. For 90 percent of EMS calls, the response time was 7.1 minutes or less.

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Response Time Analysis for Structure and Outside Fire Calls The following tables and charts report our response time analysis of first arriving units for structure and outside fire calls. The analysis focuses on the arrival of firefighting equipment, including engine and truck units. The response time analysis does NOT include the dispatched rescue unit for structure and outside fire calls, since the rescue unit typically arrives along with the engine company based in the same station. Table 18. Average Response Time for Structure Fire and Outside Fire Calls by First Arriving Fire Units
First Arriving Unit BRT41 ENG91 ENG92 ENG93 ENG94 T41 Outside Fire Response Number Time of Calls 6.0 4 9.6 2 4.6 9 5.0 15 5.3 12 5.2 5 Structure Fire Response Number Time of Calls 5.1 11 6.7 3 5.5 19 5.3 5 7.4 3 Total Response Number Time of Calls 6.0 4 5.8 13 5.1 12 5.3 34 5.3 17 6.0 8

Note: One outside fire call is excluded since unit on-scene time is missing.

Observations: For outside fire calls, Engine ENG93 was the first unit on scene most often, and had an average response time of 5.0 minutes. For outside fire calls, ENG92 had the shortest average response time of 4.6 minutes when it was the first unit on scene. For structure fire calls, Engine ENG93 was the first unit on scene most often, and had an average response time of 5.5 minutes. For structure fire calls, ENG92 had the shortest average response time of 5.1 minutes when it was the first unit on scene.

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Table 19. Average Response Time for Structure Fire and Outside Fire Calls by Second Arriving Fire Units
Second Arriving Unit BRT41 ENG91 ENG92 ENG93 ENG94 HZ41 T41 Outside Fire Response Number Time of Calls 9.0 5 7.0 2 5.1 2 5.8 5 8.6 1 16.9 1 11.0 5 Structure Fire Response Number Time of Calls 7.6 5 7.4 6 6.8 5 10.5 4 6.0 16 Total Response Number Time of Calls 9.0 5 7.4 7 6.8 8 6.3 10 10.1 5 16.9 1 7.2 21

Observations: Truck T41 was the second unit on scene most often. When ENG93 was the second unit on scene, it had the shortest average response time of 6.3 minutes.

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Figure 18. Cumulative Distribution Function (CDF) of Response Time of First, Second, and Third Arriving Fire Units for Structure and Outside Fire Calls

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Table 20. Cumulative Distribution Function (CDF) of Response Time of First, Second, and Third Arriving Fire Units for Structure and Outside Fire Calls
Response Time 0 min. 1 min. 2 min. 3 min. 4 min. 5 min. 6 min. 7 min. 8 min. 9 min. 10 min. 11 min. 12 min. 13 min. >=14 min. First Unit Cumulative Frequency Percent 0 0.0 0 0.0 1 1.1 5 6.8 10 18.2 15 35.2 28 67.0 19 88.6 3 92.0 3 95.5 3 98.9 1 100.0 0 100.0 0 100.0 0 100.0 Second Unit Cumulative Frequency Percent 0 0.0 0 0.0 0 0.0 1 1.8 5 10.5 7 22.8 10 40.4 10 57.9 11 77.2 3 82.5 2 86.0 0 86.0 1 87.7 3 93.0 4 100.0 Third Unit Cumulative Frequency Percent 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 2 4.8 7 21.4 7 38.1 5 50.0 7 66.7 6 81.0 2 85.7 1 88.1 1 90.5 4 100.0

Observations: The average response time of the first arriving fire unit for structure and outside fire calls was 5.4 minutes. Ninety percent of the time, the first fire unit arrived on scene in fewer than 7.7 minutes. On average, the response time of the second arriving unit was 7.6 minutes, which was 2.2 minutes longer than that of the first arriving unit. Ninety percent of the time, the second fire unit arrived on scene in fewer than 12.1 minutes.

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IV. Analysis of Busiest Hours in the Year
There was significant variability in the number of calls from hour to hour. One special concern relates to the fire resources available for the hours with the highest workload. We tabulated the data for all 8,760 hours in the year. Approximately once every six days the fire department will respond to three or more calls in an hour. This is 0.7 percent of the total number of hours. Once during the year, there were more than five calls (eight calls) in a single hour. In studying these call totals, it is important to remember that an EMS run lasts on average only 26.4 minutes and a fire category call lasts on average 23.1 minutes. For the majority of these high-volume hours, the total workload of all units combined is equivalent to four or fewer units being busy the entire hour. Here, we report on the ten hours with the most calls received. We also provide detailed analysis of the two busiest hours of the year. Table 21. Frequency Distribution of the Number of Calls
Number of Calls in an Hour 0 1 2 3 4 5 8 Frequency 6,531 1,836 332 49 7 4 1 Percentage 74.6 21.0 3.8 0.6 0.1 0.0 0.0

Observations: There were sixty-one hours (0.7 percent) during the year in which three or more calls occurred in an hour. This is approximately once every six days.

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Table 22. Ten Hours with the Most Calls Received
Number Number Total Busy of Calls of Runs Minutes 01/29/2010 10 p.m. 8 9 243 04/13/2010 10 a.m. 5 8 263 03/23/2010 5 p.m. 5 8 185 05/01/2010 10 a.m. 5 9 125 08/18/2009 8 p.m. 5 7 228 09/09/2009 9 a.m. 4 4 96 12/22/2009 6 p.m. 4 7 215 07/29/2009 11 a.m. 4 6 149 12/28/2009 5 p.m. 4 8 154 01/30/2010 1 a.m. 4 4 394 Note: The combined workload was the total busy minutes responding to calls received in the hour, and the response may have extended into the next hour or hours. Hour

Observations: The hour with the most calls received was between 10 p.m. and 11 p.m. on January 29, 2010. The eight calls received involved nine runs. The combined workload was 243 minutes, which may have extended into the next hour or hours. This is equivalent to four firefighting units being busy the entire hour. The hour with the second most calls received was between 10 a.m. and 11 a.m. on April 13, 2010. The five calls received involved eight runs. The combined workload was 263 minutes, which may have extended into the next hour or hours. This is equivalent of between four and five firefighting units being busy the entire hour. The hour on January 30th that had the highest total busy minutes (1 a.m. to 2 a.m.) included work that continued into the next hour or hours. This was the result of one long public assistance call. Engine unit ENG93 was tied up for six hours on this call.

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Table 23. Unit Workload Analysis Between 10 p.m. and 11 p.m. on January 29, 2010
1 2 3 Station Unit ENG91 HZ41 ENG92 RES41 BRT41 ENG93 0-5 5-10 10-15 3.9 15-20 5.0 20-25 5.0 25-30 4.5 5.0 4.1 30-35 5.0 2.1 1.9 5.0 35-40 5.0 5.0 5.0 5.0 40-45 1.4 5.0 5.0 2.3 45-50 5.0 5.0 50-55 5.0 5.0 55-60 5.0 5.0 Total 15.9 0.0 46.0 0.0 26.9 16.4 Note: The numbers in the cells are the busy minutes within values greater than 2.5 are coded as red. T41 4 ENG94 5.0 4.9 Number of Busy Units 1 1 2 2 2 4 5 5 6 4 4 3

1.5 0.1

1.2 5.0 5.0 5.0 3.2 5.0 5.0 5.0 0.9 5.0 5.0 10.7 46.1 the five minute block. The cell

Observations: In the city there are six units staffed all of the time. During the worst portion of the hour between 10:45 p.m. and 10:50 p.m., all six units were busy. Only two units were busy more than thirty minutes during this hour.

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Figure 19. Unit Workload Analysis by Call Type Between 10 p.m. and 11 p.m. on January 29, 2010

Observations: Busy minutes for EMS calls totaled 36.2 minutes, which accounted for 22.3 percent of the total busy minutes. Busy minutes for nonstructure and outside fire category calls totaled 125.8 minutes, which accounted for 77.7 percent of the total busy minutes.

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Table 24. Unit Workload Analysis Between 10 a.m. and 11 a.m. on April 13, 2010
Station 1 2 3 Unit ENG91 HZ41 ENG92 RES41 BRT41 ENG93 0-5 5-10 1.6 1.6 10-15 5.0 5.0 15-20 5.0 5.0 20-25 5.0 5.0 25-30 5.0 5.0 30-35 1.8 1.8 35-40 40-45 5.0 2.8 45-50 5.0 5.0 50-55 5.0 5.0 55-60 4.4 5.0 Total 42.8 23.4 0.0 0.0 0.0 17.8 Note: The numbers in the cells are the busy minutes within values greater than 2.5 are coded as red. T41 4 ENG94 Number of Busy Units 0 3 3 3 3 3 3 1 4 4 4 4

1.6 5.0 5.0 5.0 5.0 5.0 5.0 5.0 5.0 2.8 5.0 5.0 5.0 5.0 5.0 17.8 51.6 the five minute block. The cell

Observations: In the city there are six units staffed all of the time. During the worst portion of the hour, between 10:40 a.m. and 11 a.m., four units were busy. Only two units were busy more than thirty minutes during this hour.

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Figure 20. Unit Workload Analysis by Call Type Between 10 a.m. and 11 a.m. on April 13, 2010

Observations: Busy minutes for EMS calls totaled 55.0 minutes, which accounted for 35.9 percent of the total busy minutes. Busy minutes for nonstructure and outside fire category calls totaled 98.4 minutes, which accounted for 64.1 percent of the total busy minutes.

Appendix I. Correspondence between Call Description and Call Type
Call Type MVA MVA MVA EMS EMS EMS EMS EMS EMS EMS EMS EMS EMS EMS EMS EMS Structure Fire Structure Fire Structure Fire Structure Fire Structure Fire Outside Fire Outside Fire Outside Fire Outside Fire Outside Fire Outside Fire Outside Fire Outside Fire Outside Fire Outside Fire Outside Fire Outside Fire Outside Fire Hazard Hazard Hazard Hazard Hazard Hazard Hazard Hazard Hazard Hazard NFIRS Code 322 323 324 300 311 321 350 353 363 445 460 463 510 3211 3212 3213 111 113 114 116 130 118 131 132 137 138 140 141 142 143 154 160 162 561 211 213 240 243 251 400 411 412 420 421 Description Motor vehicle accident with injuries Motor vehicle/pedestrian accident (MV Ped) Motor vehicle accident with no injuries Rescue, EMS incident, other Medical assist, assist EMS crew EMS call, excluding vehicle accident with injury Extrication, rescue, other Removal of victim(s) from stalled elevator Swift water rescue Arcing, shorted electrical equipment Accident, potential accident, other Vehicle accident, general cleanup Person in distress, other EMS call, excluding vehicle accident with injury EMS call, excluding vehicle accident with injury EMS call, excluding vehicle accident with injury Building fire Cooking fire, confined to container Chimney or flue fire, confined to chimney or flue Fuel burner/boiler malfunction, fire confined Mobile property (vehicle) fire, other Trash or rubbish fire, contained Passenger vehicle fire Road freight or transport vehicle fire Camper or recreational vehicle (RV) fire Off-road vehicle or heavy equipment fire Natural vegetation fire, other Forest, woods or wildland fire Brush or brush-and-grass mixture fire Grass fire Dumpster or other outside trash receptacle fire Special outside fire, other Outside equipment fire Unauthorized burning Overpressure rupture of steam pipe or pipeline Steam rupture of pressure or process vessel Explosion (no fire), other Fireworks explosion (no fire) Excessive heat, scorch burns with no ignition Hazardous condition, other Gasoline or other flammable liquid spill Gas leak (natural gas or LPG) Toxic condition, other Chemical hazard (no spill or leak)

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Hazard Hazard Hazard Hazard Hazard Hazard Hazard Hazard Hazard Hazard Hazard Hazard Hazard Hazard Hazard Hazard Hazard Hazard Alarm Alarm Alarm Alarm Alarm Alarm Alarm Alarm Alarm Alarm Alarm Alarm Alarm Alarm Public Service Public Service Public Service Public Service Public Service Public Service Public Service Public Service Public Service Public Service Public Service Public Service Public Service Public Service Public Service

422 440 441 442 443 444 480 522 531 650 651 652 671 672 746 814 2511 2512 700 710 713 730 733 734 735 736 740 741 743 744 745 7412 331 462 500 511 512 520 550 551 552 553 554 800 813 5211 5212

Chemical spill or leak Electrical wiring/equipment problem, other Heat from short circuit (wiring), defective/worn Overheated motor Breakdown of light ballast Power line down Attempted burning, illegal action, other Water or steam leak Smoke or odor removal Steam, other gas mistaken for smoke, other Smoke scare, odor of smoke Steam, vapor, fog or dust thought to be smoke HazMat release investigation w/no HazMat Biological hazard investigation, none found Carbon monoxide detector activation, no CO Lightning strike (no fire) Excessive heat, scorch burns with no ignition Excessive heat, scorch burns with no ignition False alarm or false call, other Malicious, mischievous false call, other Telephone, malicious false alarm System malfunction, other Smoke detector activation due to malfunction Heat detector activation due to malfunction Alarm system sounded due to malfunction CO detector activation due to malfunction Unintentional transmission of alarm, other Sprinkler activation, no fire - unintentional Smoke detector activation, no fire unintentional Detector activation, no fire - unintentional Alarm system activation, no fire - unintentional Sprinkler activation, no fire - unintentional Lock-in (if lock out , use 511 ) Aircraft standby Service Call, other Lock-out Ring or jewelry removal Water problem, other Public service assistance, other Assist police or other governmental agency Police matter Public service Assist invalid Severe weather or natural disaster, other Wind storm, tornado/hurricane assessment Water evacuation Water evacuation

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Public Service Public Service Public Service Public Service Public Service Public Service Public Service Standby Good Intent Canceled Canceled Canceled

5213 5214 5215 5216 8001 8002 8003 571 600 611 621 622

Water evacuation Water evacuation Water evacuation Water evacuation Severe weather or natural disaster, other Severe weather or natural disaster, other Severe weather or natural disaster, other Cover assignment, standby, moveup Good intent call, other Dispatched & canceled en route Wrong location No incident found on arrival at dispatch address

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Appendix II. Workload Analysis for Administrative Units and Non-Germantown Units
Station 1 3 Unit F-158 BT41 UT41 400 401 402 403 416 BC42 MUTAID WING RM31 RM32 RM36 RM42 RM45 RM50 Description A command and interoperability communications truck. On duty Battalion chief SUV Pickup truck Fire chief car Assistant Fire Chief car Deputy Fire Chief car Fire marshal car Assistant Fire Marshal car Off duty Battalion chief Mutual aid vehicle Private Helicopter Ambulance Ambulance Ambulance Ambulance Ambulance Ambulance Number of Runs 1 636 3 21 26 15 32 6 5 5 2 1 31 951 397 34 4 Busy Hours 11.2 286.5 1.0 20.0 42.3 32.2 47.1 16.5 1.6 2.9 1.5 0.5 12.9 388 173.3 12.4 2.5

Admin

Rural/Metro

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