Over the last 18 months, nearly every aspect of local government has been dramatically impacted by the COVID-19 pandemic. During these times, our local emergency medical services (EMS) systems are one of our most affected entities.
We’ve heard from many EMS leaders that have seen call volumes double or even triple overnight! Many departments have not planned for a dramatic increase in demand like this, and are now dealing with shortages of vehicles, equipment, and staff.
Today, fleet planning and implementation have taken on a new level of importance, here’s why…
- For numerous reasons, lead times on new equipment have increased dramatically, and often times manufacturers cannot give accurate delivery dates.
- Material prices continue to increase based on worldwide shortages of raw materials.
- Due to increased call volume, transport distances, hospital diversions, ER wait time, and decontamination protocols, Time-On-Task averages have skyrocketed for many agencies.
- Ever-broadening expectations of EMS to cover gaps in healthcare such as on-demand testing, treatment, and immunization services further stresses EMS personnel and infrastructure.
Vehicle Replacement Strategy
Today’s reality is, past experience may not be as reliable in predicting tomorrow’s needs as it once was. A replacement plan is deliberate and should be in place before that shiny new unit is ordered. It’s essential that agencies create an Apparatus Replacement Strategy that focuses on balancing equipment needs with your present and anticipated future demands for service.
Achieving an optimal Vehicle Replacement Strategy considers multiple factors and is revisited often. Some factors may include current and future Peak Staffing Levels, unit hour utilization, anticipated population growth, shifting demographics, transport distances, opening or closing of facilities, shifting weather patterns, etc. Of these factors, Peak Staffing Level is one of the most straightforward but misunderstood planning elements.
Peak Staffing Level is defined as the highest concurrent number of staffed units on duty on a regular / planned basis. Many agencies consider an optimal fleet size as 1.5 fully equipped and mission capable units per Peak Staffing Level.
Equation: Peak # of units x 1.5 = X, then round up.
- If you staff 5 units during peak demand, you should have 8 total units in your fleet.
- If you staff 10 units during peak demand, you should have 15 total units in your fleet.
- If you staff 15 units during peak demand, you should have 23 total units in your fleet.
A rural community, for example, has three units in its fleet. They run approximately 400 calls per year, and usually, transport 2 miles into their local small hospital, or 12 miles into the larger community’s Hospital with a Level III trauma center. They have mutual aid available with an average response time of 30 minutes as needed. They occasionally need to transport to the larger city 35 miles away for specialty care. Since the time on task is lengthy they try to use on-call crews to backfill or handle the transport. They also regularly schedule and staff a dedicated unit at most high school athletic events, the annual county fair, and the Labor Day town festival. This does not include any unusual surges due to an unplanned natural disaster or the occasional unplanned busy day.
With this schedule, their Peak Staffing Level is three. With only three units, routine maintenance is often delayed or cut short during busy times or special events season. Crews are reluctant to switch out of the “primary” unit because both “reserves” are unreliable, uncomfortable, or have suboptimal performance. The situation festers until the primary unit suffers a catastrophic transmission failure, and is intensified when the second unit has a deer strike that took out the radiator. In the blink of an eye, the community is in an equipment crisis.
Using the equation of 1.5 units per Peak Staffed Unit (rounded up), the community would have avoided this crisis and may have even avoided the costly and lengthy transmission replacement by comfortably having all units inspected and serviced prior to the failure.
What About Reserve Units?
Many EMS agencies are stuck in the traditional “front line” and “reserve” fleet management, which has been in use for as long as there has been fire apparatus. The fundamental difference between Fire and EMS apparatus is that EMS apparatus will often “wear out” based on mileage, where many Fire apparatus (especially support and specialty apparatus) will “age out”. A 20-year-old Type 6 Engine with 40,000 miles is usually far more serviceable and reliable than a 15-year-old ambulance with 300,000 miles.
A more successful and cost-effective fleet strategy for EMS is to maintain a fleet where ANY unit is fully mission-capable and all units are regularly rotated into service on a regular basis. Using a strategy like this will balance out fleet mileage, allow for regular equipment inspection and when surges hit, EVERY unit will be ready to respond.
Does your agency use Reserve Units? How has that practice evolved over time to influence your Fleet Size? We’d love to hear your thoughts.
New vs Remounting
If you’ve needed to replace an EMS vehicle in your fleet over the last year and a half, then you may have considered remounting. Remounting is where we remove your Frazer module from the existing chassis and mount it onto a newer chassis.
If chassis procurement is not an issue, then remounting may be a better use of funds during times where materials and equipment costs are increased. It also may be a good option if your department uses Reserve Units as they can be great candidates for remounting.
More on Fleet Sizes
Determining the right number of fleet vehicles requires analyzing multiple potential factors. To learn more about our thoughts on Fleet Size, read our Fleet Size Matters article.