Trend and Analysis

This measure has shown improvement over the past several years.  The balancing factors for response time performance and reliability are (a) efficient production of resources, (b) effective deployment of those resources and (c) managing demand for services.  The agency has executed improvement projects in all three domains that have resulted in performance gains. 
 The Fire/EMS Department improved production by increasing the number of ALS first response (Paramedic Engine) units by one in FY 2018.  This increase shows a direct and impactful improvement of 16% in the three closest response areas. The agency improved deployment through the Automatic Resource Location (ARL) technology. The agency uses ARL to improve both average response time and reliability for this measure.  In FY 2019, the agency proposes to add an additional technology solution that works in conjunction with ARL to allow units to be moved from communities least likely to request to services to the communities most likely to request services, hence further improving response time performance and reliability. The agency addressed demand through development of a Mobile Integrated Healthcare unit that interacts with the patient population that most frequently consumes resources of various County agencies and the greater healthcare system.  As an example, a single patient has requested assistance via 911 for a total of 74 incidents, requiring 190 unit responses and consuming 168 unit hours in the past year.  Addressing the needs, connecting resources and services, and actively managing these patients is a goal of the program.  Working in coordination with our partners, this effort has resulted in a 48% reduction in demand from these patients. 
The agency continuously evaluates the number of units required to address the needs of each incident.  The number of unit responses per ALS incident has been trending downward – currently at 3.1 for ALS2 (cardiac arrest) and 2.3 for ALS1 (ALS emergency).  These measures are down from 4.3 and 2.5, respectively.  This translates to the agency becoming more efficient by consuming fewer resources while responding to a generally increasing number of incidents.  The recently improved staffing model and future development of a single unit (ALS0) response will allow for this efficiency measure to improve even further.  This serves to improve performance in two ways: reducing workload on the employees and volunteers and increasing the probability that a unit is available to respond to the next request.