CLEVELAND, Ohio — After years of resistance rooted in politics and race, Cleveland’s Fire Department and ambulance service may finally be on the road to a merger.
Or maybe the resistance is rooted in the past history of “mergers” of EMS and fire where EMS gets worse, the EMS employees are treated like second class employees, and costs go up, not down. See, New York, San Francisco, Winnipeg, and other cities where this has been done. Or Louisville, KY where a few years back the Mayor unmerged the services because it work so well.
Jackson said he expected the move to improve service and dramatically reduce the time crews take to get to accidents and other medical emergencies. Victims also will no longer be left to wonder whether a fire truck or an ambulance is on the way.
Stop me if you’ve heard this before, but the best way to improve EMS response times is to add EMS units, not take a band aid approach to fixing the resource mismatch.
While most major cities combined the two services long ago, Cleveland spent years debating whether to follow their lead or continue having both firefighters and emergency-medical crews independently deal with accidents and other emergencies.
This sounds like a communications center issue, not an EMS or fire issue.
Jackson said that improved response times will result from medical treatment dispatched from neighborhood fire stations.
Moving ambulances into fire stations won’t work. Everywhere else where it’s been tried, the ambulances are never there because demand for ambulances exceeds supply. They tried that in San Francisco in the late 1990s, even moving EMS only employees to fire fighter schedules and assigning them station duties. Epic fail. I have to wonder if that means that they’ll send ambulances only to calls where fire apparatus used to respond as first responders?
“The most effective rescue departments across this country operate with combined fire and EMS services,” Polensek said in the email.
I don’t suppose Polensk has any proof of that. Or even a definition of what “most effective” means. I’d suggest that it should mean those with acceptable response times and good patient outcomes. Somehow though, I think he means something different.
EMS union chief Stephen Palek said the time for informal discussion has ended, and it is time for collective bargaining to begin — barring approval of Issue 2, (issue 2 failed, Ed) which he said would eliminate that possibility.
He, too, was optimistic about the outcome of joining the operations. “We have a unique opportunity here to do something pretty tremendous,” he said.
Palek did note that getting patients to trauma centers from the scene of an emergency may still have to be addressed.
“It’s a juggling act,” he said. “You could have 20 paramedics on the scene but if you don’t have a way to get that patient to a trauma center to get the definitive care they need, that’s where the juggling is going to come in.”
Did I mention that the best way to address a shortage of EMS resources was to add EMS resources? Just want to be sure.
All in all this has fail written all over it. But, it will save the jobs of fire fighters so it’s got to be good, right?