Consultants report on Toronto Fire-EMS Merger

[WolfmanHarris]

http://xa.yimg.com/kq/groups/13135525/1343983969/name/Pomax%20backgroundfile-59902.pdf

The consultants hired to examine whether Toronto EMS and Fire should merge have released their final report for council. They have come out firmly against. The report is long but it's a very good read. They explored financial implications, staffing, dispatch and the actual impact of Fire-EMS on patient care.

[Richard B the EMT]

The report mentions a "Mature Paramedic Service". Could someone give me a definition of that ("Mature Service")? The NYC EMS, organized as a part of the NYC Health and Hospitals Corporation, was 26 years old (1970-1996) when we were merged into the FDNY, which had been organized for over a century at the time.

It is my presumption that EMS, being a much younger "thing" than Police/Sheriff's Departments, and Fire Department/Brigades, will continue to some indeterminable time in the future, to be regarded as a "red headed stepchild" emergency service

[WolfmanHarris]

I just realized I only attached the executive summary, everything is far better explained in the complete report.

From my reading of the report, "mature service" refers more to it being a fully developed functioning system. That's not to say NYC wasn't, but from everything I read that merger was entirely political.

Here is the link to the complete report:

http://xa.yimg.com/kq/groups/13135525/780718542/name/Pomax%20Final%20backgroundfile-59903.pdf

One of the most interesting sections is where they address placing Paramedics on Fire apparatus. They do a very good job discussing the time spent on scene prior to Ambulance arrival, the calls where Fire first response may have a clinically significant impact (approx 1% of all EMS calls) and whether the increased scope of practice would actually be utilized balanced against the cost of training and equipment.

The part where they call for a 223 000 annual man hour increase in EMS staffing to meet need and response times is pretty good too. Equates to approx 24 additional Ambulances on the road 24/7. I doubt we'll see TO get that or anything close in the current fiscal environment, but it makes it clear that they will no be able to meet demand at current staffing and that it will only get worse.

[rock_shoes]

I find it interesting how heavily they relied on the BCAS model when discussing the efficacy of a targeted ALS model. Even someone on the outside looking in can tell AMPDS is the bain of our existence in a targeted system.