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EMS Strategic Plan
Montgomery County Emergency Medical Service Strives to provide the highest standard of emergency medical, transport and rescue services to Montgomery County's citizens.
On Going Areas of Improvement
- Response Times to All Areas of the County (i.e. new stations and additional crews for existing stations)
- Scheduled Fleet Replacements
- Reduction of OJI injuries by purchasing newer & more technologically advanced equipment
- Develop a new administrative office building
- Personnel Education/Development (i.e. continued education and new classroom facilities)
- The exponential growth of our community has created an added burden upon this department's mission to provide timely responses to all areas. EMS has been forced to look for additional ways to reduce response times especially to northern and eastern sections of the county that have seen a massive housing explosion. The increasing volume of congested traffic on the county's roadways also hampers our ability to reach patients within the national standard of eight minutes. To address these concerns, EMS must construct new stations in strategic areas as well as placing additional crews within existing stations. These measures will allow our service to effectively decrease response times and most importantly save lives.
- With the major growth comes an ever increasing call volume. The most used piece of equipment that we use is our ambulances. We desperately need to replace at least 3 units per year. These units have the criteria for being replaced as units over 150,000 miles or greater than 6 years of use. The older the units are, the more mechanical problems develop. This increases the chances of a breakdown on an emergency response.
- Reduction of injuries to our workforce is another top issue. The cost of a major orthopedic injury to an employee is staggering. We have discovered new equipment that will allow our employees to work smarter, not harder. By doing this we hope to significantly reduce the incidents of career ending back injuries. In the area of OJI Pay out, we have paid $40,014.03from July 1, 2008 to June 30, 2009. As well as lost wages during this same period of $9897.68, this is a total of $49,911.77. We have had our new Power lift cots for several years & haven't seen the number of back injuries we previously saw. Between the Stair Chair, Auto Pulse & Power Cot use, we feel that this has been a tremendous success.
- Our Administrative offices are in need of total replacement. We have outgrown the existing building. By replacing it, we will be able to establish a more effective work flow environment thus improving collections, speed billing & make the work environment more conducive to its function. It will also allow more administrative functions to be taken care of here instead of having to hold staff meetings elsewhere. We will also be able to incorporate a classroom in the replacement that is essential to continuing our mission & will go hand & hand with Issue Statement # 6.
- The issue of education and personnel development is complex as the medical field continually changes. Our job functions require our employees to have a higher level of training than other departments. In order to keep up with the latest Medical Advancements, we must adapt and address the public's demand for the highest quality of care possible. On-going education is essential to addressing this department's goals. This task becomes greater as the size of our staff increases to match our community's growth.
List of Mandates
- State of Tennessee's EMS Division requires certain types of specific equipment to maintain the service's "A" rating.
- Federal government's Department of Transportation mandates regulations for ambulances – size, construction.
- State of Tennessee's EMS Division mandates the submission statistical information from all calls made.
- State of Tennessee mandates all ambulances have a VHF radio for statewide mutual aid and hospital contact.
- OSHA requires our service to provide personal protective clothing to be worn by personnel on hazardous emergency scenes such as automobile accidents.
- State of Tennessee dictates a list of mandatory in-service classes to be offered to personnel including Vanessa K. Free defensive driving, pediatric emergencies, hazardous materials and domestic violence awareness.
Goals of Emergency Medical Services Emergency Treatment and Transport Program
Improve Response Times
By July of 2011 begin dialog with the Clarksville Montgomery County School system to find a suitable location to co-locate an EMS station in the Highway 12 area. (Chief, Deputy Chief & their designees).
Obtain approval of the CMCSS Administrative personnel.
The output will be the agreement to allow our department to co-locate on their property.
The population & citizens demand fast & efficient delivery of emergency medical services.
The efficient decrease of our response times to the target areas will decrease morbidity & mortality.
These are indeterminate due to not knowing the
exact location of any proposed school in that area. An approximate cost
should be around $250,000.
By July of 2010 begin to initiate supplemental ambulance crews at a station location to be determined by the Chief of EMS. (Chief of EMS).
Obtain approval of the Budget Committee as well as the County Commission of Montgomery County.
To put an extra 2 person crew where the demand is needed.
The citizens as well as the Hospital staff will demand a low response time for their patients/ citizens.
This will be accomplished in 2 ways: 1-a reduction in response times to the heavy growth area of northeast Montgomery County (i.e. Kirkwood, Hampton Station, & Port Royal areas). 2- A reduction in response times to the New Hospital for Emergent Critical transports as well as other transports.
The cost of this will be as follows:
- Additional Crews
Additional EMT's (July 1 of 2010 to June 30, 2011) - $36,172.20 per person (Salary) and a 30% benefit package at $10,851.66 for a total of $47,023.86 X 3 =$141,071.58 (employee figures are for the FY 08/09. New figures will increase the cost accordingly)
- Additional Paramedics
Additional Paramedics (July 1 2010-June 30 2011)- $41,048.60 per person (Salary) and a 30% benefit package at $12,314.58 for a total of $53,363.18 X 3 =$160,089.54 For all 6 employees, the total cost will be $301,161.12 3 Additional Paramedics to assist in staffing issues. $41,048.60 X 30% =$12,314.58. Total of $53,363.18 X 3 = $160,089.54. 58 (employee figures are for the FY 08/09. New figures will increase the cost accordingly)
By July of 2008, continue the implementation of yearly replacement of at least 3 older ambulances. (Deputy Chief & 2ND Lt.'s.) We will continue to use remounting strategies as long as we are eligible to do so by statutory regulations.
Replacement of older units on a yearly basis
This is conditional upon the approval by the Budget Committee & County Commission.
The public demands safe & reliable transportation of its citizens.
By replacing at least 3 units per year, we insure the citizens of our community that we are using the best & most mechanically sound vehicle possible.
Breakdown of costs from 2009, projected through 2012:
- In 2009, the cost was $75,095.00 each X 2 = $150,190.00
- For 2010, we estimate a cost of $80,000.00 each, for a cost $240,000 for 3
- For 2011, the estimate a cost of $84,800.00 each, for a cost of $254,400 for 3
- For 2012, the estimated cost of $89,888 each, for a cost of $269,664 for 3
By July of 2012, begin to select locations in the Highway 149 area that will be suitable for a replacement station. (Chief & Deputy Chief).
The successful acquisition of the land needed for the project
Upon approval from the Budget Committee & County Commission
Our citizens will demand a reduction in response times during medical emergencies
This will be the timely delivery of an ambulance with a decreased response time. This will decrease morbidity & mortality
An estimated cost of $289,000 for the land & building.
Employee cost will be $231,662.40 per year (using FY 2008-2009 figures).
Total Cost- $520662.40
Goals of Emergency Medical Services Injury Prevention Program
By July of 2008 continue the Implementation of replacement of our older ambulance cots with newer, more technologically advanced equipment such as electric power lift cots and stair chairs. (Deputy Chief & 2nd Lt's).Result
Replace older outdated cots with newer, more ergonomically designed power lift cots and stair chairs.Output
Insure the budget reflects money for the purchase of these items from a sole-source vendor.Demand
A reduction in the cost of several major medical claims will be realized by purchasing these cots.Efficiency
By preventing back injuries, we reduce the cost incurred in treating and rehabilitation of these employees as well as potentially having to pay out large settlements when their career is over.Costs (Estimated)
- In 2009 this cost for the cot should be $11,290.00 X 3= $33,870
- In 2010 the cost for the cot should be $11,500 X 3 = $34,500
- In 2011 the cost for the cot should be $12,100 X 3= $36,300
- In 2009 the cost of the stair chairs should be $2500.00 x 5 = $12,500.00
- In 2010 the cost of the stair chairs should be $2625.00 x 3= $7,875.00
- In 2011, the cost of the stair chairs should be $2,757.00 x 3=$8,271.00
Goals of Emergency Medical Services Administrative Services Program
By July of 2012 begin the process for the addition to or replacement of our Administrative offices. (Chief & Deputy Chief)Results
Upon County Commission approval, renovating or building a larger administrative officeOutput
The output will be an improvement in the work flow making our staff more efficient & timely in filing claims and revenue collectionsDemand
Presently, our current building is inadequate for the productivity of filing insurance claims to increase departmental revenuesCosts
The estimated cost is $1.79 million dollars depending on location
By January of 2009, continue steps toward the improvement in delivery of High Quality medical services through increases in specialized training classes and Better medical equipment.Training
Successful completion of Advanced Cardiac Life Support, Pre-Hospital Trauma Life Support, Pediatric Advanced Life Support, Emergency Vehicle Operations, & Domestic Violence Awareness training.
Training of all our pre-hospital providers in specialized classes
The increase of our standard of care & treatment for our citizens
By completing these classes, we increase our skill level thus enhancing performance & hopefully increasing survivability
The following classes will cost the following: (The hourly rates have been figured on 2008-2009 FY hourly rates).
- ACLS- 60 Paramedics - $10,500.00
- PALS -60 Paramedics - $10,500.00
- PEEP- 45 EMT's - $8,750.00
- EVOC-$12.29 X 6=$73.74 X 60=$4,424.40
$10.83 X 6= $64.98 X 45=$3,898.80
- Domestic Violence Awareness - 60 Paramedics X 4 X $12.29=$2949.60
- 45 EMT's X 4 X $10.83= $1,949.40
- Haz-Mat Awareness -
- 60 Paramedics X 4 X $12.29=$2949.60
- 45 EMT's X 4 X $10.83=1,949.40
- Rapid Sequence Intubation -
- 60 Paramedics X 3 X $12.29=$2,212.22
- Pre-Hospital Trauma Life Support -
- 60 Paramedics-$11,000.00
- Basic Life Support (CPR) -
- 4 instructors-$384.00
- Total cost $76,159.20
Improved cardiac responses and interventions, improved ventalatory control, improved cardiac perfusion, improved spinal immobilization care & improved Carbon Monoxide poisoning detection.
Improved cardiac responses and interventions, improved ventalatory control, improved cardiac perfusion, improved spinal immobilization care & improved Carbon Monoxide poisoning detection
The increase of our standard of care & treatment for our citizens
By insuring these devices are on the units, we increase the technical abilities of our Paramedics, for our patients.
- 16 Zoll, AED Plus Series Defibrillator $1,995.00 each. Total of $31,920.00
- 6 Zoll AED Pro Series AED's @ $2500.00 each. Total of $15,000.00
- 4 Zoll Auto-Pulses $15,000.00 each. Total of $60,000.00
- 2 Auto-Ventilators $2,000.00 each. Total of $4,000.00
- 1 Carbon Monoxide Detector $4,000.00. Total $4,000.00
- 20 Spine boards @$200.00 each. Total of $4,000.00
- Grand Total of $118,920.00
Energy Saving Measures
In conjunction with the mission of our department, we are committed to trying to save tax dollars by trying to save money where we can. 1 area is by the moving of our supply room to a location closer to the hospital. By doing this, we will eliminate the need for units to come across town for supplies as they can stop by on their way back to their zones. We also have our supply/logistics officer pull supply orders every morning & deliver them to the stations. In addition, the Shift Officers can assist in resupplying units after hours as needed. This saves time, saves diesel fuel, & keeps the units in their assigned zones to answer calls for service.
In the future, we will be looking at automatic, programmable thermostats that will prevent major swings in temperature thus saving gas and electricity, moving to all fluorescent bulbs in light fixtures, as they fail, upgrading to energy star appliances and mandatory lights off campaign for all stations when they are not occupied.