To improve county Fire Department’s effectiveness, three full-time crew members instead of two should be assigned to each engine, consulting firm says

Response times to calls prove longer than recommended by national standards

A graphic shows details about the processing time for 911 calls in Sarasota County. ‘MVA’ stands for motor vehicle accidents. Image courtesy Sarasota County

The Sarasota County Fire Department “is one of the best that we have looked at” nationwide in terms of configuration of stations and service delivery, Stuart McElhaney, director of planning and strategic services for Emergency Services Consulting International (ESCI), has reported to the Sarasota County Commission.

However, after his firm spent 20 months undertaking an in-depth analysis of the department, at the county’s behest, McElhaney told the commissioners on March 13 that ESCI had a number of recommendations that would enable Fire Department personnel to respond more effectively to calls. At the top of the list was an increase in the number of full-time crew members per fire apparatus from two to three per shift.

The nearly 300-page report ESCI produced put it this way: “[S]taffing is now the limiting factor in response time.”

The report also points out that a 2010 National Institute of Standards and Technology (NIST) study “showed that fire victims are likely to survive 89 percent of the time when initial arriving engine company is staffed with three [people] versus less than 50 percent of the time when staffed with two in slow to moderate growth fires.”

The Fire Department was working on that increase in staffing before the Great Recession began, McElhaney noted. The ESCI analysis found that the county budget for this fiscal year calls for three-person staffing on five engines.

A graphic provides data about fire and EMS call locations in comparison with population centers in the county. Image courtesy Sarasota County

Among its other recommendations, ESCI said the Fire Department should set response goals on the basis of population density, add units to help deal with calls during peak periods, and reduce the time it takes for crews to leave stations after calls for service has been received.

Sarasota is “a rapidly growing community [and] we don’t see that stopping,” McElhaney told the commissioners.

On the positive side, McElhaney pointed out, “Your buildings and equipment [are] second to none in the nation. You guys have done a tremendous job building proper infrastructure for public safety.”

Additionally, he told the board, the county Fire Department has “a very strong management team” and training programs. “There is no emergency that you can’t respond to.”

Details in the data

A graphic shows the location of the county fire stations. Image courtesy Sarasota County

During its review of the Fire Department’s operations, McElhaney continued, the firm utilized the 90thpercentile in determining response times. He explained that, at ESCI, “We don’t like to look at averages. McElhaney called the 90thpercentile “a reallygood indicator.”

The first figure he provided the board was the time it takes for the processing of a 911 call in Sarasota County — including requests for emergency medical services (EMS) assistance and fire alarms. Ninety percent of the time, he said, ESCI found that it takes 2 minutes and 17 seconds. At the 99thpercentile, the time was 4 minutes and 35 seconds.

However, the National Fire Protection Association (NFPA) standard is 60 seconds, he added, “so you are well above that.”

He did note that the NFPA does not just represent public safety professionals; contractors and private industry representatives, for examples, are among its stakeholders. Altogether, he said, the committees of the NFPA work to reach consensus on standards.

When a 911 call comes in, he continued, a dispatcher has to ask questions about the type of emergency, “to get that call dispatched to the proper resource.”

After the determination was made about the response time in Sarasota County, McElhaney said, Rich Collins, director of the county’s Emergency Services Department, and Fire Chief Michael Regnier talked with representatives of the Sarasota County Sheriff’s Office, as that department handles the Public Safety Communications Center. An effort is underway, he noted, to determine “how they can possibly change some of these triage protocols” to speed up the process.

Among other recommendations, the ESCI report calls for identification of low-priority calls, to which a non-emergency or non-transport unit could be dispatched. It also suggests the Fire Department consider adding “peak demand units” for non-emergency calls that occur during the middle of the day from November through April, when the county population count is higher because of seasonal residents and visitors.

This graphic provides details about the turnout time. Image courtesy Sarasota County

Next, he continued, ESCI looked at the amount of time it takes for crews to leave the station after a call comes in. Ninety percent of the time, he said, that “turnout” period takes 1 minute and 52 seconds. The NFPA standard is 80 seconds for fire and special operations calls, he added. For EMS calls, it is 60 seconds.

He pointed out that 80% of the calls the Sarasota County Fire Department gets are for EMS assistance.

“That is absolutely common with just about every jurisdiction that we look at,” he said of those longer turnout times for the Sarasota County Fire Department.

Chief Regnier is looking into ways to shorten them, McElhaney added.

In regard to travel time: Ninety percent of the time, the county Fire Department takes 7 minutes and 40 seconds to reach the location of an emergency, he continued. The NFPA standard is 4 minutes. “Very, very few communities ever meet this goal,” he said.

One factor in the county’s response time, McElhaney noted, is the high demand for service. Almost 30% of the time, he said, the station that is closest to the caller is not the one that responds because its equipment already is tied up. “So another unit has to take [the new call],” and that unit will be further away.

Graphics in the ESCI report offer information about when the majority of calls are received. Image courtesy Sarasota County

Yet another concern ESCI found, McElhaney continued, is that turnaround time at the area’s hospitals can be more than double the period recommended. “We’d like to see a turnaround time of 20 to 25 minutes,” he said. “It can take upwards of an hour if the [emergency room] is very busy.”

When Commissioner Michael Moran asked whether some hospitals create more problems for the Fire Department than others, Collins, the Emergency Services director, replied that his team “works very diligently” to rectify problems when they do arise.

“We meet with the hospitals directly,” Chief Regnier added, to talk about how best to limit the waiting time for EMS crews who bring patients to the facilities. Yet, he said, delays do happen, “especially in peak [tourist] season.”

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