Dallas chief: EMS services under 'substantial strain'

Increasing call volume, a growing population and a shrinking department have spelled trouble for the city's emergency medical responders

By Tristan Hallman
The Dallas Morning News

DALLAS — When Dallas Fire-Rescue Chief David Coatney rode out on an ambulance for a shift in southern Dallas on the night of New Year's Eve, his paramedics responded to a hectic 10 calls in 12 hours.

"I thought that was an anomaly because of New Year's Eve," Coatney said. "But then when I pulled the data, I found that was a normal shift for them."

It's too normal for too many paramedics, Coatney said. He told members of the City Council's public safety committee on Monday that the rescue side of Dallas Fire-Rescue is under a "substantial strain" and needs more resources in the years ahead.

Increasing call volume, a growing population and a shrinking department have spelled trouble for the city's emergency medical responders. Coatney said he's looking at several plans to reshape EMS service, but it's going to cost money.

In the interim, Dallas Fire-Rescue officials will rely on the same system they always have: using overtime during peak hours to meet the demand.

Currently, the average number of ambulance runs are slightly above what the department considers the optimal rate of usage, which is about 55 percent of the hours an ambulance is available for service. One downtown ambulance had a 72 percent usage rating. Those rates have been steadily rising in recent years.

"These numbers suggest our ambulances, our paramedics, our firefighters are running at a very, very high rate — well above the industry standard," said Dr. Marshal Isaacs, the city's medical director. "But the volume is what it is, and we're charged with responding to it."

Dallas Fire-Rescue has 40 front-line ambulances and three more that are put into service during peak hours. Relying on overtime and peak-demand units has some advantages, Coatney and Isaacs said. But it can be a beatdown on already busy paramedics who have seen a 13 percent increase in ambulance runs in the past three years.

Acting Assistant Chief George Gamez, who oversees the EMS division of the department, said morale among his firefighters is "tough, but with them knowing we're looking to find solutions, it's good."

Dallas Fire Fighters Association President Jim McDade agreed, and worried that the workload was too strenuous and was causing younger firefighters to leave. So far this fiscal year, which ends Sept. 30, 80 firefighters have left.

He faulted past fire leadership for failing to address the department's needs.

"We haven't had a lot of forward-thinking leadership in the fire department," he said. "It's just that simple. It's the answer of, 'It's the way we've always done things.'"

McDade and others are part of a departmental committee looking at a half dozen different models for responding to emergencies. Coatney is considering staffing in Phoenix and San Antonio, where he rose through the ranks, as more flexible response models.

Council members were receptive to hearing more and supportive of improving ambulance response, but didn't offer many opinions on fixes before they heard the details.

Coatney said the costs to modernize the department could end up being "pretty substantial," but necessary. He could parse the needs out over a few years to help mitigate any sticker shock.

Any solution will incorporate a long-desired priority-dispatch system, which would allow the fire department to respond to medical emergencies according to need rather than the current response model: as fast as possible, pretty much no matter what.

The dispatch system, used by other cities, should have been implemented "about five years ago," said Coatney, who became the chief last summer. And the city hasn't been keeping up with ambulance units and staffing, he said. Ideally, Coatney would like to have more than 50 ambulances.

"We're well behind the curve on what we need to do," Coatney said.

Copyright 2017 The Dallas Morning News

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