Author: Tim Nowak
Anecdotally speaking, the average “lifespan” of a fire/emergency medical services (EMS) chief is only about five years … that’s excluding some of the long-tenured volunteer fire chiefs remaining within today’s current market.
Generational mindsets, local cost-of-living, expanding opportunities within the industry for growth, and quite frankly, local politics and individual agendas all impact the longevity of the role. So, when it comes to “long-term” strategic or master planning, how “long” should departments be planning into the future?
While the American fire service has existed for over a century, the EMS industry is just rounding a half-century in many long-established organizations. With this in mind, 25, 10, and even five years could all be considered a “long” time … especially when you put things into context.
Twenty-five years ago, for example, electronic patient care reporting systems were hardly in existence. Air-conditioned cabs within fire apparatus were scarcely available even 15 years ago, and the notion of community risk reduction through preventing patients from going to the hospital was hardly acceptable even 10 years ago. Today, however, we’re planning toward integrating telehealth options, cloud-based information storage, and information exchanges that cross multiple software platforms and state boundaries. Amidst such a fast-paced industry, there’s no telling what the next five years will bring! Perhaps, five years is the new “long-term?”
Needless to say, whether your fire department or EMS agency is looking to plan five, 10, or even 25 years into the future, here is a “top five” list for you to consider when developing your strategic or master plan.
1: Funding Sources
Tax levy limits, transport reimbursement maximums, non-balanced-billing practices, and limitations on fee-for-service revenues can all impact your agency’s bottom line. Looking into the future—whether purchasing your next ambulance or building a new station, for example—it’s imperative that you consider what your current and future projected finances will look like … especially with a “worst case scenario” mindset. After all, there’s no guarantee that your voters will approve your next increase or that the Centers for Medicare and Medicaid Services (CMS) will dramatically adjust its reimbursement schedule to the benefit of your budget.
Pro tip >> Approach budget and finance projections with a “worst case scenario” mindset.
2: Formula for Growth
Should your department have expansion on the horizon, it’s important to develop a standardized – approved – formula to account for its staffing necessities. It seems obvious that adding a new full-time ambulance would equate to one emergency medical technician (EMT) and one paramedic, times three shifts … so, six personnel. But, what about “behind the curtain?” Have you accounted for the required training, the quality assurance and chart reviews, overtime coverage for vacations, supervision, etc.? The reality is that one ambulance may not equate to two personnel times three shifts: in fact, it may also require 0.25 supervisory staff, 0.25 training and quality assurance staff, 0.5 overtime staff, etc.
Pro tip >> Remember to consider “behind the curtain” staffing needs.
What are your goals? What does your mission or vision say about your organization? Striving to be better should always be on your department’s mind as it strategically plans for the future. Let’s face it, the status quo only works for a couple of years. After that, next generations of EMS and fire personnel will simply want more (and that may mean elsewhere!). What benchmarks are you looking to move the needle on in the next one, three, and five years? Is it a move toward a reduction in lights and siren responses? How about an ambition to professionally credential all of your officer staff?
Pro tip >> Review (and prioritize) your goals for the next one to five years.
An aging fleet, for example, will only continue to age as the years pass … so, planning for and communicating about this continued aging (challenge) is a necessity. If you’re fortunate, replacement vehicles may be on the horizon. If not, then additional upkeep, repair costs, and wear-and-tear considerations need to be factored into your plan. Or, taking this one step further – toward innovation – it may prompt you to consider a positive disruption in your challenging path (an opportunity to do something differently, rather than just applying more money to try to fix what’s currently causing the challenge).
Pro tip >> Remember that challenges may lead to opportunities for innovation.
5: Who’s Next?
Maybe not by name … but “who” is next to lead your organization? If the current chief or director is still around to see your five-year plan come to fruition, great! If not, what does your agency plan to do between now and then to build its internal force to handle the passing of the baton (i.e., succession planning)? What does professional development – and not just continued education – look like for your department? Or perhaps better yet, what do you want it to look like?
Pro tip >> Focus on succession planning and strategic growth opportunities (e.g., professional development) for your department.
Five years seemingly goes by quite fast, but in the context of today’s ever-changing and evolving fire/EMS industry, it’s about as far out as we can feasibly plan for with some level of confidence. Take a look back five years, or even 10 ago: did you think you would be where you are now (as an individual or an organization)? After all, when you consider all of the changes that you’ve seen between now and then, a lot can happen in the span of five years.