A Couple More Thoughts on KCFD and EMS

What is done is indeed done. The Kansas City Fire Department has taken over emergency medical services in Kansas City. The imperfect meshing of systems and cultures is still in process after two years--anyone who says this thing is working perfectly is fooling themselves at this point.

Somewhere is a line where non-support turns into hostility, and sticking it out becomes tolerating abuse. The only ones who know where that line is are the people experiencing it. Because we are all individuals, with different experiences and needs, that threshold will be reached in different places. It is also up to each person to make up their mind what they will tolerate, and what is enough.

Once the squishy stuff of morale is out of the way, it is time to ask tough questions about operations. That brings us to the qualifications and abilities of those running the system. There are 24 crews running ridiculous numbers of calls in the city. There are 24 hour shifts in fire houses not staffed. The irony of a lot of dynamic (i.e. not stationed in a fire house) crews is not lost on me--the reduction of use of the dynamic model was one of the points used to sell the merger/take over.

Whatever you think of response time as a measure of performance, there is no doubt that it is not up to standard in many respects. Changing the numbers by changing the status of calls from emergency to non-emergency only puts lipstick on the ugly pig. Better to be honest and ask the hard questions about the system, or to admit that with the resources given, this may be the best that can be done--if that is true.

And when you bottom line this thing at this point, that is the question you have to ask: Are we doing the best job we can or do we need to change some things to truly do as well as we can do? That question can be applied both to EMS performance and to those morale issues.