FRI 2017 Quick Take: Reducing EMS calls through community partnerships

Chief Travis Myklebust offered strategies to create community partnerships and collaboration to achieve a reduction in 911 calls the fire service responds to

By Kerri Hatt, FireRescue1 Senior Editor

CHARLOTTE, N.C. — Fire and EMS services are facing a significant issue today with call volumes increasing faster than they can add personnel.

Chief Myklebust’s department is seeing a new increase in calls, but they are genuine, emergent calls, resulting in revenue-building transports.
Chief Myklebust’s department is seeing a new increase in calls, but they are genuine, emergent calls, resulting in revenue-building transports. (Photo/Joe Thomas of Greenbox Photography)

In his FRI session on “Reducing EMS calls through community partnerships,” Chief Travis Myklebust, with the Lewiston (Idaho) Fire Department, shared how his department has successfully decreased their EMS run volume by over 9 percent by implementing fresh strategies to optimize community collaboration.

Chief Myklebust discussed methods to make an organization more efficient and effective with the resources they currently have and help reduce the number of 911 calls an agency responds to.

Memorable quotes from Chief Myklebust on reducing EMS calls in the fire service

  • “We’re here to steal ideas. If we’ve done something that may work in your community, please, steal it.”
  • “If you’re going to take anything away, it’s to think out of the box and change what you’re doing. It’s the biggest thing that holds back the fire service today, ‘this is the way we’ve always done it.’”
  • “I told my crew, my goal is that you go on emergencies, because that’s what we’re here for.”

 “We created this problem,” Chief Myklebust noted. “We’re too good. People know if they call 911 we’re going to be professional, courteous and compassionate. And they want more. And so we’ve become kind of a fallback.”

Educate the public about the fire department’s role

Chief Myklebust certainly supports community engagement, and encourages his crews to help out beyond the scope of firefighting: (e.g., to repair the hoses and put the towels in the dryer when they respond to the single mother’s house for a leaking washing machine). However, he acknowledges news stories where firefighters go above and beyond can contribute to a misperception that they provide more community resources, like meal planning, than they really do.  

The general public sees all the apparatus and resources at the local fire station, and doesn’t realize that the department might not have all the staffing in place to operate each vehicle simultaneously. Chief Myklebust's department educated its local community, using maps and drive time statistics, so the public has a better understanding that a 911 call for a sore throat can have deadly consequences for the STEMI patient whose response time is delayed.

Create a host of “Know when to call 911” resources. Chief Myklebust's department distributes handouts in the community, and collaborates with health care providers to hand out dry-erase refrigerator boards for patients to track their medications, which contain reminders about how to utilize 911, which also has the non-emergency dispatch phone number.

Reducing EMS Calls: Patient Handout 

Chief Myklebust told attendees to create a public awareness campaign, and then share those resources by:

  • Doing community presentations, at civic groups, chamber meetings, religious groups, retired groups, even the local (and oftentimes, vocal) group that meets at the local coffee shop
  • Get out and do static displays – at health fairs, county fairs and other community events
  • Use social media to share resources
  • Create a PSA and share it with the community

Implementing change in your fire department

Chief Myklebust’s department collected, analyzed and disseminated call volume data to community partners, finding allies and shared resources in public support, forming a continuum of care coalition.

Initiating conversations about public health with allied organizations identified symbiotic goals. Local schools were facing hungry, unfocused children. The food bank was supporting many underfed families. The community free clinic was working to support community members who fell into the gap between Medicaid and the Affordable Care Act.

Slowly, joint efforts began to form:

  • Community partnership nurses offered medication reconciliation
  • The coalition collaborated to put out a resource guide for citizens needing assistance with housing, clothing, emergency assistance and food
  • At a joint community fair, the health department offered vaccinations, the medical clinic offered free physicals, the food bank gave out bags of potatoes and apples, and the hospital provided adolescent behavioral health support
  • The fire department union now delivers Meals on Wheels once a month
  • The Spokane CARES organization partnered with college social work students in their practicum to perform in-home assessments on frequent callers to connect them with social service support or family networks
  • The department educated the local assisted living center on when to call 911, and created a DNR response chart, drastically reducing the number of calls from this high volume emergency services user
  • After identifying a lack of bystander CPR in call data, the coalition started community CPR and public defibrillator training, which led to a 7 percent increase in echo transports year to year

By providing resources to the community before they become urgent needs, 911 abuse is diminishing. Chief Myklebust noted his staff loves giving people options. One reason people resist change is because they focus on what they have to give up instead of what they have to gain, he added. Flip the script to focus on the potential. “If there is no struggle, there is no progress,” Chief Myklebust reported.

In addition to the community efforts, the fire department made some strategic changes to dispatch and deployment models. They implemented pilot programs to test holding inter-facility transport when two ALS ambulances were not available, taking engines off Charlie code responses and sending them on Alpha calls, and sending the battalion chief on Delta calls. 

They found engine call volume decreased, leaving time for company level inspections. After their initial progress in reducing 911 calls, Chief Myklebust’s department is seeing a new increase in calls, but they are genuine, emergent calls, resulting in revenue-building transports.

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