Houston Fire Department struggles to find efficient response to some 911 calls

Numbers loom large for department with 4,031 employees

HOUSTON – The Houston Fire Department is struggling to find a more efficient way to respond to the tens of thousands of medical calls it receives each year.

According to the HFD, out of the 341,729 incidents it responded to in 2017, 297,269 were medical in nature. These numbers loom large for a department with 4,031 employees.

Fire Chief Samuel Pena was blunt in saying the current way the HFD responds to many of these calls is inefficient and putting a strain on a department already struggling to meet the demands of a growing city.

"We're strictly focused on response times," Pena said. "But that's not the most efficient way of deploying our resources."

Pena said an "All Hazards" response policy was put in place by his predecessor as a way to cut down on lengthy response times to medical calls. Pena said the department's goal is to respond to all 911 calls in six minutes or less.

"Right now, we'll send you anything to any call," Pena said. "We will send the closest unit, even if it's not the unit that you need to handle your emergency."

While that sounds great in theory, Pena said this response approach can wind up having firefighters, emergency medical technicians and paramedics all responding to a non-life-threatening emergency medical services call.

Pena explained under the current protocol, sending the closest unit means a fire engine can be the first to arrive at a medical call. There are four firefighters on each truck.

Firefighters are also trained as EMTs, which means they can provide basic life-saving care, but cannot transport a patient to the hospital. If a call turns out to be more urgent or the severity of the person’s ailment is still unclear, then the department can dispatch a “Squad Unit” when an ambulance is not immediately available. “Squads” are SUVs manned by two paramedics.

While the paramedics assigned to squads are trained to provide advanced life-saving care, the units they drive also cannot transport someone to the hospital. When an ambulance does arrive, it is manned by two more people.

"So now you have eight individuals at a call, 3 apparatus for what is essentially an unknown," Pena said.

Pena wants to change the way the department dispatches and prioritizes many of these medical calls. Pena said right now medical calls are split into two major categories, Advanced Life Support or Basic Life Support. Pena wants a more granular system of dispatching calls.

He said that process begins with the information the department receives from the person dialing 911.

"We should be able to answer more pointed questions and get more targeted answers to be able to send less resources," Pena said.

Pena points to a system in place when he was the chief of the El Paso Fire Department.

"It changed our deployment model," Pena said.

The system uses computer algorithms, based on responses, to guide dispatchers through a detailed series of questions.

"It refines that response," said Capt. Ruben Candelaria, with the El Paso Fire Department. "We're using our units more efficiently, more effectively."

Pena said the system he is considering costs $500,000. He said that price tag could be offset through lower maintenance costs. Channel 2 Investigates has detailed the HFD's issues with trucks and ambulances breaking down during calls for service.

Pena said a more targeted approach will result in less wear and tear on fire engines that currently respond to everything from fires to headaches.

However, not everyone is convinced a new dispatching model will solve all of the HFD's problems.

"We seem to always go back to putting a Band-Aid on problems," said Patrick Lancton, president of the firefighters union. "The Houston Fire Department is stretched to the limit."

Lancton argues unless the city adds more manpower, a new method of deploying resources won't be enough.

"Until the city makes the Houston Fire Department a priority, nothing is ever going to change," Lancton said.

The city's medical director, Dr. David Persse, believes Pena's goals can be met with existing resources.

"We need to go through the data first to see if we can achieve these results," Persse said.

Persse said the city did have two people whose job it was to analyze all the data collected from 911 calls and responses and propose changes. However, when those people retired, their positions were eliminated through budget cutbacks.

Following KPRC's interview with Pena, he said he will work with Persse to determine if the current system can be refined. If not, then Pena said he will move forward with getting the mayor and City Council's approval to purchase a system similar to the one being used in El Paso.

A little background on a story I am working on for 10pm regarding HFD’s response to certain calls for help.

Posted by KPRC2 Robert Arnold on Tuesday, January 30, 2018