Ambulance service business plan
Ambulance service business planuploaded by myfoxmemphisrelated interestsemergency medical servicesemergency medical technicianparamedicambulancenew york city fire departmentrating and stats5. 3)document actionsdownloadshare or embed documentembedview morecopyright: attribution non-commercial (by-nc)download as doc, pdf, txt or read online from scribdflag for inappropriate contentpage 1 of 36emergency ambulance service business plan for the city of town fire correale, battalion chief jeff beaman, lieutenant-paramedic mark carter, lieutenant-paramedic 7766 farmington blvd germantown, tn 38138-2902 (901) 757-7268 (901) 757-7290 - fax lcorreale@ jbeaman@r@ of contents....................................................................................................... The fire department is in the business of saving lives, protecting property, educating the public on issues of fire and home safety, responding to a wide range of emergencies, solving problems, and preparing the community to be able to respond to disasters. As the primary provider of advanced life support services to the community since 1979, the fire department proposes to establish an emergency ambulance transport service that will serve as the gateway for the sick and injured into the local health care system. For over 50 years, the germantown fire department has been an innovative leader in the fire and emergency services. The men and women are well trained and have demonstrated time after time their ability to plan and adapt to the changing needs of the community. The city of germantown currently participates with shelby county and the cities of arlington, collierville, lakeland, and millington in a contract with rural metro ambulance service to emergency ambulance service in these cities and the unincorporated areas of shelby county. Many of the past problems with the ambulance transport service have been alleviated, but unfortunately, some of those problems persist today. The average ambulance response time has improved, but not to the time frame recommended by the american heart association which is five minutes. On medical emergency calls, fire department paramedics initiate advanced patient care, and then turn the patient over to the third party ambulance service for transport. Even though the private ambulance personnel are licensed, their knowledge, skills, and abilities are not known. It is foreseen that germantown will need to provide medical and other services to seniors sooner than other communities. The most common calls for medical services associated with an older population are breathing problems, chest pain, cardiac arrest, stroke, diabetic emergencies, and falls. The socioeconomic environment in germantown and the surrounding areas indicate a high potential for collecting revenues for transport services. The major capital cost is the purchase of four type i ambulances that will be strategically placed at two of the four fire stations. Thirteen personnel will be hired, with at least 6 paramedic/firefighters and the rest fire fighter/ ems supervisor position will be established to manage the day-to-day ambulance operations, supplies, in-house ceu training, and be the point of contact between the department and the billing vendor. Policies will be established to provide mutual aid requests for an ambulance, transport geographic boundaries, and to request mutual aid for an ambulance in the event there are no ambulances available. Transporting the sick and injured is the only part of emergency services not provided by the germantown fire department. By providing ambulance transportation, the fire department will have total control and involvement from the time a person dials 911 until they enter the healthcare system. The best product is a fire-based emergency ambulance service provided by the germantown fire l company n statement: the mission of the germantown fire department is to provide timely and effective response to fire and medical emergencies for the protection of life and property in germantown. Primary businesses suppress fires* treat patients with medical emergencies* educate community on fire, health and safety* rescue people and provide specialized rescue services* develop and enforce fire-related laws and codes* handle hazmat emergencies other as lead agency for emergency management advocate for fire service and life safety respond to and solve community problems – “ghostbusters” pursue business opportunities under managed competition the city of germantown is driven by its core beliefs, which were established through a community-wide consensus process that created vision 2020. The philosophy of the city of germantown is that we, the germantown managers and employees, strive for service excellence, produce “‘a+” results, take the initiative, are responsible, are innovative, and practice teamwork. The germantown fire department’s core beliefs were developed through a department-wide consensus process that produced the germantown fire department's strategic plan. The fire department's core beliefs are reflected in the following statement: we, the employees of the ment, demonstrate responsibility, effectiveness, service, productivity, effort, caring and teamwork. In summary, the business philosophy of the germantown fire department is that we demonstrate respect for each other and for our customers. The vision 2020 philosophy and the fire department’s core beliefs interconnect on responsibility, service, productivity, and teamwork, with the added values of effort and caring. The fire department is in the business of saving lives, protecting property, educating the public on issues of fire, emergency medicine, and general safety. For the purpose of this business plan, our target market for an emergency transport ambulance service is the residents and visitors to the city of germantown and our principle objective is the maintenance of life and relief of suffering. Providing fire, medical and other emergency response services to a community has historically been the duty of local government. Very few private companies offer municipal fire services, but there are many private companies that offer emergency ambulance service.
The germantown fire department is the primary provider of advanced life support (als) services to the community with paramedics, and began providing als service in 1979. In 1975, three germantown fire fighters became licensed as emergency medical technicians and the department placed a basic life support (bls) response truck in service. Germantown is home to several world-class medical facilities providing specialized services, such as cardiac and orthopaedic care, to residents of germantown and the region. Four major hospitals are located within 7 miles of germantown’s city hall, which makes germantown attractive for doctor’s offices, medical clinics, and specialized medical service facilities such as diagnostic imaging and outpatient surgery. Form of ownership: the germantown fire department is a key business unit of the city of germantown, a political subdivision and municipal corporation in the state of tennessee. Even though the department is young in terms of a career fire department, the men and women of the department are well trained and provide a widerange of emergency and non-emergency services. These services range from fire suppression, ems and fire inspections to responding to hazardous materials (hazmat) incidents and responding with tennessee task force 1 (tn-tf1) to national emergencies including the pentagon on 9/11 and hurricane katrina. These examples illustrate the leadership ability of the department, the department’s ability to provide a wide variety of services in an effective and efficient manner, and the ability to plan for and adapt to the changing needs of the community. Members of the command staff possess academic degrees and professional certifications that reflect on the department’s commitment to stay current on all aspects of leading and managing a full-service fire department enjoys an excellent reputation in the community, having scored as the top city department on the last two citizen satisfaction surveys. Throughout the years, the department has met and solved problems through innovation and adapting to changes in the emergency services environment. This experience has taught the department that germantown residents take pride in their community and expect exceptional service. Emergency medical calls account for over 60% of the total emergency incidents and this is the largest emergency service we provide. Yet, emergency medical service is the only service we provide where we lack total control over the service. For example, in the early 1980s the department followed a detailed plan of improvement and improved the department’s iso rating from class 5 to class 3, which significantly reduced the cost of insurance for germantown residents and business owners. Long-range planning identified a major risk to the community from a transportation accident involving hazardous materials, so germantown created a level a (able to respond to the highest hazards) hazmat team and was the first team in tennessee to achieve certification from the tennessee emergency management agency (tema). The germantown fire department’s major competitive strengths are its strategic plan, its continued focus on providing its core businesses and, most importantly, the highly skilled professional workforce that constantly demonstrates a commitment to service excellence. The fire department consistently demonstrates the ability to provide an exceptionally high level of emergency and non-emergency services to the community, which is our strongest core department’s ability to serve is reflected in the response to the city’s third community survey in 2005. The purpose of the survey was to measure how satisfied residents were with current services, to obtain their input on specific issues, and to find out what residents like best and least about living in germantown. Such a high response rate indicated that germantown residents do care about city services and do have strong opinions about issues facing the city. The men and women of the fire department built this level of trust and satisfaction by consistently doing their job well, one day at a time, and this level of care, concern, and compassion will carry over to a transport ambulance service. The next stage after build-out is a maturing community where the revenues will stabilize but the cost of services will continue to increase. The city has developed a smart growth plan to renew the community with a focus around the current center business area to bring together commercial, residential, and areas that will renew growth within the city. The city must make decisions to avoid having the cost of city services exceed revenues while still maintaining the high level of service the residents of germantown desire. Germantown is using managed competition to reduce the cost of service delivery without sacrificing quality and accountability. The city’s directors have been tasked with maintaining service levels without the traditional use of a tax increase. Germantown currently participates with shelby county and the cities of arlington, collierville, lakeland and millington in a contract with rural/metro ambulance service for emergency ambulance service in these cities and the unincorporated areas of shelby county. Under the current shelby county ambulance contract, most of the problems of the past that plagued the ambulance transport service have been alleviated. This includes lack of equipment on the ambulances, the vendor charging patients for supplies and medical procedures provided by fire department personnel, and the overall lack of accountability and control by the germantown fire department. The average response time of the ambulances has improved to a contract required 9 minutes, 90% of the time. The germantown fire department is well suited to provide emergency ambulance service to the residents of germantown.
Currently, at emergency medical incidents, fire department paramedics provide patient treatment and then turn patient care over to the thirdparty ambulance service. When patient care is turned over to the private ambulance service, germantown relinquishes a large amount of accountability and control. Even though the personnel on the private ambulance are licensed, germantown does not know or control the level of knowledge, skills and ability of the private company’s employees. The international association of fire chiefs has stated that the documented survival rates are markedly higher for patients served by cross-trained, multi-role fire fighters than for those victims served by providers of non-fire service based systems. The fire department proposes to gain full control and accountability for all emergency medical services in the city by operating an emergency ambulance service with germantown fire department personnel. Long term: the fire department proposes to operate an emergency ambulance service for the city of germantown. This service meets the immediate need of providing exceptional patient care and having full control of the ems system. Under this business plan, the fire department will operate a primary emergency ambulance service that provides als response to 911 ts and germantown fire department provides an als first responder service within the corporate limits of germantown and serves as the entry point for patients into the local healthcare system for ems calls. Factors that give the germantown fire department a competitive advantage include the department’s strategic plan, its understanding of vision 2020, its experience in providing ems services in the community, response capabilities, and the commitment of the men and women of the department. The fire chief is a licensed paramedic with 34 years of ems experience, 32 of those years as a paramedic, and has completed the management of emergency medical services course at the national fire academy. He has been involved in drafting past county ambulance contracts and representing germantown’s interests on ambulance contract committees dating back to the early 1980s. He has served on the mid-south ems council, and currently represents germantown on the shelby county emergency medical response oversight committee (emroc), charged with administration of the shelby county ambulance service contract. The ems coordinator is a licensed paramedic with over 27 years in ems, including service as a supervisor with a private ambulance company. The most important key factor germantown brings to the table is desire: the men and women of the germantown fire department want to provide this service to the community. They have witnessed the quality of service from the current and past providers of ambulance service, and this is not what they want for germantown. Fire department personnel providing a transport ambulance service within the fire department is logical since fire personnel initiate patient care through the first responder program. The most important product the germantown fire department has to offer in creating a fire-based ambulance service is a quality and effective emergency response by highly skilled, professional employees dedicated to serving the community. There are no other systems, except for fire serviced based medical services, that come with a complete toolbox to handle any incident out of a hospital that requires emergency medical ics and research in tennessee, only one county and five cities use a fire department based ambulance service as the primary provider of emergency ambulance service for their local community, which represents just 1. The current demand for service in the target market area of germantown 1,650 ems calls annually with approximately 1,350 actual transports. The growth of germantown’s medical community will result in an increase in emergency ambulance responses to these facilities. In four years, the largest group will be 55 and older germantown will need to provide medical (and other) services to seniors sooner and at a much higher rate than in many other number of medical responses the fire department makes to elderly residents is increasing. In tennessee, residents seek hospital services at a higher rate than the national average because of a lack of primary care providers leading these patients to use the ems system as a substitute for a primary health care provider. The socioeconomic environment in germantown and the market area indicates a high potential for collecting revenue for services provided. The national per capita income is $21, factors for the germantown fire department ambulance service capital costs – four type i ambulances will be purchased. Two new ambulances will be used for front-line service and two used will serve as back-up ambulances. Consumer acceptance/brand recognition – the germantown fire department enjoys an exceptional reputation in the community for fast, professional response, quality personnel, excellent equipment, and premier service. Since management and oversight is already in place for the first responder program, there will be minimal increased costs for overseeing the ambulance operation. Housing the crews and ambulances in fire stations eliminates the need to rent space for quarters. Germantown should get excellent rates, should the decision be made, to lease or lease-purchase ambulances and ts the germantown fire department’s product is a consistently high quality, professional emergency medical response with the best equipment in good working order. This is the product the germantown fire department will provide through a fire based emergency ambulance y research has shown that the number one issue with users of the ems system and an ambulance service is quality service and a quick response by medical personnel.
Excessive response times for a transport ambulance negate the benefits of a quality paramedic first response program. Customers can be distressed over ambulances that respond without the proper equipment or basic amenities such as sheets and blankets. Fire department personnel have witnessed firsthand ambulances arriving lacking critical equipment such as the way to measure a diabetic patient’s blood glucose level or working equipment such as an ekg monitor for a heart patient, and getting lost responding to calls. Features and benefits the germantown fire department will provide a professional, well-managed emergency transport ambulance service with the best paramedics, emts and equipment, responding in a timely and efficient manner, committed to saving lives and to ease pain and suffering. Premier healthcare includes emergency ambulance service as this serves as the point of entry into the healthcare system. Unlike a private contractor, the major motivator for the germantown fire department to provide emergency ambulance service is desire: the men and women of the germantown fire department want to provide this service to the community because it meets the s. Safest city in the are safe and feel ive approach to community ess of national trends and “best practices” and how they apply to our ive emergency g response time standards: ems 5 minutes response by highly trained, professional public safety personnel prepared to handle the emergency right equipment and resources available to handle the emergency emergency medical transport ambulance service with state-ofthe-art patient care operated by the city effective communications and dispatch facilitating the emergency response retaining total control for patient care from the emergency scene to the -quality and retaining the “best public safety employees” highly skilled, professional workforce dedicated to serve the community training and educational opportunities available to develop knowledge, skills and ers our customers include the residential population of the city of germantown (approximately 41,000 people) plus daily visitors to the area. Ninety percent of patients transported from within germantown go to four hospitals that are located within 7 miles of the intersection of germantown road and farmington boulevard, which means the ambulance is able to return to service in germantown in a minimal amount of time once the patient has been accepted by the hospital. More and more of our customers are located in medical facilities at the time of the request for service. This economic statistic indicates a high likelihood that the majority of the residents have well paying jobs with medical germantown fire department is intimately familiar with the ems market in germantown, is adept at providing exceptionally good service, has an excellent reputation in the community, has fire stations strategically located to provide rapid response to all portions of the city, has a strategic plan that envisions the department providing transport ambulance service, and has the desire to provide the service. The city of germantown is financially sound and able to fund the cost of providing a transport ambulance service. The service provided will be exceptional, with control and accountability that cannot be matched by contracting with a for-profit company. Pricing transport fees have been established based upon the level of service provided to the patient. These categories were developed utilizing the medicare reimbursement rates for ambulance transport as a guide. All billing vendors interviewed, expressed that private medical insurance companies utilize medicare’s classification of patient transport services. The billing vendors also suggested when billing for transport service, to bill a flat rate fee versus itemized billing. Non-transport fee will be assessed when a call for emergency services is made from a specific address by the patient or by the patient’s immediate family, who is located at the same address as the patient, and the patient then decides not to be transported against medical advice from the fire department paramedics. Of service the germantown fire department will respond to calls for emergency ambulance service made within the service area. The dispatch office germantown will process the request and dispatch the appropriate first responder fire company and ambulance(s). The department will use its existing quality improvement program to monitor the service provided and ensure that all patient care meets state standards and follows approved protocols. Revisions to operating procedures will be made as needed after review and evaluation of the first quarter of operation of the service and thereafter as needed. A quality review council (qrc) will be established with fire department representatives to oversee operation of the service. Ambulances will be strategically placed at fire stations 3 and 4 to provide the best coverage and response times for the service area. These stations offer living quarters for the ambulance crews and bay space to house ambulances, along with the infrastructure for dispatching the ambulances and space for storage, recording keeping and related activities, which keeps ambulances from having to travel to a “home office” for paperwork and re-supply. The fire stations are well maintained and present a positive public image, which will match the image projected by the ambulances and crews. Legal environment the germantown fire department will apply to the tennessee department of health, emergency medical services division for a class a ambulance e. A class a license indicates that the service provides advanced life support or critical care service. The city will be required to have each ambulance inspected and permitted by the state before placing the ambulance in service. The service audit demonstrates that the ambulance service complies with pertinent federal and state laws and regulations. The city will provide the required liability insurance for operating an ambulance service and insurance on the ambulances.
Many of the fire department’s paramedics and emts have vast experience providing ambulance transportation services which will streamline the transition from providing only als first responder service to an als ambulance transportation service. The department will use proven hiring techniques to ensure that personnel hired for the ambulance service meet the same high standards as existing personnel. The personnel required to staff the ambulance service will be compensated based upon the fire department’s career development program. Since ambulance personnel will be public safety employees, they will receive the same benefit package as police officers and fire fighters. Fire fighter/paramedics and fire fighter/emts will staff fire apparatus and ambulances utilizing an approved rotating policies the fire department will provide transport ambulance service on an asneeded credit basis. Although payment will be due when service is rendered, the ambulance crew will transport the patient without regard to collecting the service fee before providing emergency medical care or transport. The ambulance crew will collect pertinent information utilizing an electronic patient care report and the selected billing vendor will execute the billing services for patient transport and treatment services. Once a billing contractor is selected, policies will be established to manage collections from delinquent ment and fire chief will lead and manage the ambulance service operation. Fire department staff possesses the knowledge, skills, ability and experience to operate an ambulance service. If this plan is adopted, the 8-hour ems supervisor position will be created and staffed. Thomas, cates, burch, porter and johnson finance o kristen geiger, assistant city administrator risk manager/treasurer o michael stoll medical director o joseph holley, ed organizational operational plan the germantown fire department will place two full-time ambulances into service daily. In the event an additional ambulance is needed for response to an emergency incident, personnel can be reallocated from engine 93 or truck 41 to staff the reserve ambulances. In the event, the need for ambulances exceed the number of available ambulances, a mutual-aid request for additional ambulances can be 29 of 36 from the memphis and shelby county fire departments or even from a private ambulance service. The memphis and bartlett fire departments have established agreements with private ambulance services, at no cost, to provide additional ambulances in the event their present call volume exceeds their current transport ial history and germantown fire department’s operating budget comes from the general fund of the city of germantown. The fire department’s fy2011 operating budget does not contain funds for the establishment of an ambulance service. This possibility was not foreseen when the budget was created starting in january of 2010, because of the desire to have total control over emergency medical services and the uncertain future of the memphis\shelby county consolidation referendum currently being proposed. If this plan is adopted by the bma, this plan will call for the service to be in place by october 1, 2010. There are many things that must be done between the adoption of the plan and the start date, including hiring and training personnel, purchasing ambulances and equipment, selecting a billing contractor, and getting the required licenses. 1st year $153, 702 $90,7 76 0 $98,0 00 nel related personnel costs vehicle ix a germantown - sex by age (census data) appendix b germantown - sex by educational attainment for population 25 years and over (census data) appendix c germantown - household income in 1999 (census data) appendix d germantown - earnings in 1999 for households (census data) appendix e germantown - year structure built (census data) appendix f seven-year history of ambulance responses in the market area appendix g collierville – household income for 1999 (census data). Census bureau census year history of ambulance responses in the market area germantown collierville market area responses change +/responses change +/responses change +/1,034 1,054 2,088 1,093 5. 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Dialogthis title now requires a credituse one of your book credits to continue reading from where you left off, or restart the t ambulance service business planuploaded by myfoxmemphisrelated interestsemergency medical servicesemergency medical technicianparamedicambulancenew york city fire departmentrating and stats5. Dialogthis title now requires a credituse one of your book credits to continue reading from where you left off, or restart the t reneur ss ectual ions l practice reneurial tivity & l business a business > starting a to start an ambulance 's some helpful information that is written for entrepreneurial folks who want to open an ambulance service. Read this advice before you open up are many pragmatic suggestions on how to open an ambulance startup additional resources regarding starting a business may be of interest to business plan you have questions or comments regarding starting an ambulance service? The small business owners who read this article after you will appreciate your helpful ons, comments, tips, and : (not displayed).
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