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EMS News in Focus
by Arthur Hsieh

Failure to change is the root of DCFEMS problems

With no long-term plan and a lack of vision, the department has barely evolved since the 1970’s

By Arthur Hsieh

The DCFEMS chief can’t seem to catch a break. Every attempt Chief Ken Ellerbe has made to revamp the department’s operation to better respond to the community’s needs has been met with resistance — and at times, total disdain.

His latest proposal to shut down a neighborhood fire station to increase on-duty medics during peak call times is no exception.

Yet, given a rancorous relation with labor and an ever-increasing distrustful city council, it’s not very likely that such a Band-Aid gesture would even make much of a difference for the department. 

It continues to suffer from poor performance and poor public perception. 

Kicking cans down the road

On one hand I can’t lay all of the blame on the current chief. He inherited decades of a poorly managed public safety organization, with each prior chief kicking a bunch of proverbial cans down the road.

It points to the greater issue of not having a plan.

The department’s own civil committee released a report in 2013 that said as much. It determined there was no coherent, logical approach to staffing an appropriate level of EMS resources by the department. It seemed leadership at the time didn’t even know how many ambulances could be available on any given day.

But even this report doesn’t capture the full extent of the issue.

Like many large urban EMS departments, DCFEMS has not evolved since the 1970s.  Revised construction codes and enforcement has led to fewer fires over the past 40 years, but staffing levels have not dropped in response.

At the same time, the demand for EMS has risen due to changing demographics, an aging population and poorly distributed health care availability. Add in the mind-numbing intricacies of reimbursement and the medical-legal environment and you have a situation that would be difficult for any department to adapt to.

It’s about mindset

But many fire departments have done just that, managing to incorporate the evolving needs of their communities, while maintaining operational effectiveness for existing ones.

What they have in common is a long-term strategic mindset that looks at needs  not just in one year, but three, five or 10 years down the road. They consider the financial, operational and cultural barriers to overcome, as well as who needs to be involved in the planning.

In many ways DCFEMS is the case study for how a department fails in the face of change. Without leadership and vision from all levels of the organization, it’s not likely things will improve anytime soon.

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at
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Skip Kirkwood Skip Kirkwood Sunday, April 20, 2014 8:08:49 AM Want to make it better? Besides having a plan (which is essential), try engaging the employees, instead of fighting them. Silly stuff like making them wear sweatshirts with initials that they don't like detracts from the important work of the department - improving service. Your workforce is not the enemy. Try harnessing all of that collective brainpower - it might just work!
Tim Thompson Tim Thompson Sunday, April 20, 2014 10:07:06 AM LRB does not know how to think like that. He is happy creating fear, he is happy when everyone around him is un-happy. He want everyone to be affraid of him. He is now and always has been a destroyer of moral. He is going to leave the department when the new Mayor is elected but when he leaves he just might make sure it is almost beyond repair. And yes, utilizing the minds of the department would be awesome, there are some great thinkers, doers and plans out there already. LRB just needs to get off his high horse and tap into them. The best ideas and plans to fix the department are in the minds of the employee's. He makes me glad that I am no longer there.
Monday, April 21, 2014 5:47:34 AM Art - your article is way, way off the mark. There is indeed a plan. The plan, is to reduce the size of the workforce. The plan is also to have the remainder of the workforce resemble the chief in skin color. If you don't resemble him in that regard, then you have no place in that workforce as far as he is concerned. Thankfully, the city council has realized this. The workforce has indeed evolved. Firefighting isn't the primary mission. EMS isn't the primary mission. Survival in an openly hostile work environment is now the primary mission.

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