By Brian Trompeter
Seeking operational efficiencies and ways to combat a paramedic shortage, the Fairfax County Fire and Rescue Department over the past three years has modified how it staffs, dispatches and delivers emergency medical services.
The department in January 2022 converted eight Advanced Life Support (ALS) units, which include paramedics providing more-intensive services, into Basic Life Support (BLS) units, which are staffed by emergency medical technicians, and made four more such conversions in February 2022.
Department officials in January 2024 plan to convert eight more ALS units into BLS ones, resulting in a total of 23 ALS and 20 BLS units. The agency also will maintain one paramedic at every station.
“We have to balance the demands of our workforce to reduce burnout and the potential loss of highly trained members of our team” due to staffing shortages, said assistant Fire Chief Dan Shaw, the department’s operations chief, during a Nov. 28 briefing of the Board of Supervisors’ Safety and Security Committee.
The Fire and Rescue Department this September implemented, in coordination with the county’s Department of Public Safety Communications, a new Emergency Medical Protocol that will try to ascertain better the specific needs during incidents in order to allocate proper resources to them.
“We found we were soliciting incorrect information with leading questions when someone would call 911,” Shaw said. “It would lead to us dispatching many ALS calls, but the final disposition would be BLS.”
The new system allows the department to dispatch appropriate resources to calls, but also ensure other personnel are available for additional incidents that could occur simultaneously, he said.
Officials this coming January also will introduce a new EMS Specialist position. Paramedics in that role will have their own vehicles and bring advanced skills and equipment to incidents. The department has three such positions and will fill them using internal candidates, Shaw said.
Because of the ongoing recruitment crunch, department officials are analyzing their staffing model, resource deployment and overtime racked up by personnel.
The national shortage of paramedics has gone hand-in-hand with a sizable reduction in the number of people seeking public-safety careers, department leaders said.
“Recruitment of a capable and trusted workforce, along with retention of those personnel, is a necessity to sustain safe and effective operations,” said Fire Chief John Butler.
The department conducts recruit schools quarterly, which is more often than many other agencies, Butler said, but is “seeing lower numbers than we would like in those recruit schools.”
Department leaders hope to have 30 to 40 recruits per class, but the numbers have been about half that, he said.
The Fire and Rescue Department currently has 1,360 uniformed members, 183 civilian staffers and 362 operational volunteers, which cover three shifts. The county has eight battalions, which each encompass four or five fire stations.
The department’s daily minimum staffing includes 363 personnel, plus 93 paramedics. All of the agency’s 61 fire-suppression apparatuses has a minimum of four personnel, including a paramedic.
The department has 43 transport units (ambulances), 39 engines, 14 hook-and-ladder vehicles, eight rescue vehicles, six tankers and a hazardous-materials unit.
The department relies heavily on data analysis, something that’s “groundbreaking” in the fire-and-EMS profession, Butler said. Leveraging accurate data supports the agency’s strategic planning and enhances its decision accuracy and performance, he said.
“While firefighting remains a manual effort, many of the tools we use are digital,” Butler said.
Shaw said the scope of requests for the department’s services has grown exponentially since he joined the agency in 1995.
“The ability to remain agile, proactive and not only a reactive fire department has become much more difficult,” he said. “Fortunately for us, we did not accept the status quo and truly became a leader in the fire service with the implementation of our data-analytics and strategy-management team.”
In 2017, the department responded to 6,293 calls requiring ALS care. So far in 2023, there have been 5,706 ALS calls, Shaw said.
Supervisor Patrick Herrity (R-Springfield) was skeptical of some of the department’s staffing shifts.
“I’m a little less accepting [of] the number of ALS units, because we had the gold standard before of all ALS units and I think we’ve got to work to get back to that as quick as we can,” he said.
Butler demurred.
“The gold standard is getting the right resource to the right patient at the right time,” the fire chief said.
The Fire and Rescue Department has a paramedic program with Virginia Commonwealth University at the department’s academy on West Ox Road in the Fairfax area, Butler said. Department officials annually selects 10 to 12 rank-and-file BLS employees who have passed the required academic and aptitude testing to enter the program, he said.
“We’re growing our own,” he said of the new paramedics, although they are not available for duty during the training period.
