Guest guest Posted October 26, 2002 Report Share Posted October 26, 2002 I think SSM is a PR related tool that, when used in advertisement, gives the uneducated public a false sense of having more ambulances in their community than there really is. The old saying: " Figures lie and liars figure " , SSM is one of many ways EMS agencies (usually large corporate ones) save money by playing the odds. This is one of the main reasons that a big corporate agency lost the City of Grand Prairie. This is the same reasons that many places are unhappy with other large providers in our state. My 2 cents Lee SSM Welcome back Gene. SSM is used as a tool to optimize staffing and vehicle deployment as a means to ensure the most efficient service possible. Unlike the fire service, most SSM operated services attempt to deploy the fewest number of personnel and vehicles as possible, while staying within the stipulated response time requirement(s). Software is used to establish demand and location patterns, which theoretically over time (sample size) increases the reliability of predicting same. That's my rendition of the official version. In human terms, I believe SSM has no basis to exist. Status plans can be constructed so " tight " that an enormous burden is placed on the workforce. This is best determined by the frequency of post moves because theoretically an entire fleet could be re-posted to new locations for a single call. It's bad enough to have to sit like a trollop at a 7-11 while sprouting hemorrhoids, and it's another thing all together to be re-posted many times in a single shift. The worst example that I can think of was 12 post moves in 8 hours without running a single call (Portland, OR). To my knowledge, no one has ever attempted to establish whether SSM has made a difference in morbidity or mortality. It has never been " sold " as medical tool. Neither has anyone ever investigated the toll it takes on the field personnel in terms of worker fatigue, traffic risks, obesity, medication errors, psychiatric disorders, domestic or marital issues, attrition, absenteeism, illness, etc. If there was any evidence that SSM improved outcomes then everyone would do it, or it would be required by statute or rule. Like many things in EMS, SSM has become institutionalized. It has its own legion of card carrying SSM planners and managers, training programs and certification - which makes some people a lot of money. It has also turned many into SSM handmaidens, who serve to perpetuate its myths of indispensability and " high performance " . The last thing that I want when I keel over is a crew that is worn out, hungry, disillusioned and pissed off because they have been jerked through the SSM " key hole " . I would prefer that they had to interrupt their nap, meal or TV program when they come to my assistance, rather than from inhaling 12 hours worth of diesel fumes and sitting on a doughnut, while eating micro waved burrito's and drinking Mountain Dew. Bob Kellow wegandy1938@... wrote: > First of all, I'm BACK! Thanks to Jay Hoskins who, guru that he is, was > finally able to thwart the idiots at Yahoo and figure out how to get me back > on the list after being unceremoniously kicked off never, I thought, to > return. So abandon all hope, ye Yahoo Dwellers: The Gandy Factor Returns. > > Now, on the subject of unit deployment, otherwise known as posting. Can > ANYBODY tell me of any scientific study done anywhere, anytime, by anybody, > which shows any advantage to so-called system status management deployment > over fixed base deployment? Other than the musings of Jack Stout and the > Stoutians? > > If moving trucks about were the definitive answer, why wouldn't fire > departments have their apparatus rove the streets, parking in cafeteria > parking lots, 7-11 lots and street corners? > > If roving units were the answer, why is it that fire departments almost > always beat the cops to a scene? Why is it that we arm fire engines with > AEDs in order to rapidly defibrillate patients and that they can arrive in 3 > minutes when the system status managed trucks can barely meet their > contracted time of 8:59 90% of the time? > > Why, oh why? > > Is there REALLY any substance to system status management? > > Gene Gandy > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 26, 2002 Report Share Posted October 26, 2002 I think SSM is a PR related tool that, when used in advertisement, gives the uneducated public a false sense of having more ambulances in their community than there really is. The old saying: " Figures lie and liars figure " , SSM is one of many ways EMS agencies (usually large corporate ones) save money by playing the odds. This is one of the main reasons that a big corporate agency lost the City of Grand Prairie. This is the same reasons that many places are unhappy with other large providers in our state. My 2 cents Lee SSM Welcome back Gene. SSM is used as a tool to optimize staffing and vehicle deployment as a means to ensure the most efficient service possible. Unlike the fire service, most SSM operated services attempt to deploy the fewest number of personnel and vehicles as possible, while staying within the stipulated response time requirement(s). Software is used to establish demand and location patterns, which theoretically over time (sample size) increases the reliability of predicting same. That's my rendition of the official version. In human terms, I believe SSM has no basis to exist. Status plans can be constructed so " tight " that an enormous burden is placed on the workforce. This is best determined by the frequency of post moves because theoretically an entire fleet could be re-posted to new locations for a single call. It's bad enough to have to sit like a trollop at a 7-11 while sprouting hemorrhoids, and it's another thing all together to be re-posted many times in a single shift. The worst example that I can think of was 12 post moves in 8 hours without running a single call (Portland, OR). To my knowledge, no one has ever attempted to establish whether SSM has made a difference in morbidity or mortality. It has never been " sold " as medical tool. Neither has anyone ever investigated the toll it takes on the field personnel in terms of worker fatigue, traffic risks, obesity, medication errors, psychiatric disorders, domestic or marital issues, attrition, absenteeism, illness, etc. If there was any evidence that SSM improved outcomes then everyone would do it, or it would be required by statute or rule. Like many things in EMS, SSM has become institutionalized. It has its own legion of card carrying SSM planners and managers, training programs and certification - which makes some people a lot of money. It has also turned many into SSM handmaidens, who serve to perpetuate its myths of indispensability and " high performance " . The last thing that I want when I keel over is a crew that is worn out, hungry, disillusioned and pissed off because they have been jerked through the SSM " key hole " . I would prefer that they had to interrupt their nap, meal or TV program when they come to my assistance, rather than from inhaling 12 hours worth of diesel fumes and sitting on a doughnut, while eating micro waved burrito's and drinking Mountain Dew. Bob Kellow wegandy1938@... wrote: > First of all, I'm BACK! Thanks to Jay Hoskins who, guru that he is, was > finally able to thwart the idiots at Yahoo and figure out how to get me back > on the list after being unceremoniously kicked off never, I thought, to > return. So abandon all hope, ye Yahoo Dwellers: The Gandy Factor Returns. > > Now, on the subject of unit deployment, otherwise known as posting. Can > ANYBODY tell me of any scientific study done anywhere, anytime, by anybody, > which shows any advantage to so-called system status management deployment > over fixed base deployment? Other than the musings of Jack Stout and the > Stoutians? > > If moving trucks about were the definitive answer, why wouldn't fire > departments have their apparatus rove the streets, parking in cafeteria > parking lots, 7-11 lots and street corners? > > If roving units were the answer, why is it that fire departments almost > always beat the cops to a scene? Why is it that we arm fire engines with > AEDs in order to rapidly defibrillate patients and that they can arrive in 3 > minutes when the system status managed trucks can barely meet their > contracted time of 8:59 90% of the time? > > Why, oh why? > > Is there REALLY any substance to system status management? > > Gene Gandy > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 26, 2002 Report Share Posted October 26, 2002 I think SSM is a PR related tool that, when used in advertisement, gives the uneducated public a false sense of having more ambulances in their community than there really is. The old saying: " Figures lie and liars figure " , SSM is one of many ways EMS agencies (usually large corporate ones) save money by playing the odds. This is one of the main reasons that a big corporate agency lost the City of Grand Prairie. This is the same reasons that many places are unhappy with other large providers in our state. My 2 cents Lee SSM Welcome back Gene. SSM is used as a tool to optimize staffing and vehicle deployment as a means to ensure the most efficient service possible. Unlike the fire service, most SSM operated services attempt to deploy the fewest number of personnel and vehicles as possible, while staying within the stipulated response time requirement(s). Software is used to establish demand and location patterns, which theoretically over time (sample size) increases the reliability of predicting same. That's my rendition of the official version. In human terms, I believe SSM has no basis to exist. Status plans can be constructed so " tight " that an enormous burden is placed on the workforce. This is best determined by the frequency of post moves because theoretically an entire fleet could be re-posted to new locations for a single call. It's bad enough to have to sit like a trollop at a 7-11 while sprouting hemorrhoids, and it's another thing all together to be re-posted many times in a single shift. The worst example that I can think of was 12 post moves in 8 hours without running a single call (Portland, OR). To my knowledge, no one has ever attempted to establish whether SSM has made a difference in morbidity or mortality. It has never been " sold " as medical tool. Neither has anyone ever investigated the toll it takes on the field personnel in terms of worker fatigue, traffic risks, obesity, medication errors, psychiatric disorders, domestic or marital issues, attrition, absenteeism, illness, etc. If there was any evidence that SSM improved outcomes then everyone would do it, or it would be required by statute or rule. Like many things in EMS, SSM has become institutionalized. It has its own legion of card carrying SSM planners and managers, training programs and certification - which makes some people a lot of money. It has also turned many into SSM handmaidens, who serve to perpetuate its myths of indispensability and " high performance " . The last thing that I want when I keel over is a crew that is worn out, hungry, disillusioned and pissed off because they have been jerked through the SSM " key hole " . I would prefer that they had to interrupt their nap, meal or TV program when they come to my assistance, rather than from inhaling 12 hours worth of diesel fumes and sitting on a doughnut, while eating micro waved burrito's and drinking Mountain Dew. Bob Kellow wegandy1938@... wrote: > First of all, I'm BACK! Thanks to Jay Hoskins who, guru that he is, was > finally able to thwart the idiots at Yahoo and figure out how to get me back > on the list after being unceremoniously kicked off never, I thought, to > return. So abandon all hope, ye Yahoo Dwellers: The Gandy Factor Returns. > > Now, on the subject of unit deployment, otherwise known as posting. Can > ANYBODY tell me of any scientific study done anywhere, anytime, by anybody, > which shows any advantage to so-called system status management deployment > over fixed base deployment? Other than the musings of Jack Stout and the > Stoutians? > > If moving trucks about were the definitive answer, why wouldn't fire > departments have their apparatus rove the streets, parking in cafeteria > parking lots, 7-11 lots and street corners? > > If roving units were the answer, why is it that fire departments almost > always beat the cops to a scene? Why is it that we arm fire engines with > AEDs in order to rapidly defibrillate patients and that they can arrive in 3 > minutes when the system status managed trucks can barely meet their > contracted time of 8:59 90% of the time? > > Why, oh why? > > Is there REALLY any substance to system status management? > > Gene Gandy > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2002 Report Share Posted October 27, 2002 >I would like to know what this term ssm is ? > > >Silsbee EMS Systems Status Management, or it has been called many other things over the years. Jim< Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2002 Report Share Posted October 27, 2002 >I would like to know what this term ssm is ? > > >Silsbee EMS Systems Status Management, or it has been called many other things over the years. Jim< Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2002 Report Share Posted October 27, 2002 Staging a unit for broader coverage with a small number of units to reduce cost . Silsbee EMS 114 hwy 96 south Silsbee, Tx 77656 Re: SSM > >I would like to know what this term ssm is ? > > > > > >Silsbee EMS > > Systems Status Management, or it has been called many other things > over the years. > > Jim< > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2002 Report Share Posted October 27, 2002 Staging a unit for broader coverage with a small number of units to reduce cost . Silsbee EMS 114 hwy 96 south Silsbee, Tx 77656 Re: SSM > >I would like to know what this term ssm is ? > > > > > >Silsbee EMS > > Systems Status Management, or it has been called many other things > over the years. > > Jim< > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2002 Report Share Posted October 27, 2002 Staging a unit for broader coverage with a small number of units to reduce cost . Silsbee EMS 114 hwy 96 south Silsbee, Tx 77656 Re: SSM > >I would like to know what this term ssm is ? > > > > > >Silsbee EMS > > Systems Status Management, or it has been called many other things > over the years. > > Jim< > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2002 Report Share Posted October 27, 2002 >Staging a unit for broader coverage with a small number of units to reduce >cost . > Actually NO; just exactly the opposite when SSM systems are constructed properly they provide excellent response times, lower costs and great patient care. Jim< Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2002 Report Share Posted October 27, 2002 Jim: Upon which data do you base your statement? I performed a literature search about a month ago and could not find one study that showed any benefit to SSM--just conjecture and anecdotal reports. BEB E. Bledsoe, DO, FACEP Midlothian, Texas All outgoing email scanned by Norton Antivirus and guaranteed " virus free " or your money back. Re: SSM >Staging a unit for broader coverage with a small number of units to reduce >cost . > Actually NO; just exactly the opposite when SSM systems are constructed properly they provide excellent response times, lower costs and great patient care. Jim< Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2002 Report Share Posted October 27, 2002 Basic EMTs don't make base hospital contact *smile* That is the great thing about being BLS-unit [with MICU capabilities] in LA, you can stop at ANY hospital ED without Paramedics on-board. Where P-EMTs can ONLY transport to paramedic receiving EDs and generally the one that is assigned by MICN [usually the closest & open if no specialty is needed]. C'mon, been there and done that. May not work for everyone, but it is the system that is there. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2002 Report Share Posted October 27, 2002 Basic EMTs don't make base hospital contact *smile* That is the great thing about being BLS-unit [with MICU capabilities] in LA, you can stop at ANY hospital ED without Paramedics on-board. Where P-EMTs can ONLY transport to paramedic receiving EDs and generally the one that is assigned by MICN [usually the closest & open if no specialty is needed]. C'mon, been there and done that. May not work for everyone, but it is the system that is there. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2002 Report Share Posted October 27, 2002 Basic EMTs don't make base hospital contact *smile* That is the great thing about being BLS-unit [with MICU capabilities] in LA, you can stop at ANY hospital ED without Paramedics on-board. Where P-EMTs can ONLY transport to paramedic receiving EDs and generally the one that is assigned by MICN [usually the closest & open if no specialty is needed]. C'mon, been there and done that. May not work for everyone, but it is the system that is there. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2002 Report Share Posted October 27, 2002 >Jim. > >Please establish the link between SSM and " great patient care " ! > >Bob Kellow Bob, I am aware of many SSM systems (maybe not in Texas) that provide excellent patient care and actually the entire system is setup around the patient. Oklahoma City, Richmond, Charlotte, Denver, Kansas City and the list goes on. Jim< Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2002 Report Share Posted October 27, 2002 >Jim: > >Upon which data do you base your statement? I performed a >literature search about a month ago and could not find one study >that showed any benefit to SSM--just conjecture and anecdotal >reports. > >BEB That's correct Dr B the research is not there, but then again its almost impossible to do. These are personal experiences with excellent SSM systems. Jim< Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2002 Report Share Posted October 27, 2002 >That's called " anecdotal " and " ill-defined " . It has no basis in emergency >medicine. > >Bob Kellow Then we might as well stop doing almost everything we do each day in emergency medicine Mr. Kellpw because EMS is an extremely undefined science and there remains little literature to support what we do or don't do. Ok systems stop. Jim< Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2002 Report Share Posted October 27, 2002 Attention Sneed (on County). One of your herd is on I35 again and the traffic is moving real fast. BEB E. Bledsoe, DO, FACEP Midlothian, Texas All outgoing email scanned by Norton Antivirus and guaranteed " virus free " or your money back. Re: SSM Basic EMTs don't make base hospital contact *smile* That is the great thing about being BLS-unit [with MICU capabilities] in LA, you can stop at ANY hospital ED without Paramedics on-board. Where P-EMTs can ONLY transport to paramedic receiving EDs and generally the one that is assigned by MICN [usually the closest & open if no specialty is needed]. C'mon, been there and done that. May not work for everyone, but it is the system that is there. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2002 Report Share Posted October 27, 2002 Attention Sneed (on County). One of your herd is on I35 again and the traffic is moving real fast. BEB E. Bledsoe, DO, FACEP Midlothian, Texas All outgoing email scanned by Norton Antivirus and guaranteed " virus free " or your money back. Re: SSM Basic EMTs don't make base hospital contact *smile* That is the great thing about being BLS-unit [with MICU capabilities] in LA, you can stop at ANY hospital ED without Paramedics on-board. Where P-EMTs can ONLY transport to paramedic receiving EDs and generally the one that is assigned by MICN [usually the closest & open if no specialty is needed]. C'mon, been there and done that. May not work for everyone, but it is the system that is there. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2002 Report Share Posted October 27, 2002 Attention Sneed (on County). One of your herd is on I35 again and the traffic is moving real fast. BEB E. Bledsoe, DO, FACEP Midlothian, Texas All outgoing email scanned by Norton Antivirus and guaranteed " virus free " or your money back. Re: SSM Basic EMTs don't make base hospital contact *smile* That is the great thing about being BLS-unit [with MICU capabilities] in LA, you can stop at ANY hospital ED without Paramedics on-board. Where P-EMTs can ONLY transport to paramedic receiving EDs and generally the one that is assigned by MICN [usually the closest & open if no specialty is needed]. C'mon, been there and done that. May not work for everyone, but it is the system that is there. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 BEB, Pu-lease, there is a great disparity between LA County in the early/mid 90s, and on County, today. 2 TOTALLY different system and 2 TOTALLY different dynamics. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 Jim. Please establish the link between SSM and " great patient care " ! Bob Kellow wrote: > >Staging a unit for broader coverage with a small number of units to reduce > >cost . > > > > Actually NO; just exactly the opposite when SSM systems are > constructed properly they provide excellent response times, lower > costs and great patient care. > > Jim< > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 That's called " anecdotal " and " ill-defined " . It has no basis in emergency medicine. Bob Kellow wrote: > >Jim: > > > >Upon which data do you base your statement? I performed a > >literature search about a month ago and could not find one study > >that showed any benefit to SSM--just conjecture and anecdotal > >reports. > > > >BEB > > That's correct Dr B the research is not there, but then again its > almost impossible to do. These are personal experiences with > excellent SSM systems. > > Jim< > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 Jim, What do you mean? Extraordinary survival rates? Less morbidity or mortality? What? Where's the evidence? Where was it published? Who were the peer (referee) reviewers? It's not proper to disgorge statements without generally accepted means to verify same! Where, and by what means did you derive your conclusions? Bob Kellow wrote: > >Jim. > > > >Please establish the link between SSM and " great patient care " ! > > > >Bob Kellow > > Bob, I am aware of many SSM systems (maybe not in Texas) that provide > excellent patient care and actually the entire system is setup around > the patient. Oklahoma City, Richmond, Charlotte, Denver, Kansas City > and the list goes on. > > Jim< > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 >BEB, > >I noticed that you have a thing for numbers and research... > >My question is --- > >#1 - Since San Diego ended its study of RSI, should we consider that RSI is >something NOT needed in pre-hospital care? > >#2 - Since Houston concluded their study on MAST, should we remove them from >ALL units nationally? > >#3 - Since LA/Orange Counties concluded their joint study, should we no >longer intubate pediatrics? Another major problem with implying the conclusions from any of that research is the vast differences in EMS systems. Paramedic's are not trained the same and the systems are vastly different. Because of this it makes it very hard to use the conclusions from one city and implement them in another area. Jim< Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2002 Report Share Posted October 28, 2002 >BEB, > >I noticed that you have a thing for numbers and research... > >My question is --- > >#1 - Since San Diego ended its study of RSI, should we consider that RSI is >something NOT needed in pre-hospital care? > >#2 - Since Houston concluded their study on MAST, should we remove them from >ALL units nationally? > >#3 - Since LA/Orange Counties concluded their joint study, should we no >longer intubate pediatrics? Another major problem with implying the conclusions from any of that research is the vast differences in EMS systems. Paramedic's are not trained the same and the systems are vastly different. Because of this it makes it very hard to use the conclusions from one city and implement them in another area. Jim< Quote Link to comment Share on other sites More sharing options...
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