Ruminations on outcome based research

Spent time as a first-line supervisor on a haz-mat rescue company, when being a "glo worm" was new and cool.

The first response with the rescue was weird. A box alarm dispatch to a mid-rise senior facility was sending four engines, two trucks, an ems unit and the rescue … and my crew was S-L-O-W-L-Y walking to the rig.

Was this a test for the new officer?

Welcome to the Toast Patrol

The chauffer explained that they ran this address two to four times a day. The first due company is a few blocks away.

On almost every incident the first engine is returning the box alarm assignment within a few minutes.

It would be the first of hundreds of times the rescue would pull out into traffic, with me wailing the 2QB and stuttering the air horns. We drove the length of the shopping center parking lot next to the fire station before going in service.

Pretty dumb – why not just send the first engine and truck?

Apparently, we used to … until a 1+1 dispatch during a severe winter storm became a two alarm fire with rescue of an occupant in the fire apartment.

Looking at the details

The mid-rise facility was constructed in 1973, before fire sprinkers were required by the code to be installed within the apartments.

Built in an "in-field" property, truck company access to the rear of the building is tight.

The facility has almost 300 bedrooms.

A smoke detector is mounted in the kitchen, near the refridgerator. Every extra crispy toast and overbrewed teapot generated an alarm … breakfast, lunch and dinner.

Lean Manufacturing Model

Dylan Scott, writing in the February 2012 issue of Governing magazine, described the application of best practices by Patricia Gabow, MD, to improving Denver Health operations.

The lean manufacturing model is based on five principles, according to the Lean Enterprise Institute:

1. Identify the value of the product for the customer
2. Map the process for creating the product and eliminate elements without value
3. Create a flow for the value-creating steps
4. Let customers pull value from that flow
5. Begin the process again and seek perfection.

Put more simply, it’s about eliminating wasteful actions. Anything that doesn’t add value for the ultimate customer is considered wasteful. “The philosophy is that waste is disrespectful to humanity because it squanders scarce resources, and waste is disrespectful to individuals because it asks them to do work with no value,” Gabow says. “We’ve added that waste is disrespectful to our patients because it asks them to endure processes with no value.”

Denver Health Becomes Profitable After Using Toyota As A Template

It it valuable to send seven fire companies two to four times a day for extra-crispy toast?

Wonder what the cost comparison and risk analysis would be if we placed a fire-rescue person at the facility to immediately respond to activated fire alarms? Maybe an ems credentialed responder with AED?

An example from Denver Health Medical Center:

Lean also inspired a restructuring of the Denver Health Medical Center’s rapid response system for patients who go into cardiac arrest. At most hospitals, a dedicated team is on call 24 hours a day, seven days a week for rapid response, and temporarily assume care of those patients from their primary nurses and doctors.

But in applying the lean principles, the medical center’s staff recognized an opportunity to cut costs while ensuring continuity of care. A regular assessment schedule was established for nurses to monitor their patients, and criteria were developed for nurses to determine if a patient was at risk. Then a specific protocol was outlined for staff to follow if a nurse made that determination, providing guidelines for moving up the chain of command if the immediate attending physician is not available or the patient’s condition did not improve.

An analysis by Denver Health staff found that the number of non-ICU cardiac arrest incidents decreased significantly following the implementation of the new procedures. And it bestowed rapid response responsibilities on staff members who were already working, rather than requiring an entirely separate team.

Mike "FossilMedic" Ward

This post dedicated to Technician Mark Baban, Rescue 401, B-shift. You left too soon.

Godspeed to the members of the Pontiac, Michigan, Fire Department

April 23, 1883 – January 31, 2012

After nearly 180 years, "Pontiac Fire Department" will no longer be the name on the side to the engines or on the front of the Stations, but it will be the name that every pontiac fire fighter past and present will never forget because it is in our heart and soul.

Once a pontiac fire fighter always a pontiac fire fighter.

http://youtu.be/CL8MHzpSTPE

Pontiac Fire Department's Last Day

PONTIAC (WXYZ) – A lot of history hangs in the halls of Pontiac’s main fire station. Pictures showcase the brave men who risk their lives daily for their community.

Tuesday, a photographer documented the last day the building will be running as part of the Pontiac Fire Department.

Wednesday morning, the Waterford Fire Department will take over and respond to calls in the city of Pontiac. A decision made by an Emergency Manager to cut costs.

Read more of Tara Edwards article HERE

History of the Pontiac Fire Department

http://youtu.be/noBc9aC-G-w

According to the agreement, the top 13 Pontiac firefighters will be granted the opportunity to take early retirement rather than working until their 25th year. The 44 remaining firefighters are eligible for employment with Waterford Township. The city of Pontiac will grant them one-time bonuses of up to $15,000.

Leslie Shepard (2012 January 4) Pontiac firefighters accept Waterford service pact. SpinalColumn

There were 57 Pontiac firefighters. Tara Edward's article today stated that 42 firefighters got jobs at Waterford.

In the FY 2009 – 2010 budget there were 103 approved positions, shrinking to 80 positions in the FY 2010 – 2011 budget. 22 of the 23 positions eliminated were firefighters.

In 2010 the city police department was disbanded, replaced with Oakland County sheriffs.

Mike "FossilMedic" Ward

Volume 2, Issue 1, hits the intertubes

Dear Blue Card Subscribers:

Check out B Shifter’s latest installment at http://bshifter.com/SelectMagazines.aspx.

Our latest installment features Joe Starnes discussing flashover causes and prevention. Some firefighting friends from Oz talk about the Australian fire service—complete with a lessons-learned tale of communications gone wrong. Bruno introduces two new reader-response columns, and Vincent Dunn discusses fire-supression techniques in single-family residences. Lots of free downloads! Take a look!

Mike "FossilMedic" Ward

What about the Board Up Truck?

Andy Mannix, writing in yesterday's City Pages, reports on the planned retirement of Fire Chief Alex Jackson in February, before the Minneapolis City Council decides on a two-year extension of his appointment:

Last month, Jackson was criticized for a $1 million overtime bill for firefighters in 2011, and a failed program that tasked firefighters with boarding up vacant houses. The latter was supposed to bring revenue to the department, but instead lost about $300,000 in its first year, according to city data.

Minneapolis Fire Chief Alex Jackson retires amid criticism

Earlier coverage of the Minneapolis Fire Department:

• Jan 2, 2012:  Problematic Firefighters
• October 13, 2010: Is Minneapolis Fire Still boarding up buildings?
• October 1, 2010: Saving Money Raises Costs in Minneapolis
• April 30, 2011: Minneapolis steals one firefighter from front-line staffing for unprofitable board-up project
• July 28, 2011: Minneapolis Set To Whack Fire Department
• August 22, 2011: Minneapolis Decimates FD. Local’s Pres. Fires Back
• August 30, 2011: Heat’s On in Minneapolis

Mike "FossilMedic" Ward

Charlie LeDuff posts an update

One Year Later: Detroit's EMS System Still in Need of a Cure: MyFoxDETROIT.com

DETROIT (WJBK) – It's a story we've been covering for more than a year — FOX 2 taking a closer look at the way Detroit manages its ambulance service. What we uncovered was a deadly system on the verge of collapse.

Posted December 20, 2011

Mike "FossilMedic" Ward

Earlier posts:

July 02, 2011: “More Ambulances, More Training, Less Fear” New Detroit Fire Commissioner Donald Austin reaches out to medical community, says 22 new transport units will start arriving in January. Not writing up guys for minor uniform infractions

Yesterday's report raises questions if the ambulances have been ordered.

The Excitement of 2 am

Another tale from the Houston Press, written by John Nova Lomax November 14th:

While police and medics were clearing up that disaster (a 1:30 am Sunday morning fatal collision), 27-year-old Matthew Mitchell attempted to navigate his Chevy Impala through the swirling sea of flashing lights of the fleet of police cruisers and ambulances on the scene.

Unfortunately, he plowed into the life-flight chopper's tail fin.

A DPS trooper on the scene quoted Mitchell thusly:

"Why was the helicopter flying so low?"

East Texas DWI Mayhem Kills One, Injures Three, Damages MedEvac Chopper, Spawns Stupid Quote of Year

Related News Articles:

KTRE ABC 9: One killed, 4 injured and medical helicopter damaged in wreck

KCBA 11 NBC: Multiple charges filed in Anderson Co. DWI wrecks

Link to KCBA news video HERE

UPDATE yourEastTexas.com: Update: Drunk driver held on bonds totaling $800,000, more charges possible  audio interview with DPS Trooper.

The trooper who worked the wreck even mentions in the audio clip that the road was completely blocked off in both directions. The driver actually went into the ditch and around the trucks before getting back on the road and crashing into the helicopter.

Mike "FossilMedic" Ward

Paramedic/firefighter Justin Shorr takes a headquarters gig

From his website:

On Monday I hang up my turnouts and late nights without sleep in exchange for a promotion and a reassignment downtown. That also means giving up that ever so comfortable and vacation friendly schedule.

I was bummed at first until I realized that now the HMjrs are in school and we can’t just pick up and go somewhere whenever we feel like it anymore. When this job at headquarters opened up it seemed too perfect a fit.

Monday I will take over the vacant CQI position that has been retooled ever so slightly to now officially include research. Talk about a perfect chance to mine the data to see what is really going on out there. I have lofty goals for my service, but it’s going to be a long while of playing catch up and learning the new job before I can start going forward with new ideas.

I also have a new political landscape to consider and will be in direct contact and communication with the regulatory agencies, budget writers and vendors that all have a stake in patient care in my jurisdiction.

It’s an amazing opportunity for me both professionally and personally and I am beyond excited to get started.

A Whole New World

Great job!

Mike "FossilMedic" Ward

Two Top Spots in Topeka

THIRTY-TWO YEARS AFTER THEY came to work together, Topeka, Kansas', two top fire officers will be retiring on the same day at the end of this year.  Fire Chief Allen Bradshaw and Deputy Chief Edward DeWitt will both retire on January 1, while working their last day on the job December 23.

Both men were appointed to the FD in the same year and worked their way up the ranks paralleling each other.  Bradshaw was appointed to the top position in October 2009, replacing Howard Giles who had been hired from outside and had a stormy relationship with the firefighters his entire tenure.  In a press release, the City of Topeka announced:

During his tenure as Chief, Bradshaw was instrumental in successfully reopening lines of communications between the firefighters and top administration following years of strained relations between the two groups. He helped negotiate the 2009 contract – the union had previously been working under an expired contract – and negotiated a new three-year contract which expires in 2013. His administration also worked under a "call back" budget that had been reduced for 2010 and 2011. The department also ended 2010 under budget.

Bradshaw oversaw the remodel of four stations. The department secured grants for new breathable air compressors, safety vests, fire prevention devices, and a Safer Grant that allowed for the hiring of nine firefighters. New performance assessments for all department classifications were put in place under his watch as well as a new tracking system for gear, training, leave and safety equipment.

"When he took over, Chief Bradshaw faced many daunting challenges – a workforce where morale was at an all-time low, fire trucks that were literally falling apart, fire stations that were sub-par, and an expanding community expecting continued adequate coverage in new growth areas," Interim City Manager Daniel Stanley said. "He has met and exceeded all expectations, addressing those challenges in an admirable and professional manner.

Bradshaw's father Richard also served as fire chief in the early 1990's.

KTKA-TV has the STORY.
Topeka Fire Department WEBSITE.

*  *  *  *  *  *  *

Updates and pictures from @BostonFire

Response at 12:45am to Calumet St. in Mission Hill for a building fire.

Engine 37 reports fire showing and orders a 2nd alarm.

37-39 Calumet St. in Mission Hill. Now a 5th alarm. Large 3 story wood frame duplex. Heavy fire in rear.

Fire now extended to 41 Calumet.

Fire still out of control. Now through front of building. Ladder pipes and decks guns operating.

Tower Ladder 17 operating now

Right now at 2:24 am

About 130 firefighters, lots of medics & police on scene. Many deck guns operating. 6 in the front of building.

Front on building. 3 of 6 guns on Calumet St. Many more in rear.

Through the roof

The Chief of Department, Ron Keating, is the Incident Commander of the fire. He will be retiring on Monday after 41 + years.

Still going 3 hours plus into it.

37-39 Calumet St. Boston 5 alarms.

Rotating crews in Tower Ladder 17.

Fire now contained to original building. Chasing hot spots. Division 2 Deputy Chief now Incident Commander.

Right now at 4:22 am:

In the first few minutes of the fire, Ladder 4 had a report of a person trapped on floor 2. They kicked in a door and found a woman.

She was transported for smoke inhalation by EMS.

Incident Commander starting to bring in fresh firefighters to continue fighting the fire. 3 ladder trucks and 1 tower ladder coming.

Our helmets off again to the Boston Sparks members for hot chocolate, cookies & coffee. They continue to be true friends.

Snow is really picking up at 5:08 am. Firefighters will be here through the morning.

No idea on how many displaced. At least 9 apartments involved. Red Cross is on scene helping a lot of people.

Chief is giving a damage estimate of $1,200,000.00 for 37-39 Calumet, 41 Calumet St. & 35 Calumet St.

Several homes on Wait St. also had large amounts of water in their basements.

< <<<<<<<<<<<<< >>>>>>>>>>>>

Mike "FossilMedic" Ward

Digital Assymetric Warfare

An amazing development in the Mexican drug wars. 

Diane Shiller, writing in the October 29 Houston Chronicle, posted this article:

An international group of online hackers is warning a Mexican drug cartel to release one of its members, kidnapped from a street protest, or it will publish the identities and addresses of the syndicate's associates, from corrupt police to taxi drivers, as well as reveal the syndicates' businesses. …

"It won't be difficult; we all know who they are and where they are located," says the man, who underlines the group's international ties by speaking Spanish with the accent of a Spaniard while using Mexican slang.

He also implies that the group will expose mainstream journalists who are somehow in cahoots with the Zetas by writing negative articles about the military, the country's biggest fist in the drug war.

"We demand his release," says the Anonymous spokesman, who is wearing a mask like the one worn by the shadowy revolutionary character in the movie V for Vendetta, which came out in 2006. "If anything happens to him, you sons of (expletive) will always remember this upcoming November 5."

Click on headline to read rest of article, which includes a transcript of the video demands: Online hackers threaten to expose cartel's secrets: Group called Anonymous demands release of one of their own who was kidnapped

Information is a disruptive power

Just as WikiLeaks raised havoc with international politics, Anonymous has the capability of disrupting the operations of the Los Zetas Cartel and their partners.

Asymmetrical Warfare

Definition: "warfare in which opposing groups or nations have unequal military resources, and the weaker opponent uses unconventional weapons and tactics, as terrorism, to exploit the vulnerabilities of the enemy."

In this situation we have the second largest and most violent Mexican drug cartel being threatened by a decentralized online community of information technologists who are growing into a significant international force.

Anna Heim, writing in TNW Latin America, looks at the online actions taken against alleged Los Zetas supporters that appear to match the approach taken by Anonymous against earlier targets.

October 29: How Anonymous is threatening a Mexican drug cartel

Why should Firegeezer readers care?

After the publicity of a NYPD commander pepper-spraying an Occupy Wall Street protestor, Anonymous made a similar threat last month:

Hello NYPD, We are Anonymous.

Around the internet, we have seen countless videos of your blatant disregard for first amendment rights. Whether it be by tasering, macing, kettling, or otherwise physically harming those involved in the occupy wall street protests.

We will not stand idly by and let these misdeeds go unpunished. We are hereby calling for an immediate apology and resignation of NYPD commissioner Raymond Kelley and the supervising officers involved. We already know who they are, their information is a matter of public record.

And to those police officers that are "just following orders:" We invite you to join us and stand with our cause in solidarity. An enemy of our enemy is our friend. Join us.

If our demands are not met by october sixth, we will unleash hell on your phones, your servers, and anything else we can find.

We are anonymous. We do not forgive. We do not forget. You have nine days.

They released personal information on the officer and disrupted some of the information technology assets of NYPD. They may have organized a denial of service (DoS) attack on the Oakland police department.

The implication is that public safety organization information (organization and personal) and digital technology are vunerable to hackers.

Mike "FossilMedic" Ward

Related: 

Tech-Savvy Occupy Protesters Use Cellphone Video, Social Networking To Publicize Police Abuse (Radley Balko [2011 Oct 29] Huffington Post)