Comparing Staffing Models for Fire Based Mobile Urgent Medical Services

Background: Comparing Full-Time (FT) and Part-Time (PT) staffing models for a mobile integrated health (MIH) program established by a local Fire Department. Objective: Determine if the program is sustainable and which staffing model is more effective at obtaining sustainability. Design: Quality Improvement project with retrospective data review. Setting: Green Valley Fire District in Green Valley, Arizona. A predominant retirement community. Target: The residents of the Green Valley Fire District. Interventions: Utilizing the RE-AIM framework, a retrospective review of the data collected by the previously implemented MIH Program in Green Valley was completed. The framework was utilized to review relevant data and determine if the program has achieved the expected outcomes, and maintained a sustainable and transferable MIH program. Measurement: Decrease in emergency medical (EM) calls for service with the implementation of the MIH program. Comparing staffing models for consistency in services. Results: The results showed a decline in EM calls for service with the MIH program, and more consistency in availability and patient services with the FT staffing model. Limitations: The demographics of the community limit the generalizability and transferability of the data obtained from the project. Additional data should be collected and analyzed both retrospectively and for successive years to substantiate the benefits and continue to improve the effectiveness of the MIH program. Conclusions: The program could be used as a model for other MIH programs, with adjustments made for the respective community. The value or sustainability of any MIH program cannot be limited to revenue solely. Other perspectives of value added service and cost savings must also be considered. Significance: This study highlights the effectiveness of an MIH program in a small retirement community and shows the benefit of a FT staffing model versus a PT staffing model for consistency of patient care and daily program operations. There are also multiple aspects of value to an MIH program, some of which are difficult to conceptualize and measure based on historical models of healthcare delivery and Fire Department Services. Further review of these types of programs is needed to establish the overall benefits of MIH.