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Friday, February 26, 2010

I've waited 28 years for this.

Last night at a SFFD Fire Commission Meeting, the Chief of Department was able to report something positive to the Commission. A report of an occasion that was momentous in my 28 year paramedic career in San Francisco. It was the first time in 28 years that the public ambulance service in San Francisco had met it's response time goals in all districts of the City of San Francisco. From January 2010 to Feb 2010, the overall Citywide 90th percentile response time for a transport ambulance was 8 minutes and 58 seconds.

I remember when I first started riding along with the DPH ambulances in 1976. I was a Medical Explorer Scout at the United States Public Health Service Hospital at 15th Avenue and Lake Street. Robert Giudice was one of the paramedics I got to ride with. There were only 8 ambulances on during the day and 5 at night for a city of 700,00 people. There was no 9-1-1, the public had to call 431-2800 to reach CMED at 50 Ivy which was also Central Emergency Hospital to request an ambulance.

In the 1980's I went to paramedic school at John Adams and did my internship on a DPH unit with Ben Dorcy and Tom Pickford as my preceptors. The number of ambulances didn't change much in the 1980's. In the mayoral administration of Diane Feinstein, the SF Chronicle headlines castigated the ambulance response times of the Department of Public Health as, "Same Day Service."

In the lat 80's and early 90's, there was much hope that the ambulance response times would improve because of a change in leadership of the DPH SFGH Paramedic Division. A young emergency physician named Charles Saunders brought new management tools and administrative skills to upgrade the ambulance service. Dr. Jim Pointer was the Medical Director of the SF EMS Agency and revamped many of the backwards and antiquated medical protocols bringing San Francisco EMS to the forefront of the time in progressive EMS service.

In spite of all their efforts, the SF General Hospital just wouldn't expend any resources to fully fund the ambulance service the way it needed to be. When the merger of the Paramedic Division into the SFFD happened in 1997, the ambulance fleet consisted of 19 vehicles and we fielded 12-14 in our best days. The average response time was 10 minutes which meant that the 90th percentile response time was in the range of 14-15 minutes. Today, the ambulance fleet numbers 41 ambulances and we deploy 21 ambulances at the peak times.

I know the merger has been very hard on the paramedics and EMT's of the public ambulance service in the past 12 years. We lost some very good people because of many missteps and failures to address problems that arose. But regardless of how my colleagues feel the path should have been, one thing is unchallenged.

The San Francisco Fire Department has committed the resources necessary to achieve a goal that had been eluding my professional efforts for 28 years. I think I will try to absorb that for a few days to let it sink in and see if I can postulate about what that means for the future and what is in store down the road for EMS in San Francisco.


  1. Obviously congratulations on the Response times Seb, but much more than that, I am more hopeful for the SFFD by the step that you have taken by starting a blog.

    To have someone like you willing to engage with everyone like this and be part of the true community of EMS Professionals speaks volumes of you and the SFFD.

    I was astounded when I saw you started a blog, and I wish that my managers would do the same thing.

    I cant wait to read more of your perspectives and will be putting a post up on my blog tomorrow to let everyone know where they can find you!

  2. I will frequent this blog just because SFFD has embraced social media and have been the leaders in public safety to show it can used in a safe and helpful way. Thank you Seb for taking this t the next level

  3. Congratulations on the Response times and your new blog. It is a wonderful way to bridge many gaps in the industry. For a long time the use of Social media as a means of information share and friendship, has almost exclusively been used by the newer generations of professionals. I can see that you, and the SFFD are positioning yourselves to be a high profile player in the future of EMS. I support it 100%

  4. Seb,

    That is a fantastic accomplishment. Appreciate that it has taken a tremendous effort.


  5. Mike,

    Thank you but the true credit for this accomplishment goes to the men and women of Station 49 who work very hard day after day to minimize down time, work professionally to be at the posting locations, clearing hospitals in a timely manner. I am very proud of the EMT's and Paramedics that have made this possible.

  6. I personally am so very excited to start reading your blog! I love seeing departments embrace social media, especially because I struggle with mine so very much to be able to blog, tweet, and podcast! So kudos to you and I can not wait to read more!


  7. Chief; firstly well done for hitting your response times - a real achievement for you and all the members of SFFD. We all know what difference a quick response can make to a patient.

    Secondly, even bigger congratulations for having the sheer guts to put your head above the parapet and to use social media. As a Chief, you will no doubt get some people criticising your decisions via the blog. True leadership, as you are showing, does not let itself be deflected by negative comments, but looks for the positive reasons behind them. (For instance, an EMT may moan about the state of vehicles [negative]. That means they actually care about their vehicle and would like to see an improvement [positive].)

    A senior management view, even if it is from the other side of the Atlantic and a damn great land-mass, will be instructive to all of us lower down the tree. (In my case, I'm down amongst the roots!)

  8. I trained at John Adams in the late '70s and certified as SF #192. I was googling some old friends and imagine my surprise when my search revealed that my classmate, Tom Pickford, had been one of your preceptors. I remember Bob Guidice and Ben Dorcy, and Bob Navarro was also in my class. If you know anything about the whereabouts of Tom, I'd love to get back in touch with him.