Okay, going to re-word my last request based on the meeting we had today.
The hospital now wants to make a protocol to guide them, step by step, on how and why to replace ambulances in order to purchase new ones. They are looking for international information that will tell them how often to buy new trucks and why some should be relegated to back up status, and others get scrapped. Also, mileage and time frame examples.
They have no info, or experience about any of this. This will be used by NON EMS PEOPLE to make the decisions. Hence, the reason that it needs to be a hand-holding, step by step protocol. Almost like a check off list.
Anyone that has info on this, please contact me.
I know of no written standards or regulations regarding ambulance replacement. I have talked with numerous agencies over the years and have seen a wide range of practices. This question is analogous to asking how often I should replace my car. I also have to preface with an, "It depends". It depends factors such as:
In my agency, ambulances are on the front line for 5 years where they will get about 150,000 miles. They are then put into reserve. General rule of thumb for us is 10 years and 200,000 miles.
These are the things that I have already explained to them. Unfortunately, they like to see things in writing from other places (one of the things they love to do is just put their logo over the top and call it their own).
They are insisting on seeing policies and procedures from other cities. I really don't know how to explain it any better. They feel that if it's not in writing, then it is not important.
Hell, one of the guys at the meeting couldn't comprehend why we couldn't keep the trucks in frontline service for fourteen years like he has owned his car!
I guess part of the problem is that all of this is new to them, and they have never done it before. If you've worked over here, it would probably be easier to understand. They are really big on paperwork. Everyone has to be able to put their stamp and signature on something to show that they were part of the decision making process.
That's the best that I can describe it right now. It's really frustrating.
Your best ally here maybe the hospital's Director of Engineering/Maintenance. Hospitals have to make these types of decisions all the time with stationary equipment such as HVAC systems generators etc. The way these decisions are made by systematic review.
Does the current equipment does it meet current requirements ( do you need refrigeration for ROSC hypothermia for example)
Does it meet applicable standards, this will be a big one for a group the lives and breaths Joint Commission.
What is the current unit costing in repairs, if it cost $12000 last year in repairs then you have an answer the accountants can get their heads around. What about Work Comp claims do the seats go back all the way in the cab what about a loading system if you can avoid one serious back injury you've paid for a new ambulance.
What about trade in value of the current unit the box at least may interest a re-mounter but how fast is that value depreciating? Ask the hospital finance group to help you understand the deprecation of assets.
The other group that might help is whoever is responsible for community relations / advertising because that ambulance is one big rolling billboard for the hospital.
There was a guy from hospital maintenance at the meeting. He is also in charge of vehicle maintenance. He really didn't offer anything very productive, though.
The current trucks meet the standards from when they were built: 2001, 2004, and 2008. They meet our requirements with the exception of the A/C, which has been the biggest issue.
I like that JCI angle. I may be able to work that one.
As far as repair costs, we don't receive that information. But I did find out at the meeting that the repairs were being farmed out to some small shop, who had to order almost all of the parts, and then wait for them to arrive.
Remounting is not an option. The '01 and '04 boxes are too worn out. The '08 boxes are from the squads made here. They are basically plywood inside of an aluminum shell. Plus, I don't think the dealer understands the concept very well as to what all is involved in doing it.
Today was fun. We were out of BLS ambulances since last night. There were no trucks to do the transfers, and big shots have now gotten involved. At least the ALS trucks are still working. For now.