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Thomas Little
Senior consultant, Fitch & Associates
Fleet replacement is a major capital expense for EMS agencies. Many services have a defined time or mileage trigger that is used to determine when it’s time to replace a vehicle. This varies by type of service and the type chassis used.
For light-duty chassis ambulances, regardless of if it’s a pick-up truck/module (Type I) a van (Type II) or a van cutaway/module, services frequently replace vehicles at 250,000 miles or five years.
World-class fleet maintenance strategies can extend this replacement cycle without increasing the risk of critical failures or additional cost. And with reimbursements shrinking and expenses growing, many EMS fleets are getting older and the funding for replacements is being placed on hold. For those reasons, it is important to know how to extend the life of your fleet safely and conservatively. The adage of “You can pay me now, or you can pay me more later” is applicable in this instance.
An effective strategic plan for fleet operations must be in place and followed. There are three essential elements to world-class fleet maintenance;
- Follow the manufacturer’s guidelines for maintenance
- Maintain detailed maintenance and repair records
- Conduct routine preventative maintenance inspections
Preventative fleet maintenance
Preventative maintenance implies that an organization can determine when an ambulance needs service or when it will likely need repair. This is accomplished by conducting preventive maintenance inspections (PMIs) on a regular basis. The PMI is defined as a schedule of a group of services and inspections that are performed at a given interval to eliminate unscheduled repairs.
Scheduling inspections and service points at the same time decreases the interval a vehicle is in shop. The result generally identifies unreported repairs. One hour of PMI can produce a savings of about five hours of unscheduled shop time.
Ambulances should be maintained under a severe service factor schedule using engine hours rather than odometer miles. Idling engines can consume up to a half gallon of fuel per hour. While mileage is not being recorded, one hour of idle time equates to 30 miles of driving. With more agencies being fully deployed or practicing aggressive move-ups to improve response time performance, using engine hours for maintenance triggers rather than miles becomes increasingly important.
Ambulance critical failures
Ambulance critical failures can be devastating to a patient and significantly impact the service. They are expensive to repair, create response readiness conflicts and can result in compliance penalties or even liability lawsuits.
Critical failures can be avoided by following established maintenance routines. A critical failure is defined as a sudden or unexpected interruption of service to a patient, that interferes with the response or transportation phase. This includes both 911 emergency and scheduled non-emergency responses.
There is no national database for critical failures, but based on our experience and research, agencies should endeavor to make sure your fleet has no more than 2 critical failures per 100,000 system miles.
EMS fleet monitoring costs
Monthly monitoring of each vehicle’s cost per mile can alert a service to potential problems. The higher the cost per mile, the increased likelihood of a critical failure occurring. A clear definition of cost is necessary to know what is being measured. The classic definition is, a fleet matrix consisting of a calculation of fuel costs, maintenance labor charge and parts cost, divided by the number of miles driven by the month. This is the cost per mile to operate a vehicle.
Typical ambulance cost per mile benchmarks vary by type of vehicle. These benchmarks may vary slightly by region and fuel prices. Here are some recent reported costs per mile by vehicle type:
- Transit Vans: $0.58
- Type II Vans: $0.85
- Type I Modular: $0.67
- Type III Modular: $0.65
- Medium Duty: $1.13
- SUV QRV: $0.26
Compare these costs to large feet truck per-mile costs at $0.69 and standard SUVs (family use) as recently reported by the American Automobile Association at $0.18 per mile.
Once a service begins to measure its costs per mile on a monthly basis, you can track your own fleet benchmarks and look for variances to make more effective decisions about what individual units should be replaced early, replaced on schedule or which may be serviceable beyond the anticipated service life.
Monetize cost savings with excellent fleet maintenence
Remember your community expects that when they dial 911, they get an ambulance that actually works – one capable of taking them to the hospital. As leaders, we also have a moral obligation to ensure that our caregivers are always operating well maintained units. With those two priorities in mind, using outstanding maintenance practices also allows a service to safely extend the life of the fleet another two years or an additional 100,000 miles without excessive risk, costs or shop time. If you are extending the chassis life of Type I or Type III modular unit, the module remains a good candidate for remounting, which also represents additional cost savings. Measure, manage and monetize the savings by using excellent maintenance practices.
About the author
Tom Little is a veteran field medic and leader in emergency medical services (EMS). He has served in significant leadership roles throughout the nation and regularly consults on fleet issues for the firm. Reach Tom directly at tlittle@fitchassoc.com
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