Ensure safety and reliable service with a cost-effective fleet maintenance plan

Developing a cost-effective fleet maintenance plan for an EMS agency should be a priority for EMS leadership regardless of agency size or complexity. A safe and well-functioning fleet is critical to ensure the safety and wellbeing of clinicians in the field as well as providing reliable and consistent service to the patients, facilities and communities served. There are a number of simple steps leaders can take today to evaluate the maintenance plan that is best for the agency. While industry best practices exist and are widely available from accreditation bodies, be prepared to start with the agency’s current state and expect to make small but incremental changes and improvements over time to have a future state that the organization will be proud of.

A good first place to start is to research local and state EMS regulation as it pertains to the maintenance of state licensed or certified EMS vehicles. There may be specific county or state regulations governing who is authorized to perform maintenance on the EMS fleet, including specific mechanic qualifications (i.e., documented ambulance manufacturer factory-provided training, SAE certification, etc.) as well as required documentation that must be maintained and available to regulators during routine or spot inspections.

Next, consult the vehicle owner’s manual for the vehicle chassis and ambulance module modifier to determine who performed the construction of the ambulance module or patient compartment. Check to see what maintenance is recommended and required, and if authorized vendors or service providers are listed to perform the work locally. This can help avoid invalidating warrantees and ensure your vehicle is maintained to specification.

Next, consider the way records of fleet maintenance activities will be recorded. A number of options exist, from low to high-tech, with varying degrees of complexity and pricing. Remember, attention to detail is the most critical part of fleet maintenance record keeping, regardless of whether the method is a simple paper-based documentation format or a much more robust mechanic-worn audio-recorded headset with transcription capability. Consideration must be given to what the data will be used for in the future. Basic documentation should include:

• Vehicle identifier
• Repair date
• Total cost of parts
• Total cost of labor
• Tax (if applicable)
• A place to store or upload documentation of the repair work performed (PDF to cloud or paper file)

This type of minimum data set will allow for reporting by month and year providing a record of the total cost of fleet maintenance and cost by vehicle. As needs for data change, and possibly become more complex, the organization may want to identify fleet repairs that are planned or scheduled, as opposed to those that are unplanned or emergent in nature. This will help determine if the fleet maintenance schedule intervals are appropriate for the agency’s specific needs and if the scheduled maintenance program is adequate. Commercially available fleet maintenance software could be a consideration for an agency that is not sure what data they wish to capture currently but anticipate greater need for in the future. Regardless, the quality of the information entered at the time of service or invoice is critical to the ability to leverage future data analysis and decision-making.

Preventative maintenance

Attempting to eliminate preventable vehicle failures through engineering controls is a current trend in EMS fleet maintenance, known as preventative vehicle maintenance. The concept involves considering the expected lifespan of various replaceable vehicle components and servicing and/or replacing these prior to the expected end-of-life of that component. Commonly considered vehicle checkpoints for EMS vehicle preventative maintenance include:

• Engine oil
• Oil filters
• Engine coolant/antifreeze
• Tires
• Brakes
• Rotors
• Ball joints
• Windshield wipers
• Headlights
• Taillights
• Shocks
• Struts
• Batteries

Based on your vehicle’s expected usage in both driven miles and engine hours, combined with the type of vehicle usage (i.e., non-emergency driving, emergency driving, urban driving, rural driving, etc.), as well as the manufacturer’s recommended replacement schedule for these components, you can develop a vehicle preventative maintenance plan and service schedule. Miles driven and engine hours are particularly important factors to capture in these calculations if your agency’s vehicles spend excessive time idling, especially if deployed via system status management.

As the organization’s plan matures, leadership will want to study the results and make modifications as necessary. A good practice is to begin benchmarking the agency against others, setting goals for vehicles, clinicians, service vendors and capital budget. Try working backwards in this area with leadership to determine appropriate targets for vehicle replacement schedules. Knowing how long a vehicle is expected to be kept in service can assist with capital budget planning for replacement or remounting the module on a new chassis. This synchronization of planning, operations and logistics functions will help ensure you do not over-invest in fleet maintenance for a particular vehicle if replacing the vehicle is the more logical and cost-effective approach.

About the author

Les Polk has worked in EMS for more than 15 years. He has worked as a paramedic at EMS agencies in both New Jersey and Pennsylvania, serving in a variety of EMS leadership capacities in logistics, operations, education, and administration. He completed his undergraduate degree at Muhlenberg College in Allentown, PA and a M.S. degree from the George Washington University in Washington, D.C. concentrating in EMS Leadership, is a Fellow of the American College of Paramedic Executives and is a Certified Six Sigma Black Belt.