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22 APRIL 2016 | EMSWORLD.com tend to idle at as high a rate and therefore experience less idle wear on engine compo- nents. Conversely, vehicles posted on street corners idling do not normally exhibit signs of wear from cold starts with full throttle operation. In terms of physical hours run, SSM-posted vehicles incur far more usage time and equivalent miles than actually shown on the odometer. New or Rechassis? A rechassis is when the vehicle is split into its two component parts—the clinical 'box' on the back and the cab and the running gear. This offers the ability to lower cost, which can be leveraged to gain operational effec- tiveness and upfitting to new equipment. Buying new allows for updates and fitting of equipment more effectively, but cost is considerably higher. Today, as the environ- ment surrounding ambulance standards continues to move forward, the cost of new or rechassis vehicles will increase. These increases are necessary, but finding the way to absorb these increases is important. The Fleet Manager's Role Finally, a key question must be asked: In clinical practice would you allow your local shop mechanic to conduct an intubation, cricothyrotomy or titrate the medication to the correct dosage? The answer is prob- ably very clear. Conversely organizations might consider looking beyond the medi- cal workforce to fill this vital vehicle life support task. A qualified and experienced fleet manager may just be worth the fuel, downtime and mechanical trouble that you will be saved. As an industry we are good at letting staff "have a go" at the non-clinical tasks, hoping that we will cope. The evi- dence suggests we should employ a fleet pro- fessional to drive our success and manage the resource that we rely so heavily on to deliver excellent patient care. ABOUT THE AUTHORS Dan Fellows joined the Richmond Ambulance Authority in 1995, where he has amassed two decades of emergency vehicle maintenance and design experience. He is a graduate of the Nashville Auto Diesel College, a licensed Virginian State Inspector, and a Stryker, Excellence and Ford factory-certified technician. Rob Lawrence, MCMI, is chief operating officer of the Richmond Ambulance Authority. Before coming to the USA in 2008 to work with RAA, he held the same position with the English county of Suffolk as part of the East of England Ambulance Service. He is a member of EMS World's editorial advisory board and host of the Word on the Street podcast. For More Information Circle 18 on Reader Service Card Fleet manager Dan Fellows conducts checks during a preventive maintenance inspection.