24-hour ambulance shifts may cause fatigue, KC audit says

A Kansas City audit warns that 24-hour shifts for ambulance crews could cause worker fatigue and affect public safety, but it says such shifts are common across the industry.

“The fire chief should regularly evaluate ambulance crew workloads and consider staffing strategies that reduce the effects of fatigue on crew performance and safety,” said the audit, released Wednesday.

The City Council had requested the audit because of concerns that some 24-hour ambulance crews might be overworked. The city adopted 24-hour shifts for most ambulance workers after the 2010 merger between the city’s Fire Department and Metropolitan Ambulance Services Trust. Before the merger, only a few MAST crews worked 24-hour shifts. Most worked 14-hour shifts, with at least 10 hours between shifts.

Councilman John Sharp, chairman of the council’s Public Safety Committee, said the council was most concerned about fatigue among ambulance workers who were too often working back-to-back 24-hour shifts. Fire Chief Paul Berardi told the committee that practice was halted late last year and every shift must be at least 10 hours apart.

The audit did not examine whether Kansas City crews were overworked or handling too many calls. Instead, City Auditor Gary White said, the objective was to find out if 24-hour ambulance shifts are common nationally — and they are. But they may carry risks.

Although the issue has not been extensively studied, the auditors found a few studies linking long shifts with fatigue and increased errors.

Berardi said the current 24-hour shift is popular with many ambulance workers, and those who don’t want to work 24-hour shifts bid for 10-hour or 14-hour shifts.

Crews generally spend less than 30 percent of their 24-hour shift responding to emergency medical calls, he said, and there is time available to rest.

The department evaluates the 24-hour shift workload on a monthly basis and will continue to smooth out the workload duties, he said.