Steve Kelman reports on a creative solution that could save lives in crowded emergency situations.
In 2016 I wrote about a fascinating innovation in the French railway system, which had started placing pianos in many big train stations and simply inviting members of the public passing by to play tunes on them, resulting in an improved customer experience. What struck me, I wrote then, was that the French railroads are a stodgy government bureaucracy – if there could be innovations there, there also could likely be innovations from anywhere in government: frontline government officials should be looking for analogous opportunities in their organizations.
Then last summer I wrote about an ingenious “out of the box” solution to a contentious problem involving what should be done with the many old statues around the country of Taiwan’s former dictator Chiang Kai-shek, which some wanted to respect and others wanted destroyed. Some anonymous government official came up with an innovative idea for what to do with the statues: take them away from their previous locations and move them to a new park, specifically devoted to Chiang statues. Chiang haters wouldn't need to see them anymore. Chiang fans could visit the park and pay their respects.
And that's what the government did. Another example of innovation coming from inside government.
Recently I came across an article in The New York Times by reporter Jan Ransom, titled “Pint-Size Emergency Vehicles Fit Through Jams That Block Ambulances.” The article discussed an initiative the New York Fire Department started last year to field “gator utility vehicles,” similar in size to a golf cart, manufactured by John Deere, and equipped with a defibrillator and other medical supplies -- to allow faster emergency medical response on the increasingly congested streets of Manhattan. (Traffic in Midtown has slowed by 23 percent in the last decade, and the average vehicle speed is down to 4.7 miles an hour; it often takes an ambulance 10-15 minutes to cross from one side of Times Square to the other.)
The basic idea is that these smaller vehicles can snake and weave through more narrow openings between other vehicles and respond to emergency calls faster than ambulances; they can also fit in a bike lane.
The fire department has set up an eight-person “gator unit” in the Times Square area between 42nd and 48th Street. The average response time, from dispatch to arrival at the emergency location, is 3 to 4 minutes. The reporter following the gator squad one day reported that, “with just a half a block to go, the gators were stuck in traffic, but the driver quickly found a space between a bus and a car and squeezed through.” The director of emergency medicine at Mount Sinai Hospital was quoted as saying, that “patients who are having a life-threatening emergency like a heart attacks, arrhythmia or a stroke – these are very time-sensitive conditions. A delay of even a few minutes can be the difference between life and death.”
So where did this idea come from? With the help of the author of the Times article, I got an email address for the head of communications at the Fire Department and contacted her. To my surprise, what came back was an offer to talk with the Commissioner Daniel Nigro himself. Nigro has been commissioner since 2014, brought out of retirement from a previous position as chief of department, the senior uniformed position in the NYFD.
It turns out the city had been buying these vehicles, for different purposes, as early as 1999, when they were acquired to help out with a New Year’s celebration and then later with patrolling beaches in summer. Their main purpose was to allow patrolling in crowded, cramped public spaces, but they could also be used for medical emergencies. Nigro knew about these uses due to a lifetime of experience rising through the ranks of the department, where he had started as a firefighter in 1969.
Then last May a terrorist plowed his vehicle into a crowd of pedestrians. Observing the scene, Nigro thought about how difficult it could be for ambulances to get through the streets in an emergency. He combined his various experiences and came up with the idea of using gator vehicles for congestion. Basically, the gator unit was his idea.
I was surprised to learn that the initiative for this came from the commissioner himself. To put it mildly, not all senior leaders are so interested in operational issues close to the ground, often preferring grand statements and generalized initiatives. It reflects well on Commissioner Nigro that he was involved -- also indicated by the fact he talked with me about this himself, rather than leaving the conversation to his public affairs team.
Nigro is a model for leaders whose organizations actually produce a product, be they Department of Veterans Affairs hospitals or military units. The frontline people will understand the importance of operational performance better if their leaders do.