Monday, August 18, 2008

On the scene in 9 minutes flat or less

Another POD. This was on ambulance response times - a hot topic in St. Joseph.

St. Joseph News-Press

Vickie Pickett remembers a day when waiting for an ambulance could sometimes seem like forever. Now, sometimes they arrive before she’s ready for them.Ms. Pickett is a night medic at the Vintage Garden South assisted living center. She joined Vintage Garden South three years ago and remembers waiting several minutes with her elderly patients before an ambulance would arrive.

“I just called one not too long ago, and they were here before I had the paperwork ready for them,” Ms. Pickett said.
About three years ago, Heartland Regional Medical Center received numerous complaints from citizens and from the St. Joseph Fire Department about ambulance response times. Heartland officials decided to make some changes, and they hired Tom Little as the director of ambulances.
Mr. Little was notified of 59 different concerns that Heartland needed to address with its ambulance department. He says now almost all 59 concerns have been addressed, including the addition of two more ambulances and new ambulance-waiting locations in the city.
For a majority of the day, Heartland has four different ambulances on standby at various locations. They also have the help of the Fire Department’s first responders on every call.
Mr. Little said there is a great need for the assistance of the Fire Department to be on every call.
“It’s crucial to have them there,” Mr. Little said. “They can get there almost three minutes ahead of us.”
Although Fire Department responders aren’t allowed to transport patients, the extra time they are there allows for initial care and assessment prior to a Heartland ambulance crew arriving to take the patient to the hospital.
How quickly the Fire Department arrives at an emergency is important, because statistics show Heartland ambulances still are coming up short in one national standard. Heartland tries to get to life-threatening situations (also called priority one calls) in less than nine minutes 90 percent of the time.
From July 2004 through June 2005, Heartland responders made it to life-threatening scenes within nine minutes just more than 60 percent of the time. Since July 2006, Heartland has made it to priority one calls within nine minutes more than 85 percent of the time.
The goal is to arrive at priority two calls, or non-life threatening situations, in less than 12 minutes. They have met their priority two goal 100 percent of the time since July 2006.
Those numbers have made the job a little more difficult for the Fire Department.
“We’re really having to hustle to beat them now,” said Steve Daniels, chief training officer for the Fire Department.
Responders from the Fire Department often use firetrucks as their transportation to a medical call, which Mr. Daniels says sometimes slows them down. However, getting smaller vehicles doesn’t appear to be an option.
“We don’t have the space,” Mr. Daniels said. “A lot of the (fire) stations are single structure buildings that just don’t have enough room for an SUV or car for us to drive on medical.”
There is one truck and one sport utility vehicle in the entire Fire Department that get used for medical calls, Mr. Daniels said.
Mr. Daniels isn’t fond of the idea of sending out a $3.25 million piece of fire equipment on a medical call.
“We’re taxpayers too, and if there were a better idea, we would take it,” Mr. Daniels said.
Even with the expense, Mr. Daniels also feels the need for both sets of responders — the Fire Department and Heartland ambulance crews.
“The two people that ride in a Heartland ambulance may not be enough to handle the situation,” Mr. Daniels said.
The Fire Department sends a minimum of three people on a medical call, which can come in handy with multi-victim situations or serious wrecks, he said.
According to Mr. Little’s statistics, the Fire Department responders have met their goal of a six-minute response time 87 percent of the time since December 2007.
Mr. Daniels would like to see that number improve to 95 percent of the time. He’d also like all firefighters to become emergency medical technician (EMT) certified. Currently, about 70 of the 132 firefighters have that certification. Mr. Daniels said it is now a requirement for all new firefighters to be certified.
Another change Mr. Little made was to EMT certify all dispatchers who take the 911 phone calls.
When a resident calls 911 for a medical emergency, the call first goes to the St. Joseph and Buchanan County Law Enforcement Center before it is routed to Heartland to dispatch an ambulance.
“It’s important to have EMT-certified dispatchers, because if it’s a case where they have assessed by phone that a baby needs CPR, they can give the caller instructions to get it started before first responders even arrive,” Mr. Little said.
While there is still progress to be made, Mr. Little said the accomplishments of the ambulance department are great.
“Heartland gets no tax dollars to run its ambulance crews,” Mr. Little said.
The department runs off a $3.5 million operating budget each year and saw a $1.2 million dollar loss (expenses over patient fees) last year.
With high gas prices, Mr. Little said it now costs about $186 a day to fill each ambulance with diesel fuel.
Regardless of the cost and grief taken, both Heartland and the Fire Department feel they must continue to support each other.
“This town’s not big enough for two ambulance services, and the one it has needs everything it can get to continue running,” Mr. Little said.

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