“No Available EMS”

No one really wants to read a bad story about some other EMS agency, but it isáeven worse to read a similar story about your own.á The purpose of this post is not to make Detroit intoásome EMSá”posterchild”ábut intended toáshed some light onásimilar problems that may be all too common at other locations as well.ááFor instance, I am sure that the Detroit EMS is not alone in being accussed of having their service underfunded and their resources understaffed.á I alsoáknow there are many other agencies out there paying penalities for “exceptions”á(calls outside the expected response time), but holding a call for an hour before dispatch as claimed by EMS workers in a Detroit Examier storyáis certainly not a common trait of a High Performance EMS.á Actions like thisáare certainly worthy of examination, however, the thing that hasáreally set Detriot apart right nowáis the realignment of its fleet áeffective January 3rd in response to the death of Gordon Mickey shortly before Christmas of 2010.

According to Detroit Free Press reporters ináan article publishedá in EMS World just today, the plan is to reallocate eight ALSá(Advanced Life Support) ambulances to Basic Life Support (BLS) units by reorganizing the Paramedic/EMT teams.á Jerald James, Detroit EMS Chief, said that the model “will help better address non-emergency runs” which can make up about 65% of theároughly 130,000 dispatches each year.á But in the same article, a “city paramedic”áwas said to have expressed concern that the wrong ambulances will end up at the wrong calls identifying dispatch’s difficultyáwith properly priortizing EMS response.á Interestingly, Detroit hadáalreadyáreorganized its EMS service back in 2004 by adding Echo units (paramedic equipped vehicles without transport capabilities) to its formerly all-ALS ambulance fleet but concern was expressed even back then that “tiering” the system to add Echo units and converting certain ALS units to BLS years ago was not an answer to increasing service.

While the specific case in Detroit may have many conditions or particular circumstancesáleading to their current status, the idea I want to spotlight is the not-so-unique idea of reallocation of staff and resources just to improve the emergency response statistics rather than looking more broadly to improve overall EMS response.á As David Konig, The Social Medic, describes the situation in his recent blog, downgrading certain 911 calls from ALS emergencies to BLS status is just “shuffling the deck” to improve response time stats in one category over another.á I believe he correctly deduces a major part of the answer by saying that “systems improve service and response through intelligent deployment.”áá

It is exactly that type of “intelligent deployment” that is the driving motivation behind the Mobile Area Routing and Vehicle Location Information System (MARVLIS) suite of products.á Using an agency’s own historical data, MARVLISápredicts future demand geographically highlighting most likely demand areas with 80% probability.á It is also the only system to dynamically predict vehicle response zones to calulate up-to-the-minute demand and geographic coverage based onávehicle status and location – even when moving!á This proven system has reduced response times, held growth in future spending, and improved the clinical outcome while working with EMS staff to improve operating conditions not squeezing productivity.

We would love to hear your comments or experiences on this topic, so pleaseáadd a comment below and check back often for future discussions.

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High Performance EMS

High Performance Emergency Medical Services (HP-EMS) systems provide effective clinical care promoting positive patient outcomes and community wellness while maintaining a focus on improving economic efficiency of the system.  This site is dedicated as a community seeking to increase agency performance by promoting useful information regarding the developing trends and improvements in the efficiency of delivering basic and advanced medical care in the field.

Comments
Joey
Static v. Dynamic: A Continuum of Cost
There are pros and cons with each model but the bottom line comes down to optimizing your EMS system and delivering rapid care within a cost efficient model. I have always worked in a drama series called "housewives of a static system" as well as in a nationally recognized dynamic system and I can honestly…
2014-08-26 06:31:07
David
Static v. Dynamic: A Continuum of Cost
John Brophy is that you.... If having a sustainable funding source , money for research, proper equipment like power cots, video laryngoscopes, state retirement, community education funding, and not eating and pooping in a gas station makes me Emergency. Then Rampart I need orders for a lobotomy. If running more calls to bill Medicare and…
2014-08-23 18:41:36
David
Is ‘SSM’ Still a ‘Bad Idea’?
If it's such a great idea why hasn't Fire Dept embraced it?
2014-08-23 14:19:25
Todd
Static v. Dynamic: A Continuum of Cost
David...I agree with John and Roger. EMS is a business and we've got to start treating it that way. The days of sitting around the station waiting for a call have come and gone. To be efficient you've got to be out in your service where the calls happen. This is the future of EMS…
2014-08-23 13:55:46
John
Static v. Dynamic: A Continuum of Cost
I thought Johnny and Roy retired in the 70's. People with a mindset like yours are what keeps the paramedicine profession from evolving like the other emergency services have. The definition of insanity...doing the same things over and over expecting something different to happen.
2014-08-23 10:53:29

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