Austin EMS in the news

[Guest guest]

New tool keeping EMS rigs on the move

System tells supervisors where ambulances may be needed to fill in gaps.

By _Tony Plohetski_

(http://www.statesman.com/news/content/news/stories/local/2009/10/05/mailto:tplo\

hetski (AT) statesman (DOT) com)

AMERICAN-STATESMAN STAFF

Monday, October 05, 2009

Regier, a communications captain for Austin- County Emergency

Medical Services, faces a computerized map showing the whereabouts of each

of the agency's 30 ambulances, their locations flashing as they move from

one place to the next.

Within seconds, she relays to paramedics awaiting a call a

computer-generated message that they should shift from their assigned post to

another

location — an effort to make sure that, at all times, Austin has ambulances

evenly proportioned throughout the city.

" It's a huge tool, " said Regier, whose agency began using the new

technology in February to help dispatch supervisors see gaps in ambulance

coverage.

Officials say that since then, EMS has met its goal response times for the

most serious calls in the city — those that include strokes, heart attacks

and traumatic injuries — for the first time.

Medics, some of whom have expressed skepticism about the new system, have

long aimed to respond to critical calls within 9 minutes, 59 seconds 90

percent of the time. Officials said they also expect to end the year meeting

that agency-set goal.

" We're very excited about that, " Assistant EMS Director and chief of staff

Shamard said. " We think we are doing it right. "

According to EMS officials, the technology uses statistics from previous

calls in various locations at different times of the day to predict where the

next emergencies could be. Based on that information, the system tells

dispatch supervisors where ambulances may be needed to fill in gaps if medics

assigned to the area have already responded to other calls.

EMS union officials also credit the new technology in part for reducing

response times. However, they said they fear that EMS officials are relying

too much on the system to plug holes in places where more ambulances and

paramedics are needed.

EMS has received no new ambulances in two years and no new medics in a

year. This year, the agency had seven available positions, but they were frozen

in a midyear budget move.

Meanwhile, the number of calls increased about 3 percent from 2008 to

2009.

Whether using past calls to predict future emergencies leads to better

responses has been a matter of debate among EMS systems in recent years.

Dr. Bledsoe, professor of emergency medicine at the University of

Nevada School of Medicine, said he has seen no studies supporting the use of

such technology.

" It looks good on paper, and they have tried really hard with statistics to

make it look good, but there is no evidence it makes any difference on the

street, " he said.

However, Jay Fitch, a founding partner of Fitch & Associates, a national

EMS consulting firm, and a former EMS director in St. Louis, said, " This is

very good common sense and risk management principles to achieve the best

possible outcome with the given resources. "

EMS union officials said other factors may have contributed to the agency

meeting its goals. For instance, EMS officials recently reduced the number

of emergencies that are considered the most serious.

Shamard said that change has given the agency more available ambulances for

the most critical calls — ambulances on their way to less serious calls

can be rerouted to more dire emergencies under agency rules.

Steve , president of the Austin- County EMS Employees

Association, said union officials also are concerned about the frequency with

which medics are being required to leave their home stations and move to a

temporary base, decreasing the recovery time they have between calls.

Temporary bases could be anything from another EMS station to a shopping

center parking lot or street corner, said.

" We agree there is a definite advantage to using these systems to help

deploy units, " he said. " We just understand it's not the only answer.

" There is a cost to that as well, " said. " We are moving the trucks

more, and we are putting more wear and tear on the individual medics. There

is an ongoing burnout cost associated with it. "

According to EMS statistics, the agency has moved an average of three

ambulances each day since February. Officials said they do not know the average

distance of each move.

Shamard said officials have not yet begun tracking the number of times a

relocated ambulance responds to a call, although he said it happens

frequently. And he said they have only recently begun tracking the number of

times

an ambulance missed a call in its assigned territory because it had been

sent somewhere else.

Shamard said dispatchers try to send medics to other EMS stations when they

need to shift their locations. He said crews are generally assigned to

another station for less than an hour.

Still, such movement can affect paramedics, said Guy Haskell, executive

director of Emergency Medical and Safety Services Consultants, in Bloomington,

Ind.

" Anything that takes away downtime between calls is going to make them less

compassionate and burned out, " he said.

Shamard said EMS officials began using the technology as part of an upgrade

to the city's multimillion-dollar computer-aided dispatch system. There

was no additional cost to the city for the program.

In prior years, communications supervisors would sometimes shift ambulances

from one area to another when they thought an area had an ambulance

shortage. Officials said such moves were much less frequent before the latest

technology.

Shamard said the technology is not without flaws: Officials must still be

wary of medic fatigue and wear and tear on ambulances. Still, he said he

thinks the system has been useful.

" It has demonstrated, pretty dramatically, how it was able to put us in the

right place at the time. "

tplohetski@...; 445-3605