Weren't we just talking about this? "Delayed ambo respo

[Richard B the EMT]

DUDE! Do not *ever* confuse me with WendyT, who is a Canadian. I am Eydawn. My real name is Wendy, and I sign my posts as such.

As I can get confused, too, that is why I only respond to the on-line names.

Richard B.

[Amhet1]

You would think I like the taste of shoe leather with the amount of time I sit here with my foot in my mouth. :shrugs:

[coloradoems]

I worked for DG back in the late 90's under Gravitz's watch. The service has always been destined to fail and puts patients in harms way.

Besides the "hazing" before you got your patch

Besides the way management allowed sexual discrimination

Besides the harrassment from the training folks

Paramedics at DG were FORCED to:

Double load patients from 2 different calls

Administer sublingual Narcan and walk away from Overdose patients

Drive like a madman to make unrealistic response times

Dump patients at the ED without proper handoff resports

Handle ALL the EMS calls with 7,8,9 buses on in the city

Refuse care and transport to patients due to overload

IMHO - The entire Division needs to be flushed, the Medics and Management need to be flushed.

Start over as a 3rd service under the Fire Department with a dedicated BLS contract with one of the privates to handle BLS calls.

[JakeEMTP]

Start over as a 3rd service under the Fire Department with a dedicated BLS contract with one of the privates to handle BLS calls.

](*,)

[Eydawn]

Say what? Meld with Denver FD? Denver FD doesn't want that! (At least on the personnel level...)

Waitaminute... isn't that kind of what is in the works? Anyone else confused?

Wendy

CO EMT-B

[n0ssb]

911 response times

Health center twists ambulance response times

The Denver hospital understates its ambulance response time, resulting in a breach of its city contract.

By Christopher N. Osher

The Denver Post

Article Last Updated: 06/06/2008 06:25:06 AM MDT

For the past four years, Denver Health Medical Center has failed to comply with its city contract because of changes in how it calculates its response times for emergency ambulance service, hospital officials said Thursday.

A paramedics union official said the shift in reporting standards allows the hospital to vastly understate the actual times it takes ambulances to arrive at emergencies after calls for help.

"No change they have made since the inception of the contract has been to the benefit of the citizens," said Bob Petre, president of the union, IAFF 3634.

"Every change in the calculation or measurement has allowed the hospital to provide poorer-quality service."

Hospital administrators did not respond to calls for comment. In a prepared statement, they said that officials in the city's safety department signed off on the changes in 2004 but failed to make them official by re vising the contract the hospital has with the city.

The statement did not provide the names of any city officials who agreed to the change.

Denver's manager of public safety, Al LaCabe, who also held the job in 2004, said the hospital's admission Thursday is the first time he has heard that the hospital changed the way response times are calculated.

Shaun Sullivan, an assistant city attorney who handles the Denver Health contract for the city, said he recalled some discussions leading to revisions in how response times were measured but could not remember the specifics.

The news comes as Denver City Council President Michael Hancock is suggesting the city should explore whether to bring paramedics into the city's Fire Department.

The contract states that paramedic response times are measured from "when the EMS dispatcher receives the call from the call-taker or from the Police or Fire Department" to "when the ambulance arrives on the scene."

Petre said that in 2004, the hospital started calculating paramedic response from the time an ambulance is assigned.

He said the shift dramatically undercounts the actual response time because all of Denver Health's ambulances are regularly in use. That means dispatchers must wait for one to come free before it can be sent to the next call. Significant delays result, Petre said, and those aren't reflected in the way Denver Health has been calculating response times.

"They routinely run out of ambulances," Petre said.

Denver's Health's new way of calculating response times was first reported this week by Westword. KMGH-TV, Channel 7, has also reported extensively on Denver Health's ambulance service.

Impact on compliance

The way ambulance response times are calculated affects the hospital's compliance with performance standards specified in the city contract.

The contract with Denver requires the hospital to get an ambulance to an emergency within 8 minutes and 58 seconds, 85 percent of the time. The hospital reports that is exactly the current response rate.

The hospital, in the news release, said the change in how response rates were calculated allows the hospital to calculate performance the same way the Fire Department does, which would allow for a more comprehensive evaluation of emergency medical services in the city.

The release added that a new software system does not calculate response rates as had been done previously.

But Petre said the Fire Department, which dispatches emergency medical technicians, who provide more limited care than paramedics, never has all its firetrucks or vehicles in use at the same time. If a fire station is overwhelmed responding to a medical emergency, then personnel at another fire station will immediately be dispatched, so there is no delay.

"This discrepancy was not intentional, and we are surprised that it remained undiscovered until now," said Stephanie Thomas, the chief operating officer at Denver Health, in the release.

Questions on service

The news of the discrepancy comes as Denver City Council members increasingly are raising questions about the hospital's paramedic services.

On Wednesday, during a meeting with the hospital's administrators, several council members repeatedly questioned the hospital's performance.

They also cited complaints from unnamed paramedics concerning inadequate equipment, lagging response rates and poor performance.

"The number one thing that I'm most interested in is that the citizens of the streets of Denver should have the confidence in knowing that if something happened to them or a loved one, they should have the best and fastest response for emergency care," Hancock said at the meeting, which Denver Health's chief executive officer Patricia Gabow also attended.

Christopher N. Osher: 303-954-1747 or cosher@denverpost.com

[Amhet1]

Thanks for the article, n0ssb! I copied part of it to my response times poll (with credit to you, of course)

Its sad really... DH Paramedics sounds like a typical FD run EMS.... If it were to go to Denver FD..... well, I guess it cant get much worse....

I guess it would be best to rebuild them as a separate and distinct 3rd service but it would require the EMS side to strip down and completely rebuild to completely change the mindset and image of the service. Your "typical" hospital based EMS functions well because it has the support of the administration and enough subject matter experts to turn to. That doesnt ensure success as in the case of DH. THough I havent looked too hard, but I havent seen anything derogatory about Wishard in Indy.

The other option is to rebuild the entire system as a PUM. Unfortunately, a PUM is the most expensive way to operate an Emergency Response System. The positive aspect is that the contractor has to meet strict standards and either lose money thru fines or risk losing the contract completely. AMR, Pridemark, ActionCare are all positioned to step up. The system has to be designed to minimize the current issues being seen in Tampa. The FDs are now sending multiple units on medicals. This is an issue that the the Emergency Manager for Pinellas Co has to deal with. There are also FDs that are pushing for their own EMS and leave the indigents to SunStar (as is the case with WestMetro dumping their boring, BLS, or indigent transports on ActionCare).

As you may notice, Im not a big fan of FD provided EMS. Most FD/EMS programs are stark and dismal failures. Many agree that EMS and Fire are very different creatures. The biggest problem is that EMS often falls under operations and there is little support from above. For EMS to work within a FD structure, EMS has to be a separate division that answers only to the Chief of the department, and even then, if the Chief doesnt have experience in EMS administration, there may still be little support.

[Don1977]

Pittsburgh just had a problem with this, slow times, but I am not surprised by this, I will just leave the comments to myself about Pittsburgh EMS.

[jackdemolay]

Allow me to clear some things up about Denver Health. First off it was not made part of the housing department. Denver Health was separated from the rest of the city into an authority, much like the denver housing authority is. Denver Health is it's own entity. for coloradoems I will reply to each of your scurrilous accusations:

Besides the "hazing" before you got your patch

Besides the way management allowed sexual discrimination

Besides the harrassment from the training folks

None of these things occur any more. The previous, Gravitz regime allowed some of this to occur. the current Chief and his team don't. At all. Which is one of the reasons there was a change in leadership about 4 years ago. You should re-apply and see the changes for yourself

Each of the following are lies. No other way to put it.

Paramedics at DG were FORCED to:

Double load patients from 2 different calls Never FORCED to do so. In some cases it has been allowed to happen

Administer sublingual Narcan and walk away from Overdose patients Never forced, nor allowed to happen. Lie!

Drive like a madman to make unrealistic response times Never forced anyone to drive a certain style, for any reason.

Dump patients at the ED without proper handoff reports "proper" as defined by whom? FORCED, NOT!

Handle ALL the EMS calls with 7,8,9 buses on in the city There haven't been this few buses on the schedule for almost 10 years!

Refuse care and transport to patients due to overload No one has ever been denied care or transport for this reason, let alone forcing employees to behave in this manner.

For a clearer and more concise response to all the recent articles/stories in Denver go to http://thetemplarofdg.wordpress.com/ . Of better yet, apply and see for yourself. Lastly I will say this- Morale be it high or low is something that while impacted by actions of others is largely a reflection of how each of us feels about our particular situation. So for someone to blame all of someone's morale on the actions or lack there of on administration is BS, INHO.

[CBEMT]

Start over as a 3rd service under the Fire Department

Contradiction in terms.

FAIL.