When does your response time clock start?

[Chief1C]

I don't think it's possible to reach many locations in our coverage area in less than 8 minutes. I may take as long as 35 minutes to drive from the station to the scene. That is on a clear, sunny day; when it's snowing it could take close to an hour.

[Amhet1]

This is from an article on Denver Paramedics and the Hospital System..... (Thanks to n0ssb for posting this in the delayed response forum)

"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. "

My guess is there was 2 changes... They changed when the clock starts from when the call is passed to the dispatcher to a point where the dispatcher can assign an ambulance thus "improving" their response times by probably 2 minutes. What the story doesnt say is that they probably the end time as arrival "on-scene"..... which would eliminate any sort of vertical response time. My guess is that they used to have the end time as "at patient". As much as I know of downtown Denver, there are plenty of buildings that could have 5-10 minute times just getting from the front door to the correct floor.

From the street level medic, times are really only a few boxes on a form, but as you can see from the article those times can have far more impact on your service. Denver Paramedics response times are starting to look like the tip of an iceberg of far deeper problems....

[MedicNorth]

Response times here are calculated for the system from the time the call is received to the time that the crew arrives at the patient. If the sytem is in Code Red (all units busy) the clock continues to tick, so essentially the caller could accurately time it.

Individual crews and stations are also timed on their response time from the dispatch to arrival, but that is NOT an accurate benchmark. In cases where the service is provided under contract with specific time requirements, timing from dispatch to arrival is clearly cheating. If Joe Blow's Ambulance service has one unit, and is required by contract to provide one-scene response within a specific time, he could time it from whenever that unit was available, even if it was sometime next Thursday.

If Denver ambulances are that busy, it is clear that they need to expand the fleet.

[Amhet1]

There is a serious problem when they have 20 ambulances on the road ant any one time and cant respond to all the of the requests.

There are at least 3 other services operating in and around Denver County.

A logical thought is that Denver could farm out the lower priority calls to the privates and use their ambulances for the "delta's" and "echo's". Im sure the privates wouldnt have a problem with that.

DH is a non-profit, tax supported Hospital so they have no incentive to make any changes or improvements. They are also not afraid to run their staff into the ground and burn them out in very few years. There are enough young, testosterone-filled P school grads available to keep most of their vehicles on the road.

Just to add one more reason for DH's poor performance is the fact that Denver Comm is about 20+ FTEs short.... so they're trying hard to burn out the comm staff too.

[katbemeEMT-B]

When we do our PCR we include time our dispatch received call, time unit was notified, and enroute. We don't include time caller actually made contact with a dispatcher because many of our calls come from a different dispatch center. Our dispatcher is from the metro, but we service a rural area about an hour south. When we get our monthly call stats, it usually will include the times noted above.

[Amhet1]

CBEMT found this article on Denvers Response time problems.... makes for interesting reading

http://www.westword.com/2008-06-05/news/de...rgency-response

[thiswillbenothingkid]

Over here it is interesting to say the least.

Phone 999, the call is answered by a telecoms operator who asks which service you require and gets the callers number. The call is then put through to ambulance service, clock starts ticking at this point (before the ambulance service answer the phone)

If it is a category A call then there is an eight minute response target for 75% of calls.

The target in the control room is to answer most calls within five seconds, however if the call is not answered then the clever bit comes into play. If the phone call is coming from a landline then a geographical location can be matched to the call and a call apprears on the dispatchers screen. The nearest resource can be dispatched at his point.

Hopefully at some point in the next five minutes the control room will get the chance to see if an ambulance is actually needed and if there is a crazed knife wielding imbecile waiting at the other end of what can often be a lot less than five minute run to the scene.

To be honest it stinks, I would rather go to calls where we are needed than just be sent because someone can't figure out how to work a DVD player and to arrive before they realise that they should not have sent you in the first place.

As a result what we seem to be getting are genuine calls that are actually waiting for a longer time to be dispatched because they try to weed out the time wasters and to send [s:9d28ad5657]an[/s:9d28ad5657] [s:9d28ad5657]ambulance[/s:9d28ad5657] a car to the ones who need it.

[dahlio]

Some dispatchers will place the ambulance available on arrival at the hospital (not good).

Oh that's the best, when you call "at Hospital" and you walk in to the ER and your pager goes off for another. Did they really think we were available? Where's that bash dispatchers thread when you need one.

In the public's eyes, response time is from the minute they call 911 to when an ambulance arrives at their door.

In my service's eyes, it's from time of dispatch, which they wish to keep under ten minutes, and is done so on 90 percent of our calls.

[firedoc5]

What we considered as the start of our response time varied. If we were in the station the time started as soon as we were notified from central dispatch, which was through the PD. If we were already out central dispatch would notify by radio, many times while still on the phone with the caller. So basically it would be determined by when notified by PD. Most of those dispatchers were very good at getting us rolling before they hung up with the caller.

As for arrival times, if in the city( a little less than 20,000 at the time) it was rarely more than three minutes. But if it was in the county, or rural, it was never more than 15 minutes. We covered a very large area and had no substations at the time. At the far reaches of the county were a few coal mines which we were called to very often. We did our best to be there within twelve minutes. Since I've been gone I know they have established a few substations. Which I know probably dropped the arrival time drastically, but I don't know how much.

[defib_wizard]

Our dispatch is through the police dept. So we use their times. This is not always a good thing, as it depends what clock they are looking at as to what time you get.

example:

Dispatch time: 1301

Time en-route: 1303

Time on-scene: 1259

However there is a computer that tracks the response time if it is needed, it is hooked to the 911 system.