What is an acceptable refusal/no transport percentage

[Just Plain Ruff]

GA Medic, bash me all you want, you just post things and stir the pot and then get mad when someone disagrees with you.

I am also not a democrat as I back up my arguments with valid points yet you only back them up with refusing to post names of services.

I have been working in the business a lot longer than you and am not new. If you would have read my previous post you will see my experience laid out.

I also have worked in 2 separate er's, I consult with ER's that would dwarf your hospital in size.

So before you slam me and call me names you had better get your facts straight or just be quiet.

[GAmedic1506]

Like i said, i am still waiting on your facts, and if you read above, you will see who attaced who first.

[Ace844]

Like i said, i am still waiting on your facts.

Who are you addressing? Ditto on your response to you....

ACE

[Just Plain Ruff]

GA medic, step away from the Kool Aid. You come here posting facts but refuse to divulge what services have a 50% refusal rate. You sir are the one who refuses to give hard facts. You also need to re-read who personally attacked who first. I told you to back up your supposed facts with cold hard facts yet you started the personal attacks.

Let's see Here is my list and maybe you will have the kahonas to respond with your services.

MAST KCMO less than 50% refusal rate (per a medic there)

AMR Independence MO, about 12% no transport (per a in-law that works there)

Golden Valley EMS - Clinton MO I used to work there and I know their numbers - about 5% no transports

Bates County EMS - Butler MO Less than about 10% (I also used to work there)

Windsor EMS - Windsor MO runs 200 calls or so a year and their no transport rate is less than 5 percent.

So GA, I've named the services I know of, I can also get figures from colorado springs, miami, New York City and others.

So name your figures or stop posting figures you cannot back up.

[whit72]

As far as the original post.

In my experience we have a higher incidence of refusals then some other areas

Urban areas in my opinion will show a higher spike in refusals for the simple fact, the pt or injured party is rarely the one who calls 911.

So you have bystanders or neighbors witness something and call 911. A person might be changing his oil under his car someone will see him, call 911 and state he was run over.

We have a large amount of homeless people, they sleep in certain areas, if someone drives by and See's this person lying on the ground they call 911 and state someones passed out on the street (PLO). We still have to get a refusal

There is a little fender bender, before the police arrive 30 people have called 911, on your arrival there are no injuries we still have to fill out refusals.

The list goes on and on.

Depends I guess on what your service requires of you. If we make pt contact whatever the reason there needs to be a refusal, if we dont transoport.

In a suburban/affluent area you don't have those, at least such a high incidence, usually the person will wait until they are critically ill before they allow anyone to call 911.

[EMS49393]

Ugh, I have a simple question myself for you GAMedic. Are you illiterate or lazy? I would guess it's not the first since you're giving headaches with nearly every post you write. I went through six or seven of the links posted for YOUR reference and finally found one that had some numbers associated with it. That took me all of about 10 minutes, and that's on the slowest computer still in existence.

According to one link given by our friend and respected colleague, Ace, a study in Toronto put the no-transport rate at between 2.0% and 9.0% in the time frame they were conducting their study. I know very little about Canadian EMS, so I have no idea what service they were looking at, however logic would dictate they were studying their very own community EMS there in Toronto.

I don't know about anyone else, but 9.0% is way different then 50% or even 36%. Toronto a rather large urban area as well. I would hazard a guess that the numbers there would be close to our own urban numbers. I work for a moderate sized urban area in the Midwest, and based on the calls I run, and hear being run when I'm on shift, I would guess our no-transport rate would be less then 15%, and that's in the city. Our rural areas transport nearly every patient that calls 911.

So there you go, I've managed to do the work for you and get you a set of numbers to correlate with a service area. I have to agree with everyone else here, be prepared to back up the large numbers you put out there. I'm sure if you had written proof that Washington D.C., Baltimore, MD, Detroit, MI, and many other rural cities have exceeding high no-transport numbers, it wouldn't be a surprise to any of us. It's not service slamming, it's bringing attention to a problem. Exceedingly high no-transport call volume means there is a problem somewhere in the system, either with the patients themselves calling, then refusing to accept help, with providers that do not want to transport, or even with poor public education on when to call 911. Bottom line, don't let your mouth write a check your brain can't cash.

Please pardon the poor flow of this post, as I'm writing it rather hastily at work, waiting for my next no-transport call to come in!

[GAmedic1506]

Yes, i saw those numbers and thanked the person who sent them, but as you stated those are canada numbers, i was hoping for some recent US numbers.

[Just Plain Ruff]

GA read my post, I posted 6 services and their refusal/no transport rates. Please read my posts before you come here saying you are waiting for figures.

How many more figures do you want. I posted mine, please post yours or are you going to hide behind "not wanting to embarass the services"

[paramedicmike]

I am sorry, I will not slam another service by name, especially behind their back, in a forum.

Why would it be slamming? Don't you think it would be good to know that a service has a refusal rate pushing 50%? Don't you think that maybe there's a greater issue here if a service has a refusal rate that high? Don't you think that getting this information out would be doing a public service to people who live in that area?

If this is, indeed, factual information (which, by the way, you haven't been able to prove) then there is no slamming a service to post the info.

And if you're concerned about it being behind their back, then use your name!

If you are not aware of services who have a percentage this high, you must be new to the business, work for a private service, or work in the rural west.

Nope, nope again, and nope a third time.

You are also obviously a democrat, in that you can not argue anything of substance, but rather find a way to slam others so that you can run from the issue.

And you must be a republican for your innate ability to throw numbers around with no proof of what you're talking about. Then, when questioned as to the source and accuracy of the numbers your providing, cry "foul!" and question the intelligence and motivation of the others in the discussion.

If you post numbers, *YOU* are the one who needs to support them. I shouldn't then have to do research to verify the info you mention. That's your responsibility. Any basic high school debate, or writing class will teach you to reference your sources. You did go to school, didn't you?

If you do not like my posts, then simply ignore them.

I'm not questioning your right to post. I'm questioning your motivation, information source and debate skills by calling you on unsubstantiated numbers.

And so far, neither of you "fact lovers" have introduced your own stats, which was what I originally asked for.

My full time job has less than a 1% refusal rate. When I started there I asked about the refusal process for paperwork purposes. The reply I got was, "Gee, I'm not sure. Talk to so and so. He had the last refusal. That was what? Two...three years ago?" Granted, this is a hospital based flight service. But I don't know that the type of agency applies. Any patient can refuse whether you're 911 or interfacility.

My two part time jobs (both strictly 911) are between 3% and 5%. Both part time jobs are in a heavily populated urban area in a neighboring county to a major east coast metropolitan area.

As usual, when you have nothing to contribute, you attack the author like a juvenile.

You're not contributing either. Not until you provide proof as to the numbers you referenced regarding a 50% refusal rate. And I'm willing to bet that you can't do it.

If you can provide proof that "many 911 systems have non-transport rates >50% (usually urban)" then this will all dissolve and go back to a conversation regarding refusal rates. But until you can do that you will continued to be called on the source and accuracy of your information.

And I still maintain that if your service has providers who, for several months, see a greater than 30% refusal rate there is something inherently wrong with either your system or your providers. And that does nothing but contribute to the greater issues EMS has with being considered a respectable profession.

[GAmedic1506]

To everyone, I apologize for my previous comments, as that was very immature. As far as the need to talk about other agencies behind their back, that is just something I will not do. If they wish to divulge or discuss their numbers, they will when they read this post. It is not my place to fix any service but my own, nor is it my place to "dog" a service that is struggeling. If there is anyone out there that does not believe there are 911 services with no transport rates near 50%, then my naming of them will not convince you. But I can assure you that there are services in GA and Florida with rates that high.

I will answer anything about my own service, though. My service is a 911 provider near but not in Atlanta. We average a 28-32% refusal rate, depending upon the month of the year. To reduce the liability in said refusals, we created pre-printed home-care instructions (illness/injury specific) that we leave with the patient. The purpose of my question was to learn what others are doing, not to call-out or punish those who do not meet my or your standard. If my failure to talk about others behind their back loses me points with you, then so be it. Either way, it is time for this to get back on the professional level.