Inter-facility transports

[spenac]

In my county we can to inter-facility transport but only if the patient requires or has the potential to require ALS care. Otherwise we have BLS services that can do the transfers instead. We can transport burn patients from an ED to a burn center, OBs to a delivery center, etc. However we can only transport within our county or to neighbouring counties. We don't do long-distance transfer. I have come to notice that it differs in a lot of EMS agencies as to how they handle interfacility transports. I suppose it depends on your resources, how rural your area is, and what the need of the patient is.

Now you are right there are a few things that require ambulance, but most that you would allow BLS to take would be fine in a Taxi rather than an ambulance.

[NREMT-Basic]

I have to admit that it left me scratching my head for a few minutes of re-reading the thread too. I thought I had missed something. But, what I finally got out of that post was that he was simply comparing the "If we only had ALS" argument to the other poster's argument that, "If she had been in a taxi, she would have needed an ambulance." I think he was just reinforcing the "what if" theory, and not specifically introducing an ALS element to it.

Oh DustDevil...youre the only one who truly understands me....swooooon :twisted:

[eroemmich]

That's what i meant by a few ambulances, we had the ALS/911 rigs, and the BLS rigs. BLS did "grandma" transports. And ALS did their job. And I was the driver, I only did the L/S to get a couple of cars out of the way, because as a good emt would know, the l/s would make the pt more confused. And I do consider myself a good driver, not perfect, but them not all persons are perfect. The pt's blood pressure went up and she turned white as a ghost. And I know she didn't go home a half an hour later, because my partner had to help with a cardic pt that came into the hospital as we were trying to leave.

[spenac]

That's what i meant by a few ambulances, we had the ALS/911 rigs, and the BLS rigs. BLS did "grandma" transports. And ALS did their job. And I was the driver, I only did the L/S to get a couple of cars out of the way, because as a good emt would know, the l/s would make the pt more confused. And I do consider myself a good driver, not perfect, but them not all persons are perfect. The pt's blood pressure went up and she turned white as a ghost. And I know she didn't go home a half an hour later, because my partner had to help with a cardic pt that came into the hospital as we were trying to leave.

Again this one instance that still may be blown out of proportion is no basis for hauling all people in ambulances. Are you going to start coming and driving me to work because I might have a heart attack on the way? There is no justification, it is a waste of taxpayers money.

[brentoli]

And I was the driver, I only did the L/S to get a couple of cars out of the way, because as a good emt would know, the l/s would make the pt more confused.

So, you only used it for part of your trip?

[Niftymedi911]

The county I work for is primary 9-1-1 response and all inter-facility transfers within Lee county.

We are currently in the process of setting up the different divisons within EMS for Lee county.

Division I: ALS primary 9-1-1 ( I want to see dual medic units) but Admin wants Medic/EMT response.

Division II: Inter-facility BLS transfer division. Dual EMT units for non-911 transfers.

I personally believe this is the only way to keep EMS, EMS without showing people were a taxi.

The NET's ( I think close to 18 different transport companies in the county) cover the rest of the spectrum... no wheelchair vans for me..

Reguarding IFT's if its going to keep my paycheck coming and a job every shift to work, I'm peachy But that doesn't mean I'm completely happy with it either. I really want EMS just to be EMS without the BS in between.

The IFT's are our cash cow. Last year for 2006 we collected over 4.6 million in user fee's from Lee Memorial Health System (the only hospital system in Lee County) for the transfers. We're in the do everything we can mode so the county doesn't cut us due to budget cuts. EMS last year had a budget of 22 million. We re-couped 15.6 million of that 22. We have a very aggressive billing department. We outsource our billing to ADPI Processing.

[spenac]

The IFT's are our cash cow.

Exactly it robs innocent tax payers of money that could be used so much better. It would be much cheaper to give medicare granny a taxi voucher than what the cheapest "ambulance"( I use the term extremely loosely ) can provide a ride for. This is sadly mostly legal fraud caused by the way medicaid, medicare, and even many insurances word policies. If this abuse was stopped they could afford to pay us at least a decent amount of what a 911 transport costs.

[Niftymedi911]

In order for us to accept a transfer, a signed waiver of necessity must be signed by the MD.

Spenac, I'm not dissing you or trying to play dumb but can you please clarify how we're robbing tax-payers money when we're providing a service in which no on else in Lee county can?

And when I mean IFT's I stating only transfers from hospital to hospital in which most are a mixture of ALS and BLS. The rest are handled by NET companies. We don't touch them.

I also want to add we are starting a taxi voucher pilot study sometime soon( unknown when). For those stubbed toes at 3 am or the fractured 5th digit finger from a trip and fall. It has been talked about immensely in the past few months.

[eroemmich]

So, you only used it for part of your trip?

Yes, due to the fact that we had a pt that was already hyper and there was only a few cars blocking our way. it was a short burst of Siren as to not scare the pt to much.

[eroemmich]

our company has three services under the term 'ambulance' .....911/ALS, your normal run of the mill ambulances. .....BLS/Inter-facility to do the transfers.... and Wheelchair to due, well that should be self ex.