(DeKalb County, GA) – After a thorough analysis of the DeKalb County Emergency Medical Services (EMS) system, AMR leaders and DeKalb County have finalized an agreement to address EMS system enhancements and have identified contract structure changes. The changes reflect the impact that the tremendous growth in the area has had on response times as well as the ability to recruit trained paramedics.
“We appreciate the firm leadership of DeKalb County CEO Michael Thurmond and his entire team. The commitment and diligence of Fire Chief Fullum and DeKalb County Fire Rescue permitted us to address the critical issues in a collaborative fashion and make the appropriate changes to further strengthen ambulance response in DeKalb County,” said AMR President and CEO Ted Van Horne. “We also greatly appreciate the community’s patience while we conducted our review. Getting to the bottom of the root causes and developing system changes required an exhaustive analysis. There was a great deal of data to sift through to fully understand the complex situation and recommend solutions that would best serve all the citizens of DeKalb County.”
AMR Regional Director Terence Ramotar pointed out that DeKalb County has grown at a rapid pace due to progress and innovation by its leadership. With that, he said, comes the additional challenges that we all need to work through – traffic, congestion and increased population and its demands.
Through a two-month analysis of response times in context of the current EMS system taking into account the wait times at hospital emergency departments and staffing levels, AMR identified key issues that affected response times as well as ways to address them:
- Increased strain on emergency departments was a primary factor. When hospitals had significant numbers of incoming patients from the EMS system, AMR ambulances and crews were tied up at the hospitals waiting to release their patients and were therefore not available to be dispatched for calls. Data analysis found that the longer wait times in emergency departments often resulted in ambulance shortages. In May 2018, for instance, hospital delays reached an all-time record: more than 96,000 minutes, or 1,600 ambulance hours, were out of service with patients waiting to be placed into the next available bed in the emergency department.
- Region-wide paramedic shortages for AMR and DeKalb County Fire Rescue were also an issue. To address this issue, AMR invested in long-term staffing solutions and has initiated an in-house paramedic training program that currently has 15 students in the class. AMR also spent more than $830,000 in additional staffing and committed $60,000 to invest in training to develop future paramedics who will ultimately work in DeKalb County. In total, AMR will have committed nearly $1.89 million above and beyond the current EMS system design requirements.
AMR is also working with DeKalb Fire Rescue to make contract changes to address how the issues affecting response times are evaluated going forward. When the contract was written, those issues were not present. Prior to July 2017, the EMS system and its expected time standards were built around previous trends and industry standard of 20-25 minutes to complete the transfer of patients to local emergency departments. AMR and DeKalb County Fire Rescue reviewed these numbers, and AMR agreed to pay $596,000 in liquidated damages under the current contract.
Ramotar added that the current EMS system is severely affected by these unexpected, untoward trends, and there is no funding to account for this out of service time. However, he noted that because the County designed a dual-response system, every patient receives care by a DeKalb County first responder within minutes while the closest available ambulance is dispatched. This system ensures that every patient is cared for immediately and allows time for transporting ambulances to return available.
“Our focus has remained steadfast on serving the citizens of DeKalb County,” Ramator added. “We are extremely proud of the critical work the men and women of AMR do in partnership with DeKalb Fire Rescue, day in and day out. In a tough job such as this, good work and good outcomes often go unnoticed. For example, just a few weeks ago, we responded to a child in cardiac arrest in Dunwoody. These are the types of calls that hit all of us hard, especially those of us who are parents. I am glad we were there to help and to know that that someone’s child survived and is one the road to recovery. That’s what we’re here to do.”
Ramotar said he is pleased that the issues have been identified and that a clear mitigation plan has been established. He further said AMR looks forward to continue its work with DeKalb Fire Rescue in service to the citizens of DeKalb County.
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About American Medical Response
American Medical Response, Inc., America’s leading provider of medical transportation, provides services in 40 states and the District of Columbia. More than 28,000 AMR paramedics, EMTs, RNs and other professionals work together to transport more than 4.8 million patients nationwide each year in critical, emergency and non-emergency situations. AMR also provides fire services through Rural Metro Fire Department, www.ruralmetrofire.com. AMR is a subsidiary of Global Medical Response, www.GlobalMedicalResponse.com. For more information about AMR, visit www.amr.net and follow American Medical Response on Facebook @AMR_Social on Twitter and Instagram.