Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

EMS Needs to Grow a Pair – EMS Garage Video Podcast


 

Like procainamide, the EMS Garage is back.

Do we need to grow a pair, or do we just need to grow up and think critically?
 

Go listen to the podcast or watch the videocast.
 

Response times only seem to matter for patients in cardiac arrest, but that does not stop people from making a big deal out of response times – even criticizing excellent response times. This was discussed (at 29:50 of the podcast) –
 

Holyoke city leaders are sounding the alarm about delayed ambulance response times in the Paper City. This comes after an ABC40 investigation last February showed troubling ambulance response times in Springfield.[1]

 

What about those EMS response times in Springfield, Massachusetts? The response times were well within the specifications of their contract, but people were complaining. How did we in EMS handle that?

Suppose that I buy a car, then have a few more kids, and then complain that the car does not do what I want it to do – grow to meet my desires. People would call my complaint ridiculous, because that complaint is ridiculous.

Brendan Monahan of WGGB News Channel 40 began an investigation into the response times of the ambulance company in Springfield. The response times are actually very good, but why let that get in the way of a story? There is dihydrogen monoxide in the water! Don’t drink it!

I wouldn’t expect Brendan Monahan and WGGB News Channel 40 to make a big deal about a car that doesn’t expand to meet the desires of its owner.

Why not?

There are many people who understand enough about cars to realize that expecting a car to expand to meet my desires is ridiculous.

EMS is much less understood. EMS contracts can be very complicated..

The contract for Springfield does not require Springfield to pay the ambulance company to staff extra ambulances, so that imaginary response times can be met.

If Springfield wanted better response times, they could have specified those requirements in their RFP (Request For Proposals). Maybe they did and nobody was willing to supply an RFP that would meet more stringent response times. That is a problem with unrealistic expectations. People will tell you that the expectations are unreasonable, they will try to fulfill the expectations and fail, or they will lie.

The contract requires 95% of life threatening dispatches have a response time of less than 10 minutes. That is what Springfield and the ambulance company agreed to.

The investigation should be – What are the motives of the people investigating an ambulance company just before contract negotiations?

What is the ambulance company being investigated for?

For providing much better service than required by their contract.

This is one place where EMS needs to be very aggressive in correcting the misinformation being presented

Now there is criticism of the same ambulance company for the same thing – much better response times than required.
 

“We do realize that they do have a bottom line and their vested interest is a lot different than what the Holyoke Fire Department is set to do,” Menwer said.[1]

 

Menwer? Fire Commissioner Yasser Menwer.

It seems that the fire department wants the ambulance company’s jobs, but they can’t find anything wrong with the ambulance company, so they are making things up.

What was the result of the WGGB News Channel 40 investigation in Springfield?

The city council unanimously renewed the contract of the ambulance company.

In other words, everybody on the city council realized that the WGGB News Channel 40 investigation was nonsense.

What will happen this time?
 

Currently, 911 calls go to police, then an AMR dispatch center and if the dispatcher thinks a fire engine could help the call, they ask for one. Holyoke Mayor Alex Morse and the fire commission say before a new contract is signed, they want firefighters dispatching AMR ambulances.[1]

 

The fire department will be competing for the contract, but they should be the ones who dispatch the ambulances, so that they can affect the already excellent response times? Would it be a surprise if response times became worse with a competitor influencing response times?
 

“We will then be able to properly track using GPS that’s already installed in their ambulances to know where they are at at all times,” Menwer said.[1]

 

Of course, Fire Commissioner Yasser Menwer will also make sure that the ambulance company has the ability to track fire trucks at all times, because he is interested in being fair and not hiding anything. Right?
 

“They shouldn’t refuse it because if they are where they are supposed to be it should be a ‘no brainer’ and that is why I’m challenging them,” Menwer said.[1]

 

The article does not mention response times, but Scott Kier did. The ambulance company’s response times are excellent.

We can expect that ABC40 will continue to hide that information, because it does not support their story.

Much more important than response times is the care provided by EMS.

Who care how quick the response is, if the people responding are not great at providing emergency medical care?
 


Image credit.
 

Fast – Cheap – Good.

There is no criticism of the cost or quality of patient care.

Does Fire Commissioner Yasser Menwer only care about fast?
 

Go listen to the podcast or watch the videocast.
 

Go read what Scott Kier wrote about the WGGB News Channel 40 investigation of the ambulance company for much better than required response times in Springfield.

Emergency Response
February 28, 2013
EMS in the New Decade
Article

A Chat with Brendan Monahan
March 1, 2013
EMS in the New Decade
Article

An Open Letter to the City of Springfield
March 24, 2013
EMS in the New Decade
Article

5 More Years for Springfield!
May 17, 2013
EMS in the New Decade
Article

Footnotes:

[1] Ambulance Delays Lead To Proposed Changes In Holyoke
August 22nd, 2013
by Brendan Monahan?
WGGB News Channel 40
Cached article

The link is to the cached article because the article is no longer available on the WGGB web site.

Why was it removed from public view?

Has it just been moved to another link? This does not appear to be the case.

Here is the original WGGB News Channel 40 link – http://www.wggb.com/2013/08/22/ambulance-delays-lead-to-proposed-changes-in-holyoke/

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