Editorial: EMS mergers make sense

[x635 4,066]

Interesting and, although not in our area, somewhat applicable to our area article.

 

Quote

Local governments — that is to say, local taxpayers — need to stretch every dollar these days, yet redundant services and duplicate costs continue to burden central Ohioans through overlapping city, county and township fire and emergency medical services.

 

http://www.dispatch.com/content/stories/editorials/2016/11/01/editorial-ems-mergers-make-sense.html

[N1Medic 69]

EMS mergers do make complete sense in Westchester. Mutual aid is rampant. What do we have to lose by it?

[GreatPlains588 131]

There is nothing to lose by consolidation of smaller districts.

People who fight it are ignorant and negligent.

Do you really have the best interest of the patients or tax payers if you can't respond to the majority of the calls?

You hear it over and over again, day after day, of re-toning for a driver or EMT.

 

Maybe there is good reason for not consolidating and people just dont know........

 

[Gomer 25]

On ‎11‎/‎1‎/‎2016 at 5:56 PM, GreatPlains588 said:

You hear it over and over again, day after day, of re-toning for a driver or EMT.

 

And what is it going to take to get something done?

[x635 4,066]

I think one of the major factors in Westchester County right now is 911 abuse. You have a large number of nursing homes, assisted living facilities, and the such that have greatly increased in the smaller communities in our area over the past few years. My local VAC used to do about 300 calls a year, a large assisted living facility was built several years ago, and now they do close to 1,000 a year. They go to this place 2-3 times day. A lot of these calls aren't even emergencies, or caused by ignorant, poorly trained staff. That's one reason I wouldn't volunteer.  Selfish, maybe so but these places are out of control and are burning out volunteers, who also have to spend more and more time training with NYS requirements.

 

A county-wide EMS system is the long term answer. Each agency contracting with a commercial provider for staffing, or hiring their own EMT's in house, is creating a patchwork solution that makes logistics even more complicated and expensive. We could greatly increase patient care while decreasing costs and response time if we went with a countywide EMS model. Maybe even having a commercial provider like Empress contracted to provide EMS with a system status management module based on stationing ambulances in areas depending on volunteer availability and predicted call load would work, especially given they have the infrastructure for an operation of this scale already existing.

 

But, this is Westchester. Anyone who attempts to spearhead a countywide EMS system or even create some sort of required performance metric will surely be crucified and branded as evil. I don't even see a pathway. Where should we be in 5 years, 10 years, etc. Who is studying this? There have been attempts over the years to do different things, but nothing has stuck. Who is, or has the power to, start the ball rolling?

 

Work together, win together.

[AFS1970 504]

One thing nobody ever looks at in this type of discussion is what a small agency is doing right. Itis always the bigger agency saying that they can take over the smaller district with minimal effort. A true assessment should look at the positives and negatives of each agency involved.

 

As for the system abuse, this has to be handled in two ways. First through facility education. In my city we used EMD however getting actual answers from the staff calling for an ambulance most often requires an adversarial interogation. Starting with their evasive answer to the simple question of "Are you with the patient"?. Because most answers end up being unknown, the response gets upgraded. This not only leads to burnout but contributes greatly to the mutual aid as a higher priority call may get shunted to another district faster.

 

Second is to stop the turf wars between the private EMS companies. Many of the bigger players have lobbied hard for regulations preventing facilities from using agencies other than the local 9-1-1 provider. Thus leading the local agency to perceive system abuse. If the local provider only had to handle calls that they would actually make a difference in, there would be no abuse.

 

Third would be to look at a combination system, retain those volunteers willing to serve the new agency. It might mean responding out of town or working with volunteers that were with different agencies, but it would help the system overall. Not that it is perfect, but NYC seems to be able to integrate FDNY, Privates and VAC's into one system. Their system should probably be looked at by anyone undertaking such a project.

[Rjsii1432 7]

Do the facilities in Westchester  also call the commercial providers directly? I've never worked in Westchester, but elsewhere where I did work, facilities used to mainly call commercial providers directly. They would usually only call 911 for cardiac arrests and similar calls where additional manpower would be needed. 

[x635 4,066]

On ‎11‎/‎18‎/‎2016 at 11:56 AM, Rjsii1432 said:

Do the facilities in Westchester  also call the commercial providers directly? I've never worked in Westchester, but elsewhere where I did work, facilities used to mainly call commercial providers directly. They would usually only call 911 for cardiac arrests and similar calls where additional manpower would be needed. 

 

It's a mix. Some do, some don't.  It used to be that nursing homes and other care venues had what was called a "Private Emergency" which they requested EMS directly from their contract EMS service. The issue now is there are residential senior assisted living facilities popping up all over, and if an attendant sees a stubbed toe, they call 911.