Agency advised:Don’t go it alone

CLINTON — Fire District 3 and Whidbey General Hospital need to focus on working together when it comes to emergency medical services, rather than the fire district trying to create its own paramedic service.

That is what district officials heard during a meeting at the Clinton Fire Station Monday with its consultant on the South End EMS system.

The recommendation is part of a draft study prepared by Kyle Gorman of Emergency Services Consulting, Inc.

Gorman also repeated the message to hospital officials later in the day.

But first, Gorman met with Fire District 3 commissioners, Chief Dan Stout and district EMS personnel to discuss his evaluation of the inner workings of EMS services.

Gorman was hired in 2007 as part of the district’s strategic plan to determine whether the district should press forward with its own EMS program or to continue to support the hospital’s basic and advanced life support system.

After pouring over a lot of data, Gorman found that a typical medical call on the South End can take about 20 minutes for emergency personnel to respond.

And with ambulance services and Fire District 3 personnel responding from generally the same locations, patients do not get necessarily better service, Gorman said.

“If the fire district monitors its response times and the ambulance provider monitors its response times individually, nobody ever knows collectively what the patient sees,” he said.

“There is an inertia in many parts of the country where you get ambulances at fire stations. What you get if that happens is perfectly overlapping response coverage areas,” he said.

A potential solution, Gorman added, is that ambulance providers locate themselves in areas where fire stations are not.

“The coverage of the system would be much better rather than overlapping a good deal of your coverage. Faster is better. If it’s not fast, then it’s not emergency services,” he said.

Gorman noticed a lack of thorough communication throughout the district, as well, and advised that maintaining EMS services without adequate radio communications puts the emergency workers’ lives at risk.

“With communications, it’s exceedingly unsafe to allow responders to go to any kind of a scene without adequate communications. The board’s number one concern should be the safety of its responders,” he said. “They need to be able to report dangers at the scene.”

Gorman promoted the idea that to make improvements, some sort of quality assurance program was needed.

“The real critical component in regard to EMS service is not what you are doing, but being able to measure, monitor and improve,” he said. “There is a theory in the quality measurement world that what gets measured gets improved.”

It is the individual EMS crews who will likely monitor and improve services, he added.

While both the district and hospital have strategic plans, there is effectively no planning together, Gorman added.

Worse yet, the hospital’s strategic plan didn’t do enough, he said.

“I was, quite frankly, a little disappointed in the hospital’s strategic plan. It wasn’t strategic enough and it also wasn’t much of a plan,” he said.

That left three options for how the district could proceed.

“You can remain in the status quo and do nothing and make marginal improvements in response time,” Gorman said.

“Or at the end of the hospital’s tax levy, you could pursue a tax levy yourself and seek to provide paramedic service and ambulance transportation.

“Or there is a middle ground. You can make incremental improvements on your part and some incremental improvements on the hospital’s part and make the system better that results in these joint efforts,” he said.

“I recommend the third option.”

Fire commissioners remained cautious about how well the district would be able to work with the hospital on ambulance transportation and paramedic issues.

“Let me play devil’s advocate here. Let’s make the assumption that the

three agencies are not going to work together,” said Commissioner Kenon Simmons.

“Do we set some time criteria? Do we set some milestones? If we don’t meet those milestones, does there come a point when we say what’s best for our customers if we’re not going to work together?” Simmons asked. “To pay what we’re paying for 20 minute response times — that’s not working.”

Gorman, however, stressed improving the system that’s in place.

“It would be years before you’re ready to assume paramedic duties,” said Gorman.

He said communications between the players needs improvement.

“There seems to be a discontinuity in the communication between the fire district, the hospital and I-COM (Island County Emergency Services Communications Center). There needs to be a joint effort and a joint communications plan,” he said.

Spencer Webster can be reached at 221-5300 or swebster@southwhidbeyrecord.com.