Deju vu all over again.
The headlines in Pittsburgh’s dailies are the same as Denver’s: “Pittsburgh EMS response times lag national average.”
And in Denver, it’s no surprise that the chronically rebuffed firefighters union continues to try to increase its membership by absorbing Denver Health’s paramedics.
For 20 years or more, the debate about ambulance response times has informed a tug-of-war between Denver’s fire union and the public hospital’s paramedic division. The data is complicated, but the bottom line is indisputable: ensuring the best survival rates for trauma victims and health emergencies reliant on Denver’s 911 response systems.
Denver residents can breathe easy. The city’s two-tiered medical response system is among the best in the nation when it comes to saving lives. When a medical emergency occurs, the fire department responds with a truck staffed by emergency medical technicians trained to deliver urgent care, defibrillation, CPR, oxygen, etc., until an ambulance arrives. Paramedics proceed to apply advanced care on the way to the hospital.
Response time is only one measure of outcome. A more critical evaluation is based on clinical care and patient survival. Denver’s two-tiered system boasts one of the best trauma survival rates in the country, at 94 percent. Cardiac survival and successful ventricular fibrillation rates compare favorably with other cities.
So what’s the reality behind the hyperbole? The national firefighters union is struggling to expand its ranks. Thanks to improved building codes and inspections, there simply aren’t as many fires as in the old days. In fact, a significant percentage of fire department calls are as first responders in the emergency medical protocol.
In 1997, when Denver Health became an independent authority, the operating contract with the city established response-time parameters. In order to provide information consistent with the two-tiered system, the framework was changed in 2004. In other words, since 2004 the hospital’s paramedic division and the fire department have jointly reported response times in quarterly, written reports to the city.
One wonders why Auditor Dennis Gallagher, a longtime favorite of the fire union, raised the EMS response time issue in a recent Denver Health audit without asking the same questions of the fire department.
According to the quarterly EMS citywide response time reports filed with the city, the two-tiered system is working well. The 2007-08 data reveals that Denver Health’s paramedic division consistently outperforms the fire department’s first responders in percentage of calls meeting response-time goals.
That makes several things clear: Data from the fire department and the hospital should be calculated according to the same criteria. The clock starts when the fire truck or the ambulance rolls. The operating agreement must be amended to reflect this change in protocol.
Finally, the most important measure of effectiveness is revealed in the system’s survival rates. Denver’s EMS is one of the best. It’s clear that the two-tiered system provides quality emergency care, professionally and promptly. A proven system of emergency care focused on saving lives should not be part of the political agendas of national unions and local elected officials.
Susan Barnes-Gelt (sbg13@comcast.net) served on the Denver City Council and worked for Mayor Federico Peña. She is a consultant to local architectural and development companies.
