Fun and games with response time reporting

As I've mentioned on several different occasions, it's a huge mistake to wait until a tragedy occurs to explain the truth about response times to your community.

Response times should be measured from the patient's perspective. In other words, from the moment the dispatcher picks up the phone and says, "9-1-1 what is your emergency?" to the moment a professional rescuer arrives at the patient's side.

Any other sub-interval is smoke and mirrors (see HERE and HERE for previous posts on EMS response time reporting and other system failures).

There is no excuse for allowing our real response times to be ambiguous. It doesn't matter if some other organization does the dispatching. It's the EMS system’s responsibility to figure it out because we are ultimately responsible for the community's chain-of-survival.

In other words, if our chain-of-survival is broken (and it surely is if we have no idea how long call processing takes) then it's our responsibility to educate our citizens and our elected officials of that fact.

Remember, millions (perhaps tens or even hundreds of millions) of dollars in 9-1-1 taxes are collected each year in the United States. Where does the money go? Our inability (or unwillingness) to measure "9-1-1 call received" to "patient's side" is completely unacceptable and patients die because we pretend that our response times are better than they actually are.

Where's the accountability?

We must never allow ourselves to become acclaimated to things that would outrage members of the general pulbic once the facts become known.

Explaining why EMS wasn't there "in 4 minutes" to treat a child in cardiac arrest is not a particulary good backdrop to have this conversation with the taxpayers.

13 Comments

  • Mick mayers says:

    Very nice. But it’s not like you and I haven’t had this discussion before over beer.

  • Scott says:

    "A careful review of the events confirms that this tragedy is not the result of neglect or malfesance on the part of any district personnel."

    … so tell me, why was there no mention of a defibrillator? They just said "CPR was in progress".

  • Ben says:

    “Our inability (or unwillingness) to measure “9-1-1 call received” to “patient’s side””
    How is this even acceptable?
    In the UK we have been assessed on the time the last ‘9’ in ‘999’ is dialed till the arrival of a trained first responder, rapid response vehicle or ambulance for the last 2 years. We dont like it as it generates a fair few wasted journeys due to being sent to jobs before they are triaged but its in the public interest.

  • This is true, Chief.

  • National Standard? What National Standard? It used to be 8:59, but that was based on some fire service calculation. Brain death supposedly occurs in 4-6 minutes, but does that mean that ALL calls should be responded too within that time frame? In our system we have a good idea of our response times and where we stand in relation to the goals that we've set. Still, do we even know how important response times are or if they matter at all?
    Like so many other things in our profession, this is driven more by politics than by science. In fact it's driven totally by politics.
    Of course the reporter is all concerned with response times, but when the various FDs and other agencies start to cut personnel to save money, where will that concern be? Oh, that was yesterdays scandal, not today's.
    Cynically yours,
    TOTWTYTR
     
     

  • brad myers says:

    Response times i wash co. Maryland are caculated from the time the 911 ansewer is receved and then after the dispatch center hits our tones and after we get the initial data for the call then se have 5 min to responed if you do not by then the nrxt due ambulance from the next town or mutual aid company from jefferson co west. Virginia for example if your in sharpsburg will be dispatched and also if they do nkt respond in the 5 min time fram the first due engine co will be dispatched. And not to nock on sheperdstown west v but sharpsbirg has accually ran more ems calls in there first due then they did a more than a few years. Ok i am a lil they need to do something. But back to Washington co md. We also have a echo response witch is usually codes or life threating trama in witch you have 3 min to responed the first due engije companybis also due and also we do have 2 chase vehicals that are always stafed with a peramedic

  • bradmyers says:

    Phone decided to submit befor i got to finish so here we fo we have a chace for south county and northerin county and each ems and fire station also has what we now call( im goin to finish this on the computer if yoi like where im goin with this you would really like to know more feel free to email black03gtgrandam@aol.com) i will finish this post in the morning if july 1st 2011

  • Mike B says:

    Dude, please copy and paste from an application with spell-check before you post anything else.  Your typos and abhorrent grammar are making my head hurt.

  • alex says:

    Here in the UK our clock starts ticking when the 999 call hits the switchboard. The call is supposed to be allocated to a crew within about 40 seconds. Our target is to reach 75% of life threatening emergencies within 8 minutes of the caller dialing 999.

    The upshot of this is that, at busy times, we are forever running on jobs with no details except the address, then getting cancelled and reallocated to another job with no details except the address, and the cycle repeats.

    We have just started recording the time we reach the patient’s side, as opposed to when the vehicle reaches ‘the scene’ (which is when our target stops). (although the target can also be hit with rapid response cars, volunteer responders, and public access defibs…)

  • Robert (Las Vegas) says:

    Lets be honest.
    The problem isn't our response times. The problem is that most communities/cities/states are uneducated on when it is appropriate to dial 911 for a real emergency. In addition, at least in our system, Paramedics respond to virtually any call, even for pyschiatric patients w/ out any complaints. It's waste of resources.
    90% of the calls we get are merely at a BLS level. It's time to start sending out BLS/ILS to the majority of the calls and keep the ALS levels ready to respond to cases like this boy.
    Our system is a mess. So unorganized, we can not even dowgrade a call to BLS/ILS units. Any call we respond to, we have to take to the hospital.

  • Larry Davids says:

    Times in our area are all relative anyway. We run a paid system from 6:00am to 6:00pm, it then shifts to volunteers. Not all volunteers staff their buildings all the time, so you have 3 to 4 min after tones are set off to get to the building. Then you have to get the truck enroute. Sometime the truck gets enroute with 1 person on board, the otherone will meet them on scene. Being in a rural area, it might take 8 to 10 minutes to get to the scene. It can be anywhere from 8 to 15 minutes to get to the victim. If they delayed calling 911 to start with, like called a relative in another town first, you can see how the time can add up.

  • on the other hand, we arrived at a bitch-slapping within 4 minutes the other day.

  • Jordan Schooler says:

    I think it's also a huge mistake to continue to focus on response times as though they were the most important metric of EMS performance, when they are probably irrelevant to the outcomes of 99% of our calls. Response time is easily measured. Unfortunately, chasing the 8:59 dream leads to urban areas saturated with paramedics who rarely perform ALS skills, and thus aren't proficient at them. But at least they arrive quickly. 

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