Each month we will feature a profile of another High Performance EMS to show the variation in these services and inspire others to reach beyond just the basic services to provide advanced pre-hospital care with a focus on high economic efficiency.
In 1996, the Mecklenburg EMS agency was one of the slowest in the US with an average call response time of about 16 minutes. Today, calls average around 7 minutes. That incredible transformation began when two competing hospital services joined together to create MEDIC which now contracts to serve the county of 540 square miles with a fixed population of 850,000 that swells to a routine daytime total of around 1 million people.
Barry Bagwell, Deputy Director of Operations, is proud to state that MEDIC has been compliant regarding performance every month since 1998. “While there is no ‘silver bullet’, all of the pieces must work together,” says Barry, “it requires technology plus the people to run it.” But a truly High Performance EMS must not be tempted to over-utilize response times as the only measure of success. The original focus for system improvement was on routing, but the partnership with Bradshaw Consulting Services has led to many operational enhancements including successful demand prediction and dynamic System Status Management planning. “Dispatch posting is a ‘chess game’,” Barry admits and real efficiency comes by balancing moves between the 60-65 posts to meet service demand with reducing fuel costs and minimizing disruption of ambulance crews. With a holistic view of clinical outcomes, MEDIC has achieved a 33-minute turn-around time from hospital to availability and 82 minutes from a call to having a Code Stemi patient on an operating table with the artery open. MEDIC also provides bicycle paramedics, ATV, and buses for special events to meet the needs of their community.
The dispatch center has used ProQA Dispatch Software protocols in both EMS and Fire since 1993 to assist dispatchers in quickly determining the appropriate determinant code. Voice communication with vehicles is maintained with a Motorola 800 MHz shared backbone radio system with priority. Non-emergency numbers are provided only to hospitals with the public being triaged through the 911 system.
While recognized as a High-Performance EMS already, MEDIC does not intend to rest where they are now but constantly looks toward additional improvements.