EMMCO West, Inc. EMS System Assessment 2008-2009 **ALL 2008 STATISTICS ARE AS OF NOVEMBER 2008 Assessment PERSONNEL Certified Personnel: FR 194 EMT 2128 EMTP 527 (see Medical Command Authorization) PHRN 84 HP 15 TOTAL 2948 EMS Instructors 112 Of the 2948 certified EMS practitioners only 1906 (65%) show up in PCR data. Medical Command Authorization Number of ALS personnel with medical command authorization functioning in EW: Year Total 2008 264 2007 268 2006 255 2005 280 2004 279 2003 279 2002 274 2001 318 2000 277 1999 315 ALS Personnel with Medical Command Authorization at more than one service in EW Year Total 2008 34 2007 41 2006 49 2005 44 2004 44 2003 43 2002 46 2001 57 2000 82 1999 80
Education: Initial Education Stats Courses Conducted 2005 2006 2007 2008 FR 5 5 1 4 EMT 11 14 26 21 EMTP 1 1 3 4 Personnel Certified from Individuals Sitting for Exams FR EMT Paramedic* 2005 27/27 (100%) 206/328 (62%) 3/8 (37%) 2006 34/39 (87%) 250/287 (87%) 3/7 (43%) 2007 6/6 (100%) 178/229 (78%) 8/23 (35%) 2008 31/36 (86%) 150/209 (72%) 6/22 (27%) * Reflects students completing a course, not necessarily sitting for an exam. Reciprocity/Re-entry 2008 Added 1 FR by reciprocity Added 8 FRs by re-entry Added 12 EMTs by reciprocity Added 12 EMTs by re-entry Added 6 Paramedics by reciprocity Practical Exam Pass Rates 2007 First Responder 71% EMT 74% Continuing Education Con-ed Courses 2005 Total of 861 classes registered. 57 classes cancelled. 804 classes ran throughout the region Con-ed Courses 2006 Total of 801 classes registered 86 cancelled 715 classes ran throughout the region Con-ed Courses 2007 Total of 704 classes registered 25 cancelled (estimated) Con-ed Courses 2008 (as of 11/27/08) Total of 690 classes registered 37 cancelled
OPERATIONS EMS Agencies ALS-=18 Air= 1 (plus one licensed in EMSI) BLS =51 QRS services recognized =16 2 Rescue services at Operations Level 1 Rescue service at First Responder Level Breakdown of vehicles: ALS- Transport = 89 ALS- Squad =18 BLS = 73 QRS = 28 Air = 1 (plus 3 licensed in EMSI) Other Resources: Approximately 35 non-recognized fire departments providing QRS type services. Call Volume: 2003: 93912 2005: 98895 2006: 101,263 2007: 106,598 2008: 107,260 Projected Interfacility transfers: 2003: 13,503 2005:14,476 2006: 16,699 2007: 17,524 2008: 18,685 Projected Call Percentage by Time of Day Year Sunday Monday Tuesday Wednesday Thursday Friday Saturday 2005 12.3% 15.1% 14.6% 14.9% 14.4% 15.2% 13.6% 2006 12.4% 14.8% 14.7% 14.6% 14.6% 15.3% 13.2% 2007 12% 15.1% 14.6% 14.8% 14.8% 15.6% 13.2% 2008 12.4% 14.3% 15.8% 14.4% 14.8% 15.3% 13.7%
SYSTEM PERFORMANCE Air Ambulance Scene Runs Air ambulance scene runs by county and per capita County 2006 2007 2007% Population Population % Scene runs per capita Clarion 36 36 14.12% 40,385 6.39% 0.8914 Crawford 38 53 20.79% 89,389 14.15% 0.5929 Erie 51 59 23.14% 279,811 44.28% 0.2109 Forest 5 7 2.75% 6,506 1.03% 1.0759 Mercer 35 36 14.12% 118,551 18.76% 0.3037 Venango 51 31 12.16% 55,488 8.78% 0.5587 Warren 20 33 12.94% 41,742 6.61% 0.7906 TOTALS 236 255 Reportable Ambulance Accidents: 2008-4 Complaints: Complaints Authorized 2006 2007 2008 14 5 11* *As of 11/17/2008. One has been submitted for authorization and is believed to be authorized. Mobilization The following charts show mobilization times (the time between dispatch to marking enroute) for calls in which the mode of response was marked emergency on the PCR for 2005, 2006, 2007, and 2008. The tables are broken down by type of agency, BLS, QRS, and ALS. Within each table the mobilization times are split out by the size of the municipality in which the responses occurred. For example, in municipalities of greater than 1000 persons per square mile, ALS services mobilized in 3 to 6 minutes 6.8% of the time in the year 2005. EMMCO West has made these reports available for all agencies in the region in order that they might be able to see how they are performing compared to like services. They can view their mobilization times and compare them to the regional averages for like services. A complete listing of mobilization times for all 4 categories of municipality sizes for all levels of service is available upon request. ALS Mobilization Summary Population of >1000 mi2 Time Span 2005 2006 2007 2008 < 2 minutes 92.0% 91.2% 91.4% 90.7% 3-6 minutes 6.8% 7.5% 7.3% 8.2% 7-10 minutes 0.5% 0.6% 0.6% 0.5% <10 minutes 0.6% 0.6% 0.8% 0.7%
ALS Mobilization Summary Population of <100 mi2 Time Span 2005 2006 2007 2008 < 2 minutes 80.3% 81.7% 82.8% 82.7% 3-6 minutes 18.0% 16.8% 15.7% 15.9% 7-10 minutes 1.4% 1.1% 0.9% 0.8% <10 minutes 0.4% 0.4% 0.6% 0.5% BLS Mobilization Summary Population 101-500 mi2 Time Span 2005 2006 2007 2008 < 2 minutes 18.0% 16.6% 17.1% 21.4% 3-6 minutes 43.7% 40.9% 41.7% 38.6% 7-10 minutes 34.3% 36.3% 32.8% 31.6% <10 minutes 5.0% 5.7% 8.4% 8.4% BLS Mobilization Summary Population <100 mi2 Time Span 2005 2006 2007 2008 < 2 minutes 14.9% 14.2% 16.9% 17% 3-6 minutes 41.8% 45.0% 39.3% 35.4% 7-10 minutes 34.0% 32.2% 34.1% 34.7% <10 minutes 9.3% 8.7% 10.7% 12.9% QRS Mobilization Summary Population <100 mi2 Time Span 2005 2006 2007 2008 < 2 minutes 44.5% 41.3% 49.0% 54.3% 3-6 minutes 44.9% 37.9% 29.7% 38.2% 7-10 minutes 9.1% 18.4% 18.4% 5.4% <10 minutes 1.6% 2.4% 2.9% 2.1% EMMCO West Municipalities Summary: Municipality Population per Number Percentage Square Mi <100 mi2 136 57% 101-500 mi2 31 13% 501-1000 mi2 39 16% >1000 mi2 33 14%
Response Times: (dispatch to arrive scene in minutes) 2005 2006 2007 2008 QRS* 5.4 5.8 2.5 5.6 BLS 10.3 9.9 10.7 10.5 ALS 8.5 8.4 8.8 8.7 *Includes data from several large, paid municipal fire based QRS. Response Time 90 th percentile values 2008: QRS 11 minutes BLS 18 minutes ALS 16 minutes Suction Unit Project Status Current pass rate 74% (spot inspections and licensure inspections). Original pass rate 81% PREPAREDNESS Equipment: Support Vehicles, Trailers Other Specialty Equipment EMMCO West preparedness trailer (see appendix B) Small cache of Mark I Kits All strike teams (6) have 4 Millennium masks and level B suits (28 total) 6, 10 man tents with heaters 2 Rescue Trailers (intended for training, appendix C) Strike Teams: 6 strike teams Communications: LR Kimball Regional Communications Assessment Objective Status: AVL AVL operational in 3 counties Currently limited to strike team units Seeking funding for 2 additional counties Seeking funding for remaining EMS units Clarion County receiving upgrades to improve connectivity between file server and CAD Crawford County receiving upgrades to enable them to receive their signal via their CAD system Mobile Communications Unit (MCU) Phase 1 and 2 implemented (radio installations) MCU purchased through NWPAERG Medical radio systems operational 800 radio to be installed in Phase 3 (spring 09)
Venango County assumed ownership via a memorandum of agreement between Venango County, EMMCO West and the NWPAERG. Allegheny River Med radio system for Medical Command operational in underserved area of significant dead spots in the Allegheny River valley in Warren, Forest county areas. INTEGRATION/PARTNERSHIPS PEHSC BOD PEHSC EMS Information Taskforce (chair) PEHSC Practical Evaluation taskforce and various other standing and dynamic PEHSC and DOH committees and taskforces. EMMCO West Regional Medical Advisory Committee EMMCO West Communications Committee integrated into Region NWPAERG task force Communications Committee. EMMCO West Transportation Committee EMMCO West QI Committee EMMCO West CISM Team Participation at Volunteer EMS Alliance of Crawford County NWPAERG SHIP Crawford Co. Active Aging Coalition Warren Co. Fire Chief s Association Erie Co. EMS Council Clarion Co. EMS Council NWPA Career Link partnership Initial Assessment Observations PERSONNEL There are fewer active ALS personnel Fewer ALS personnel are working at multiple agencies Only 65% of EMS personnel at all levels are active Fewer people are taking EMS training The ALS pass rate is poor Fewer con-ed courses are being conducted but LMS seems to be popular. Reciprocity and Re-entry seem to be adding personnel to the system but their activity is not monitored after gaining/re-gaining certification. OPERATIONS Most fire departments providing a QRS type service are not recognized EMS Call volumes are increasing, especially interfacility transfers EMS system stress seems to be greater during week days.
SYSTEM PERFORMANCE Some counties have a disproportionate number of air ambulance scene runs compared to their population. QRS services seem to mobilize more quickly than BLS agencies in like municipalities. BLS response times are greater than those of ALS and QRS Areas of the region are served by BLS services in very close proximity. Some of which experience difficulty staffing. QI suction project seems to be making less of an impact than hoped PREPAREDNESS Strike team participation could be better It would be desirable to expand AVL to more counties and agencies. Goals/Tasks PERSONNEL Provide technical, educational, and if possible financial assistance to services in efforts to improve recruitment, retention, and recognition. o Provide an educational opportunity for services related to utilizing EMSOF or other funding to maximize the results of recruitment, retention, and recognition projects. o Sponsor an event for elected officials and EMS personnel o Provide other educational/outreach opportunities including but not limited to continuing education, station visits, items of recognition, ride-alongs and other related programming. Enhance the skill and knowledge of EMS instructors through education and constructive evaluation. o Implement the EMS instructor evaluation program as prescribed by the modular instructor enrichment program. o Strategize a method for re-evaluation or evaluation of instructors where there may be a perception of bias. Provide education and outreach programs to EMS personnel o Conduct annual educational conference pending registration and interest. o Advertise and provide continuing education opportunities to EMS agencies. o Pending funding, continue to offer EMS Leaders of Tomorrow programming. o Provide at least one CPR training open to EMS personnel in conjunction with EMMCO West staff CPR training.
o Enhance the core training of the CISM team. o Strategize methods to educate EMS stakeholders regarding the need for CISM and how to active CISM. PREPAREDNESS Enhance the region s ability to respond to natural and man-made disasters and/or mass casualty incidents. o Conduct at least 1 in-house exercises aimed at regional council staff s responsibilities during an activation of resources. o Conduct or participate in a multi disciplined tabletop or full scale exercise. o Seek out means to transport preparedness resource trailers in the event of a deployment requiring multiple resource trailers. o Pending unexpected sources of funding expand AVL capabilities. o Continue partnership with the ERGs o Increase level of coordination with Erie Medical Reserve Corps. o Continue to seek additional strike team services (pending funding). o Conduct strike team drills with resources such as MSEC. INTEGRATION/PARTNERSHIPS Enhance the region s ability to respond to sudden cardiac arrest o Should funding become available, administer rural AED grants. Provide education and outreach programs to the public o Offer a public service speaking bureau to community organizations. Enhance region s services capabilities to provide care to pediatric population. o Assist PEHSC and BEMS in implementing EMSC programming. SYSTEM PERFORMANCE Assure the readiness of suction units through QI measures. o Increase participation in QI projects. o Identify primary sources of failure o Identify trends o Identify avenues for corrective action o Implement corrective action Evaluate various safety concerns o The transportation committee will conduct an evaluation of safety concerns and prioritize safety initiatives for future development. o Provide technical, educational, and financial resources as available for safety initiatives. o Pending funding continue CO monitoring funding. Improve 12 lead transmission capabilities through the region. Review and evaluate data on basic EMS skills. o Provide technical, educational, and financial resources as available. Pending status of EMS Act, orient services to aspects of EMS Act.
o Provide education/orientation to services regarding aspects of the EMS Act. o In partnership with the Bureau of EMS, implement mechanism to provide regional input into the content of the Regulations.