This is an incident action status report from the Contra Costa EMS Agency on Fire Station Closures affecting the communities of Lafayette, Martinez, Walnut Creek and Clayton. This report was given to the Contra Costa Fire District Board on February 12, 2013 For more information please contact EMS Director Pat Frost at 925 646 4690 1
Annually the county, emergency response zone and city has very predictable utilization of EMS services The EMS Agency evaluates emergency response based on coordination of services and patient care outcomes 2
The entire Contra Costa EMS System is engaged in mitigation of fire station closures. When a 911 call comes in, the call is quickly transferred to a fire EMS dispatch center and the caller is asked a series of questions to quickly assess the problem and what is needed. The dispatcher then dispatches the appropriate emergency medical first response. Minimum medical first response deployment requirements are determined by the County EMS medical director. Fire agencies determine what level of service they wish to provide the community. In Contra Costa fire competently provide both basic and advanced life support medical first response in different communities. Most 911 calls are currently being sent (lights and sirens) and fire first responders and AMR ambulance are dispatched within seconds of each other. If fire is not available due to a fire, other call or a fire station closure paramedic ambulance personnel may become the first medical response. This occurs normally throughout our EMS System about 10% of the time and more often when fire stations close. Response times are also affected by how busy the system is. The EMS system works to provide the most timely response within the operational capabilities of each community. 3
CPR and time to defibrillation is most important We have strong partnerships with City leadership supporting HEARTSAFE communities Our fire agencies play an active role in supporting our HeartSafe Communities efforts Citizen CPR and Public access AEDs (Automated Emergency Defibrillators) make a difference Over 80% of law enforcement agencies now voluntarily support first medical response with AEDs 4
EMS Agency: Local Authority responsible for the practice of medicine in the field, coordination and patient care oversight of the EMS System. Our highest priorities are patient safety and to improve patient care outcomes. Act as the county s 911 ambulance service contract manager The following measures are being taken to reduce impacts to the community. EMS has called on every partner in the EMS System to respond to reductions in fire first response. We accomplish this through a highly coordinated public private partnership with dispatch agencies, law, fire, ambulance services, hospitals and health care system The EMS agency has been through fire station closures in other fire districts throughout the county and understands the gaps that these cutbacks create but we have no extra ambulances or funding to reverse the decisions that have been made. Contra Costa has a highly collaborative, high performance EMS system committed to serving our community and we will continue to do that. 5
In every city and countywide only 7 11 % of code 3 responses require lights and sirens (critical) transport to the hospital. If fire station closures continue dispatch criteria for the use of fire first medical response will become increasingly more important. Fire will be given more choice on what they respond to so they are available for the most critical calls 6
Response time data reflects measurement of time fire or ambulance unit dispatched to unit on scene (apples to apples comparison) Clayton code 3 (lights and sirens) EMS utilization volume averages about 500+ EMS responses per year The data in the chart represents urban citywide response with fire compared to ambulance data (representing approximately 120 calls since Sept 2012) Numbers during this period are really too small to draw any conclusions An upward trend in fire station response was anticipated given station closure and low overall call volume Ambulance (AMR) posting changes appear to be providing consistent service levels during this interval Response variations normally occur during busy times in the system when resources are stretched The wide variations reflect artifact caused by small number of calls in this community More reliable conclusions can be made over time Shows relation of fire to ambulance response and where fire can make a difference in first medical response 7
Response time data reflects measurement of time fire or ambulance unit dispatched to unit on scene (apples to apples comparison) Lafayette code 3 (lights and sirens) EMS utilization volume averages about 1300+ EMS responses per year The data in the chart represents urban citywide response with fire compared to ambulance data (representing approximately 350 calls since Sept 2012) Mitigation appears to be working providing consistent service levels Response variations likely due to call occurring during busy times in the system when resources are stretched More reliable conclusions can be made over time Shows relation of fire to ambulance response and where fire can make a difference in first medical response 8
Response time data reflects measurement of time fire or ambulance unit dispatched to unit on scene (apples to apples comparison) Martinez code 3 (lights and sirens) EMS utilization volume averages about 3500+ EMS responses per year The data in the chart represents urban citywide response with fire compared to ambulance data (representing approximately 890 calls since Sept 2012) Changes in ambulance only deployment for clinics/health care centers making the most difference here providing consistent service levels Response variations likely due to call occurring during busy times in the system when resources are stretched More reliable conclusions can be made over time Shows relation of fire to ambulance response and where fire can make a difference in first medical response 9
Response time data reflects measurement of time fire or ambulance unit dispatched to unit on scene (apples to apples comparison) Walnut Creek code 3 (lights and sirens) EMS utilization volume averages about 7700+ EMS responses per year The data in the chart represents urban citywide response with fire compared to ambulance data (representing approximately 2000+ calls since Sept 2012) Mitigation working providing consistent service levels Areas with larger volumes are generally less affected by fire station closures than areas with small EMS utilization Response variations likely due to call occurring during busy times in the system when resources are stretched More reliable conclusions can be made over time Shows relation of fire to ambulance response and where fire can make a difference in first medical response 10
The following is a list of EMS system protective measures that help assure a high level of service countywide 11
Pulse point dispatch software is a recent enhancement added to support first medical response Congratulations to Contra Costa Fire Dispatch on this implementation 12