Ask not what what your service can do for you…

You know it’s a good meeting when the Chief Administrator of the North East Ambulance Service turns to you and says, “What do you need from us?” Points at the senior managers, “How can we help you?”

Preconceptions were answered for and systems were compared.  I brought up the countless stories we seem to hear about ambulances here leaving old women in the streets for hours and the mandatory meal breaks.  I asked about the fire brigade responding to assist and the rapid response cars being sent before a call is classified.

And I got answers.  From the Chief Administrator.  And they weren’t the usual political safe answers so common back in the US.  He spoke of peeak usage times and limmited resources available in crtain areas, not unlike in the US.  Mandatory stand down times CAN be broken into, it just means the crew gets paid more.  Circumstances such as the ones reported are investigated very seriously and performance standards from call takers, to dispatchers to field crews are all monitored very closely.

While in the Headquarters building I was given the opportunity to listen in on call takers using the new NHS pathways system which differs from Criteria Based Dispatch in an amazing way: It does not classify based on a differential diagnosis, but by specific questions pertaining to the severity of certain conditions.  This allows the computer to narrow down the proper response or treatment pathway the same way those little compters play 20 questions with you.  On one call I listened to never in the conversation or the screen did “Heart Attack or Stroke” come in except for the question about past history.

The car was assigned as the call came in and the call taker could see the unit travelling on the GPS screen and update the caller as to how far away they were.  When you hear all the things about the 8 minute target by the way, that’s from the time the call is answered, not from time of dispatch.  The call taker has a buzz in their ear and the line is instantly connected.  Before she had time to say “Ambulance Serivce” the clock was ticking and doesn’t stop until a vehicle able to transport arrives on the scene.  As the call is coded, if appropriate, the car can be stood down and reassigned wile the ambulance continues, or the caller can be advised to call their Doctor.  Yes, you read that correctly, the person who calls with the stomach ache who answers pertinent negative questions is referred to their Doctor.

In the end, the meeting had a simple message to all of you reading this or thinking about changing your systems:

Patient outcome.  Not magic response times, not little yellow cars or big red trucks, but the desire to do what is right for the patient.  If you arrive on scene in 8 mintes and 10 seconds instead of under eight minutes, but made a life saving intervention, shouldn’t that be a success instead of a failure?  How many systems in the US are tracking their staff this way?  Granted it is a hard metric to judge, but with the electronice collection of data, we can now look at more than response times, so let’s do it.

Mark’s administrative officers were also discussing a possible trial of Syncronized Cardioversion, something the system does not currently offer but we in the SFFD do.

And all because two bloggers felt like getting together.

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