EMS Response Updates

November 18, 2020

 Desired Outcome is 30% Reduction in EMS Responses

Reduction of WFD EMS responses by 30% without a negative patient effect

 In 2018, EMS comprised 59% of annual calls, but 42% did not involve patient care

0% 0%
EMS 2% 42%
0%
4%
Good Intent 6000
6%
4798
False Alarms 5000
7% 4000
Hazardous Conditions
3000
Service Calls 12% 1915
2000
Fires 59% 953
1000 381 147
10% 20
Fire Dispatched and Canceled Enroute 0
EMS EMS EMS EMS EMS Load EMS Driver
Overpressure/Rupture
n = 14,005 Treatment Canceled Dispatched Standby Patient Only
Special Incident Provided on Arrival and Only
Canceled
Weather Enroute
*These numbers represent every call WFD went on in 2018
WFD Responds to Delta and Echo EMS Calls
Type Priority Description

Omega Low Ambulance Only. For non-emergency transports or lift assists

Alpha Low BLS Ambulance. Non-emergency response. For sick person, minor allergic reactions, etc.

Bravo Low/Medium BLS Ambulance. Emergency response. For minor hemorrhaging, etc.

ALS & BLS Ambulances. Emergency or non-emergency response. For stroke symptoms,
Charlie Medium
etc.

Delta Medium/High ALS Ambulance & Fire Apparatus. Emergency response for serious injuries

Multiple ALS Ambulances & Fire Apparatus. Emergency response for life threatening
Echo High
situations
Delta calls: No Patient Care Was Provided 86% of the Time
• WFD currently only responds to Delta and Echo calls
6000
• Of the 32 Delta call types
14%
• 63% of the time we were canceled prior to arrival 5000

• The 37% where we did arrive 61% of the time we provided no 4000 23%

treatment 3000

• In order to meet our desired outcome of a 30% reduction in 2000

EMS call volume, we analyzed the data and chose 10 types of 63%

1000
Delta calls to pilot
0
10 Delta Calls Chosen As a Pilot
• Of the 10 types of calls chosen, for 7 of them we were canceled prior to arrival or provided no
treatment upon arrival 85% of the time or greater

• Of the remaining 3, there was both a low occurrence of incidents as well as a low percentage of
treatment provided

• Specific Delta calls with a low percentage of treatment provided will still remain on the WFD
response plan due to the amount of time WFD administered Narcan as well as because of the
nature of the calls, such as motor vehicle accidents

• If the trial is successful, there are 6 additional calls that may be added to the list of those where
WFD is removed from the response plan
10 Delta Calls Chosen As a Pilot
1200

141
1000

261
800
66 No Arrival
600 No Treatment Provided
203
Treatment Provided
10
400
746 26 45
87 48 18
458 85 59 36
200 358 66
237 189 213 11 5
153 22 27 4 22 2
0
6 Delta 10 Delta 32 Delta 26 Delta 12 Delta 21 Delta 17 Delta 2 Delta 4 Delta 5 Delta
Breathing Unk Problem/ Convulsions/ Hemorrhage/ Allergies/ Assault/ Back Pain
Chest Pain Sick Person Falls
Problems Life Status ? Seizures Lacerations Envenomation Sexual Assault
'
Outcome: Pilot began June 1, 2019
• 10 Delta calls were removed June 1, 2019
• Data was analyzed after 3 months (June 1-September 10, 2019)
• Of the 10 Delta calls in the pilot program, EMS responded to 1,232 over this
time period
• Of those 1,232calls, EMS requested WFD respond 53 times (4.3%)
• 27 times were as first responders
• 26 times were to provide assistance of a non-medical nature
• EMS continues to QC data and has found no impact on patient care from the
piloted changes
Outcome: EMS requested WFD only 4% of the time during the trial

400

350 7
7
300
3
6
250

200
336
150 1
271 6 3
2 3
100 5 1
5 1
143
50 115 101
84 90
2
0 23 14 2
2 Delta 4 Delta 5 Delta 6 Delta 10 Delta 12 Delta 17 Delta 21 Delta 26 Delta 32 Delta
Solo EMS Run EMS Requested Fire FR EMS Requested Fire ManPower

*These numbers are from June 1, 2019 to September 10, 2019

*Fire FR = Fire First Response
*Manpower refers to things like lift assistance and providing driving assistance
Outcome: During the pilot, EMS calls** were reduced by 46%

2500

1956
2000

1500
2018 2019
1046
1000
649
520 517
500 402
208 247 270
189

0
EMS Requested Fire EMS Canceled on Arrival EMS call, excluding EMS Dispatched and Total
Manpower vehicle accident with Canceled En Route
injury

**This data excludes motor vehicle accidents

*These numbers are from June 1 to September 10
*Between 2018 and 2019, WFD created removed some call types and created some call type subcategories in the record
management system (Firehouse) to better classify EMS calls. As such, for 2018, “EMS Requested Fire Manpower” includes 311
and 321 call types and for 2019, “EMS Requested Fire Manpower” includes 3113 and 3114 call types.
4 Additional Delta Calls Chosen to Continue Pilot
• We believed there were 6 additional calls to add to the pilot, but after further
analysis, only 4 will be added
• Of the 4 additional call types of calls chosen, we were canceled prior to arrival or
provided no treatment upon arrival 83% of the time or greater
• Specific Delta calls with a low percentage of treatment provided will still remain
on the WFD response plan due to the amount of time WFD administered Narcan
as well as because of the nature of the calls, such as motor vehicle accidents
Continue pilot with 4 additional call types

200
180
160 31 No Arrival
140 No Treatement Provided
8
120 12 Treatment Provided
71
100
80
60 112
40 76 4
20 11
18
0 0
1
19 Delta 25 Delta 1 Delta 16 Delta
Heart Psychiatric/Abnormal Abdominal Pain Eye
Problems/AICD behavior/Suicide Attempt Problems/Injuries
WFD will continue to monitor and analyze data
• WFD will monitor and analyze data on a monthly, tri-annual and yearly basis
• WFD will provide an update to council June 2020
Questions?
Appendix
 10 Delta Calls Chosen As a Pilot
n= 1,148 727 394 369 322 290 255 60 42 3
100% Oral Airway Inserted
Placed 12 Lead Electrodes
90% Splinted Extremities
80% Spinal Immobilization
Bleeding Control
70%
Nasal Airway Inserted
60% King Airway Inserted
Defibrillation by AED
50%
Suction/Aspirate
40% Oxygen Therapy
30% Medication Therapy
CPR
20% Blood Glucose
10% Assisted Ventilation
No Treatment
0% No Arrival
6 Delta 10 Delta 32 Delta 26 Delta 12 Delta 21 Delta 17 Delta 2 Delta 4 Delta 5 Delta
Breathing Unk Problem/ Convulsions/ Hemorrhage/ Allergies/ Assault/
Chest Pain Sick Person Falls Back Pain
Problems Life Stat Seizures Lacerations Envenomation Sexual Assault
Question