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EMS Response Times Under Heavy Scrutiny

FULTON COUNTY, Ga. -- A dramatic 911 call made Aug. 2 by Johns Creek resident Darlene Dukes put metro Atlanta's emergency medical response system under scrutiny.

A Fulton County 911 operator was fired for mishandling Dukes' call by sending it to the wrong address the operator, Gina Conteh, is appealing her firing and Alfred "Rocky" Moore was removed from his role as the county's 911 director.

Even before Dukes, a mother of two, died from a blood clot in her lungs, a task force had begun compiling statistics on local emergency ambulance providers.

The Region III EMS Council, which covers metro Atlanta, formed the task force in part to monitor any changes in response times after the elimination of all county subsidies for emergency ambulance service took effect in Fulton County on July 1.

Statistics compiled by the council show that almost 50,000 people in metro Atlanta's four most populous counties called for emergency ambulance service in July. Close to 30,000 were transported to local hospitals. Most ambulances responded within 15 minutes, even for calls that weren't life-threatening.

But comparing responses between jurisdictions can be misleading. Because the council doesn't regulate 911 centers and there are no national or state standards for response times, call centers and ambulance providers determine their own call classifications and measures. Some ambulance providers start the clock when a call comes in; others count from the time an ambulance is dispatched.

The counties also have different methods of providing ambulance services. In Gwinnett, emergency ambulances are operated by the county, as are some ambulances in DeKalb. But DeKalb contracts with Care Ambulance Service for backup, and Fulton and Cobb contract with ambulance companies for all emergency ambulance service. Some cities have separate contracts and call centers.

Local officials say they want control of public safety functions for their residents, but too much fragmentation can be a problem, said Dr. Robert Bass, executive director of the Maryland Institute for Emergency Medical Services Systems. Bass also served as a member of the Institute of Medicine's Committee on the Future of Emergency Care in the U. S. Health System.

The goal of EMS is the best outcome for the patient, he said.

"That involves making sure you're getting the right ambulance to the right patient at the right time," he said. Then, he added, "You have to get the right patient to the right hospital for the right care."

To get the best results, emergency medical services across a region should be "coordinated, integrated and accountable," he said.

Here are excerpts from the report compiled by the Region III EMS Council.

--- Gayle White

RESPONSE TIMES BY AREA

North and Southeast Cobb County MetroAtlanta Ambulance

* Average no. calls per week, July: 711

* Average no. patients transported per week: 503

* Response times/potential life-threatening calls: 12 mins

* Response times/non-life-threatening calls: 12 mins

Southwest Cobb County Puckett EMS

* Average no. calls per week, July: 206

* Average no. patients transported per week: 145

* Response times/potential life-threatening calls: 12 mins

* Response times/non-life-threatening calls: 12 mins

DeKalb County

* Average no. calls per week, July: 2,339

* Average no. patients transported per week: 854

* Response times/potential life-threatening calls: 5 mins

* Response times/non-life-threatening calls: 8 mins

DeKalb County Care Ambulance

* Average no. calls per week, July: 1,819

* Average no. patients transported per week: 1,442

* Response times/potential life-threatening calls: 12 mins

* Response times/non-life-threatening calls: 15 mins

Fulton County Hapeville

* Average no. calls per week, July: 30

* Average no. patients transported per week: 16

* Response times/potential life-threatening calls: 4 mins*

* Response times/non-life-threatening calls: 4 mins*

(*response time includes fire responders)

Central Fulton County/Atlanta Grady EMS

* Average no. calls per week, July: 1,860

* Average no. patients transported per week: 1,300

* Response times/potential life-threatening calls: 10 mins

* Response times/non-life-threatening calls: 15 mins

North Fulton County Rural/Metro Ambulance

* Average no. calls per week, July: 1,758

* Average no. patients transported per week: 1,156

* Response times/potential life-threatening calls: 8 mins

* Response times/non-life-threatening calls: 15 mins

South Fulton County Rural/Metro Ambulance

* Average no. calls per week, July: 1,935

* Average no. patients transported per week: 1,328

* Response times/potential life-threatening calls: 8-10 mins*

* Response times/non-life-threatening calls: 15-20 mins*

(*longer response times for rural areas)

Gwinnett County

* Average no. calls per week, July: 1,295

* Average no. patients transported per week: 585

* Response times/potential life-threatening calls: 8 mins

* Response times/non-life-threatening calls: 10 mins

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