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EMS Aims to Speed Response

JEMS.com Editor's Note: Click here to read about one delayed response that caught the attention of the Austin, Texas media.

AUSTIN -- Officials at Austin-Travis County Emergency Medical Services plan to begin tracking and setting goals for response times on certain calls in which a patient's life is not at immediate risk, including those having chest pain or difficulty breathing, and lessen the time it takes to reach patients who may be dying.

Beginning in the next couple of months, paramedics will aim to arrive within 10 minutes at immediate calls that could - but don't necessarily - involve life-threatening situations. Their goal for responding to less severe cases, which could involve ailments such as a prolonged stomach ache or a twisted ankle, will be within 13 minutes.

EMS officials have historically had no response-time goals for such calls, nor have they tracked the speed with which they got to those patients.

Officials also are moving their response-time goal for patients with life-threatening problems to within nine minutes, from within 10 minutes, a standard they meet more than 80 percent of the time on average.

EMS director Ernie Rodriguez said the goals are part of a renewed effort to evaluate how quickly the agency reaches patients throughout Austin and Travis County.

Each year, EMS medics get about 117,000 calls, and their emergency priorities are usually set based on information dispatchers receive from callers.

"If you don't set a goal, you are never going to have anything to live up to," Rodriguez said. "I believe this represents what our customers expect."

By having the goals and collecting data about how often they are met, the agency will be better able to determine where more ambulances may be needed or where EMS stations should be built, officials said.

As part of the effort, EMS officials also plan to begin calculating response times from when a 911 call-taker picks up the phone to when paramedics reach a patient.

Officials have traditionally stopped the timer when medics arrive at a scene.

Rodriguez said the change will account for the time medics may spend climbing stairs or going up elevators, particularly in high-rise condos and apartments downtown, which he said can add several minutes.

Rodriguez said the EMS system will be among only a few in the nation to establish response-time goals for less critical calls. Such standards have traditionally been reserved only for patients in life-threatening situations, who accounted for about 39,040 Austin EMS calls last year, Rodriguez said.

The agency's current response-time goal for the highest-priority calls was set by the National Fire Protection Association.

EMS officials said that also is the reason they haven't previously established response-time goals for lower-priority calls.

Rodriguez said the new goals are based in part on standards other systems have set and that he may alter his expectations after measuring how often medics meet them.

"I'd rather set out goals that are lofty for us," Rodriguez said. "That will force us to think, to learn to use our resources better. I think it increases the level of accountability for us."

Dr. Pat Crocker , chief of emergency medicine at Dell Children's Medical Center and a member of the EMS advisory board, said the idea of setting new response-time goals will advance the agency, but that officials should continually evaluate them.

"What are the most medically reasonable goals, and what can the community actually afford?" he asked.

Chebon Tiger, president of the Austin-Travis County EMS Employees Association, which represents nearly all of the agency's 300 paramedics and employees, said he thinks the system's medics will embrace the new goals.

"We are caretakers," he said. "We want to get to people who need it most. By having response-time goals, we get there to help the person and in time to do something about it."

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