Administration and Leadership, JEMS Games, News, Patient Care, Training

Mesa Fire Department Implements Transitional Response Vehicles Program

Issue 4 and Volume 37.

Smooth Transitions
The Mesa (Ariz.) Fire Department aims to be on the cutting edge in delivering service to its citizens. So the department is developing a new service model to increase efficiency and live within budgetary constraints.

Mesa Fire Chief Harry Beck proposed the idea of staffing some of the agency’s vehicles with a paramedic and EMT to run without drug boxes to handle some of the BLS calls. These vehicles, known as Transitional Response Vehicles (TRVs), are dispatched to calls that don’t require the resources of a four-person engine. According to Terence Mason, Mesa Fire Department EMS coordinator, the area receives a great deal of calls from assisted living facilities. Often, a call comes in just as an ambulance is leaving one of these facilities, says Mason. These are instances when the TRV comes in handy.

“To not have to dispatch a full engine all the time is great,” says Mason.

The call-takers and dispatchers ask the appropriate questions, based on collaboration with the Mesa Fire Department medical director, to determine whether the call requires a TRV or engine company. If a call turns ALS, Mason says, then an engine company can be called to respond.

Currently, the department has four TRVs in operation around the city for staggered 12-hour shifts, depending on the call volume in each response area. The agency has calculated that this program has accounted for 196 patient encounters and follow ups. Although Mason couldn’t estimate the exact dollar amount of financial resources saved, he says the program has definitely decreased the wear and tear on vehicles and eased the agency’s overall transport process.

We tip our hat to the Mesa Fire Department for implementing the TRV program. Bravo to them for taking an out-of the box idea and making it a success.

Better Tracking
EMS workers will now have a place to record near-miss and line of duty death (LODD) incidents thanks to a partnership between the National Association of EMTs (NAEMT) and the Center for Leadership, Innovation and Research in EMS Together they’ve created a website to gather such information, which can then be used to develop future EMS policies
and procedures.

“The overall goal is to reduce errors made by EMTs and paramedics that affect patients and practitioners,” says Gary Wingrove of the Center for Leadership, Innovation and Research in EMS. “It is necessary to have an understanding of what kinds of errors there are, and what the root cause is, before fixes can be designed and implemented.”

Anyone with information can post it online, and no individual responses will be shared. The information will be aggregated and distributed to state EMS agencies and federal agencies. Until now, LODD and near-miss information had been gathered by various agencies, but not in any one central database.

“The government has recognized that medical errors account for a significant cost within healthcare,” Wingrove says. “While no one has adequately studied EMS, we know errors occur because of local systems that have done their own work.” Wingrove says success will be measured by increased participation in the process.

“Safety is a journey, not a destination. Along the journey, we will feel good about the incremental progress,” he says. “Ultimately, we’d like to see a designated Patient Safety Organization dedicated to EMS be formed.”

We applaud the NAEMT for spearheading such an important system. Hopefully, this program will help reduce medical errors and raise awareness about provider safety.

Excellent Care
It’s not every day EMS providers treat patients with severe asthma, penetrating trauma and anxiety all in one call. But for the finalists of the 2012 JEMS Games Clinical Skills Competition, treating these patients, and more, was all part of the challenge of the surprise final scenario.

We applaud the winning team from Cumberland County (N.C.) EMS for demonstrating an outstanding level of care, and thank each of the 14 teams that competed this year for setting an example to providers everywhere of the level of care our patient’s deserve. Keep up the good work.This article originally appeared in April 2012 JEMS as “Last Word: The Ups & Downs of EMS.”