Jersey City, N.J., is one of the densest cities in the United States, with more than 16,000 residents in every square mile on average. Despite this, the city has one of the fastest emergency response times in the nation, clocking in at under five minutes. That’s less than half the national average.
Robert Luckritz, NREMT-P, JD, thinks the city can do better.
Luckritz, the director of EMS at Jersey City Medical Center, along with an influential group of stakeholders in Jersey City, plans to accomplish this using the new program United Rescue Jersey City, modeled off an Israeli-based emergency response system that uses trained volunteers to respond to 9-1-1 calls with lightning-fast speed.
Beginning in Israel in 2006, United Rescue integrates volunteer first responders into the city’s EMS system to provide rapid response, as the volunteers are theoretically much more widely dispersed throughout the city at any given time than ambulances and fire departments ever could be. United Hatzalah, as it’s known in Israel, even uses motorcycles to navigate the city faster. Response times have dropped down to a mere three minutes where it’s been implemented.
As the first American city to implement United Rescue, Jersey City leaders hope to prove the model can have a similarly positive effect in the U.S.
With or without emergency motorcycles weaving through traffic, Jersey City seems uniquely fit for United Rescue. Tightly packed populations, huge urban developments and sprawling traffic often present challenges for EMS systems and strategies, but United Rescue is strengthened by Jersey City’s dense neighborhoods, rather than inhibited by it.
Jersey City’s iteration of the program works by integrating a cohort of volunteers called “community based emergency caregivers” (CBECs), into Jersey City’s EMS system through a smartphone app and a unique radio channel. They also carry a Medibag with standard first responder supplies (oxygen, a defibrillator, Narcan, etc.). When emergency strikes, the nearest two CBECs are notified through the smartphone app, and they can then coordinate with other first responders with their radio. This provides a critical head start, especially when calls are located in notoriously difficult areas for EMTs to access quickly in Jersey City, such as high rises and college campuses. Theoretically, the system should grow more responsive with each new CBEC added.
Luckritz says United Rescue first approached Jersey City Mayor Steven Fulop with hopes the organization could find a forward-thinking city to which they could introduce their unique EMS program. The method had made a revolutionary impact in Israel, and United Rescue’s creators hoped to prove it could have just as great an impact elsewhere.
In Jersey City, response times for the most critical calls clock in below six minutes, on average (“An average of between four minutes and 30 seconds to five minutes, as of late,” says Luckritz). Still, the city identified target areas where they could improve. Specifically, college campuses and high rises—a common sighting in Jersey City—presented unique challenges for EMTs and paramedics. A financial district high-rise, for example, which often requires a lengthy trip to the 50th floor after arriving on the scene, could double the time it takes to get to the patient’s side in some cases. Luckritz said that finding a way to put responders inside these mega high rises in anticipation of medical emergencies makes sense operationally.
“Some of our buildings hold over 5,000 tenants on any given day, so you have a community in and of itself in one single building,” Luckritz said. “So it makes sense to put some responders in there.”
The potential for improvement in these key areas, along with Jersey City leaders’ penchant for innovation, made Jersey City a ready and willing partner when United Rescue leaders showed interest in implementing the program there.
“We have a mayor who’s a big proponent of innovation, and we have an EMS agency here that’s always strived to be on the cutting edge of EMS, and is willing to consider ideas that are very outside of the box of what we consider EMS,” Luckritz said.
Although the program seemed to fit naturally with Jersey City, Luckritz said there was a great deal to consider prior to implementing such a radically new project, like unique liability concerns and coalescing with existing EMS systems. Even for someone with his experience and pedigree—an EMS management degree from Springfield College, in Springfield, Mass., and a law degree from Western New England College, in Springfield, Mass.—Luckritz would be wading into uncharted territory spearheading the effort.
“We’re not an organization that has experience managing volunteers,” Luckritz said. He wondered, “How do you fold these folks into an already-existing career EMS agency that’s one of the oldest in the country? It’s been around for over 130 years, so there’s a lot of tradition here.”
Luckritz’s greatest worry, however, was whether Jersey City could draw in the necessary volunteers.
“The biggest question was ‘Do we have a base here for this?’ You constantly hear about volunteerism in EMS,” Luckritz said. “I think everyone knows the stereotypes of people from the northeast: Everybody’s got some place to be. Is this the kind of place where this is going to really take off, where people are going to volunteer their time to go through training and then respond to calls?”
The answer to both of Luckritz’s questions was a resounding “yes.”
“We were absolutely shocked. Within a week we had over 100 applicants. Within a few weeks it was over 300,” he said. “By the time we had our first group of graduates, we had over 700 applicants.”
Now with over 1,000 applicants, Luckritz has a new bittersweet worry: Where should URJC set the ceiling for amount of CBECs?
“When we first implemented this program, we didn’t anticipate it ever hitting more than 250 or 300 volunteers,” Luckritz said.
As Luckritz mentioned, one of the concerns about the project was its impact on the existing EMS system, namely, its impact on the career EMTs and paramedics who might have concerns about bringing unpaid volunteers into the fold. Luckritz said that in order to foster the same camaraderie and team-based attitude between the CBECs and employed responders the department was already known for, the full-time EMTs and paramedics trained the volunteer CBECs, so that the two groups could build a repertoire and come to see each other as partners in improving medical services for their city.
“That was one of the best decisions we made, because we were able to build a connection,” Luckritz said. “[The EMTs and paramedics] had the hands-on knowledge, they’re the ones who have been doing this on a day-to-day basis, so they could relay this to the volunteers.
“And when we launched it, the volunteers knew the staff by name already, and I think that was a key part,” Luckritz added.
Jersey City staff interviewed dozens of applicants to choose the volunteers, ultimately deciding on a first cohort of 62 students to undergo 60 hours of training. Luckritz said that he and other stakeholders initially expected to see the applicant pool primarily filled with college-aged individuals and high-rise residents, but he says he was pleasantly surprised by the amazingly diverse group of applicants Jersey City Medical Center received.
“We got folks from all walks of life,” he said. “Anything from corporate executives and financial firms to day laborers … all different socioeconomic backgrounds, all different ethnicities, all different corners of our city here.”
EMS Today 2016 Interview with Robert Luckritz
URJC saw its first 49 graduates complete their training in late 2015, and Luckritz said the program is already seeing results: The volunteers responded to 15 calls in their first week alone.
“This is a perfect project for a rural community; this is a perfect project for a hyper-urban community, where there are delays accumulating because of traffic or high rise buildings,” Luckritz said. “Other agencies’ gaps might be in a rural area of their response area, so this program could work in any kind of environment and be successful.”
Now, with many in EMS eagerly watching, Jersey City hopes to continue proving that United Rescue can be an effective tool in the United States. In the meantime, he has a story from a Jersey City CBEC applicant he often uses to relay the importance of the program.
“I go back to the story that was told to me by one of the first volunteers who signed up for United Rescue,” Luckritz recalls. “It was a retired police officer who lived across the street from someone who was having a medical emergency during a blizzard. NYC was inundated with calls. They were having multi-hour response times to get to calls. The whole area was just completely shut down. And this retired police officer lived across the street from a friend of his who had a heart attack. There was a delay in getting both the firefighter and the ambulance there, because they just couldn’t get through the snow. One of his comments was he just loves this program because it could have made a difference in that case. There are so many different areas where [United Rescue] can really truly make a difference.”
Thanks to Luckritz and all those involved with United Rescue, such an occurrence is becoming less and less likely to happen again in Jersey City.