In his recent JEMS article, ‘EMS Forced Entry Checklist’, Scot Phelps recounts a decision that many paramedics and other first responders face on a regular basis: forcing entry when unable to gain access to the address to which they’ve been dispatched.
Some calls of this nature highlight safety concerns that Phelps’ checklist does an outstanding job of addressing. Others, by contrast, are generally known to be safe because they involve callers who are actively talking with dispatch. Patients can communicate their problem, but their condition has rendered them unable to get to the front door to unlock it for responding crews.
Like many communities, St. Charles County (MO) has an aging population. This issue began to present itself with increasing frequency more than a decade ago; often, the calls were for general weakness or a non-injury/minor injury fall. If paramedics were unable to gain access via a front door, back door, or even a window, forced entry became a necessity.
While typically very grateful for paramedics’ assistance, residents would understandably become frustrated regarding forced entry. It left them with damage that was costly to repair, and their house sat unsecured for anywhere from a few hours to a several days if transport occurred.
To combat instances of forced entry needing to occur, St. Charles County Ambulance District (SCCAD) developed Rapid Access – a safe entry program that over the past 13 years has grown to become one of the District’s flagship safety programs. Knowing that senior citizens would be the demographic most likely to participate, the program was designed to be simple and hassle-free.
Logistics
Since the program’s inception, SCCAD has partnered with the contractor services team at a Home Depot within the District’s 592-square mile service area. The team worked with SCCAD to source a push-button key safe that checked all our boxes: secure, affordable, easy to use and slim in design. The Kidde Access Point two-key safe has been the product of choice for more than a decade, and at approximately $30, is affordable for virtually everyone.
Residents pay to cover the cost of the box, but the District provides delivery and installation service at no additional charge via its Community Relations team. Installation appointments provide an opportunity to share information on other District safety programs from which the resident may benefit.
The slim layout of the Kidde boxes enables the team to mount to the door jamb between the front and storm doors, protecting them from the elements. Those who prefer to keep their storm doors locked may request an alternate mounting location, which is noted in the dispatch record.
At the time of install, the homeowner completes a liability waiver and code reporting sheet, which SCCAD uses to provide the entry information to St. Charles County Department of Emergency Communication – the agency responsible for dispatching all EMS and fire apparatus within St. Charles County.
If a 911 call occurs at a residence that participates in Rapid Access, code information is automatically visible in the Entry Notes section of all responding SCCAD units, as well as any fire units assigned to the call. The resident does not need to remember or provide their code to Dispatch at the time of the call; the process is fully automated.
Marketing
The District has employed a multi-pronged marketing effort to communicate the program to residents throughout the program’s history. Though social media and online marketing have played a role in the program’s success, it is the most traditional of efforts that bear the most fruit.
- Public Presentations – the District’s Community Relations team actively solicits speaking engagements at church groups, homeowners’ associations, and other community organizations, focusing on Rapid Access and other senior-centric programs.
- Paramedic Recommendations – a detailed communication piece is kept on all ambulances so SCCAD paramedics may provide a copy to patients whom they feel may benefit from the program.
- Home Health/Private Duty Agencies – visiting nurse/health aide agencies in St. Charles Co. have enthusiastically embraced the program; many include the handout in their new client packets.
- Skilled Nursing Facilities – facilities, particularly those that do a lot of rehab, are often willing to include information in discharge packets.
- Word of Mouth – arguably the most effective of all efforts, clients are often very quick to tell friends and neighbors about the program!
Not only helpful on an operational level, Rapid Access has also been a tremendous public relations win for SCCAD. Residents comment regularly that they’re grateful for the District offering the program, stating that it gives them peace of mind to know paramedics will be able to reach them quickly and safely should they require their services.
Points to Consider
- Installation Services – though SCCAD has made the decision to offer installation and find it offers value, it is most certainly a time commitment and may not be feasible for all agencies.
- Alternate Funding – consider that there are residents within all communities for whom the cost of the box may be a barrier to participation. In St. Charles County, a Lions Club chapter provides funding to cover boxes for these residents – exploring one or more partnerships of this nature may be necessary depending on the income demographics of a given service area.
- Changes in Ownership – it will be important to develop a system for releasing codes to new owners of homes or other individuals in the event that a resident dies, moves to a long-term care facility, etc.
St. Charles County Ambulance District is a third-service EMS provider in St. Charles County, MO. Located just northwest of St. Louis City and County, the area has experienced significant growth throughout SCCAD’s nearly five decades of service to the community. Today, paramedics respond to more than 50,000 calls annually. The Districts provides not only 911 service, but non-emergency transports, critical care ground transport, mobile integrated health (community paramedicine), and the American Ambulance Award-winning Substance Use Recovery Response Team.
Agencies interested in exploring the possibility of offering Rapid Access in their community are more than welcome to contact SCCAD Director of Community Relations Kyle Gaines at 636.344.7634, or via email at kgaines@sccad.com.
