Monroeville (Pa.) Hospitals Angle for Ambulances

MONROEVILLE, Pa. — A budding hospital war in Monroeville has the region’s two largest health care systems offering holiday cookies, sandwiches, calendars and coffee mugs to help woo ambulance crews that deliver patients to emergency rooms.

But paramedics and emergency medical technicians told the Tribune-Review that they would rather get costly medical equipment to treat patients, continuing education classes and lucrative contracts for doing non-emergency transfers that help pay the bills.

“I don’t want T-shirts, and I don’t want hats,” said Bob Moran, deputy director of the Plum Emergency Medical Service. “What I need is what’s going to help the service provide the care in the communities we’re in. Bottom line: We’re in this business to help people.”

UPMC East officials held a luncheon this week and told paramedics that they plan to open their new 156-bed, $240 million hospital in Monroeville on July 2. West Penn Allegheny Health System, which runs Forbes Regional Hospital less than a mile away on Mosside Boulevard, has been offering its own perks to keep emergency crews connected to the facility.

For both hospitals, the stakes are high. Although ambulance crews provide increasingly sophisticated care in the field, they still need a hospital in which to deposit patients. Each emergency service must maintain a command with a medical director, typically a doctor based at a hospital where the crew receives supplies and training.

“Certainly the emergency department is the front door of the hospital, and EMS represents a significant volume of patients who are coming into that emergency department,” said Myron Rickens, director of UPMC Pre-Hospital Care.

In emergencies, state law dictates crews must take the patient to the nearest hospital that can best handle the person’s injuries. Forbes plans to open a Level 2 trauma center in 2013, which will allow it to take serious cases that can go only to Pittsburgh hospitals now. Ambulances could then take trauma patients past UPMC East to reach Forbes.

Patients who are stable, however, can choose where they go. If they don’t have a preference, the ambulance crew can decide where the patient goes — usually where they maintain a command.

Forbes, which opened in 1978, has long-standing relationships with many emergency crews — in Monroeville, Jeannette, Penn Hills, Pitcairn, Penn Township, Plum and Trafford — and the hospital has taken steps in recent years to solidify those agreements.

It spent $784,000 to outfit 28 vehicles based there with heart monitors, and it provides the crews with continuing education, supplies and a lounge where they can rest between calls. Forbes recently hired Monroeville at $36,000 a year to provide dispatch services. For Christmas, the hospital sends cookies to the ambulance stations.

UPMC East offers similar perks, including calendars and coffee mugs handed out at Tuesday’s luncheon. Moran said he relished the chance to talk with hospital executives on a tour of the new building about ways to make it easily accessible for crews to deliver patients, quickly get supplies and get back on the road.

Even though he broke bread with UPMC, Moran said his loyalties remain with Forbes — for now. He would like Forbes to buy his vehicles a mechanical CPR machine that costs more than $12,000.

“We know where our bread’s buttered, meaning Forbes, because they work with us and help us,” Moran said. “I think UPMC always has stepped back and said, ‘That may change down the road.'”

For smaller ambulance services based at Forbes, non-emergency transfers can be the difference that keeps them running, said Bill Bittner, chief of the Pitcairn Ambulance Association. Until about a year ago, Forbes ran most of its transfers through one service, but then started spreading around the work, he said.

Pitcairn also has a temporary transfer contract with UPMC. Each trip could be worth anywhere from $35 for taking a wheelchair patient to a rehabilitation facility to up to $350 or more to take a medical patient from one hospital to another.

“Transfers for us is a very big thing,” Bittner said. “It helps us generate payroll. We can’t survive on our community alone.”

Forbes also reached out to crews by hiring a physician, Dr. Daniel Schwartz, who can ride out to an emergency, provide guidance and ride back with the ambulance if needed. UPMC hospitals throughout its system offer similar services.

That does not mean Schwartz directs calls only to Forbes. That would be unethical, he said. Crews still go to the best, nearest hospital.

The only thing Forbes gets, he said, is good will.

“This is not about bringing patients to Forbes,” Schwartz said. “The purpose is to support the community and do the right thing. And when you do the right thing as a hospital, it will pay off for you. Patients will show up because there will be a good feeling.”

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