Columbus’ expanding west side is continuing to challenge firefighters and ambulance crews, who want to reduce response times for heart attacks, injuries and other medical emergencies to a national standard of 9 minutes or less 90 percent of the time.
A report presented to the city’s Board of Works last week showed that Columbus Regional Health ambulance service met the city’s 9-minute response-time standard nearly 96 percent of the time in 2013, when the local hospital began providing service under a new contract.
Performance improved from 2012, when the overall ambulance response time was within 9 minutes 90.3 percent of the time.
The ambulances are “greatly exceeding their response time goals,” according to Mayor Kristen Brown. “We are paying less while seeing improved service and significantly better results.”
Results are not even across the city’s four ambulance-coverage zones, however.
On the city’s west side, response times of 9 minutes or less were met 87.3 percent of the time, below the desired 90 percent threshold.
Reasons for the longer response times on the west side included distance, heavy traffic and bad weather, Columbus Fire Department firefighter Mike Kutsko said.
“Area 4 (west side) is an island,” Brown said. “And it’s sprawled out.”
The city placed an ambulance at the Goeller Boulevard fire station to improve response times to West State Road 46 and surrounding development, representing the largest of the ambulance districts by geography.
The size of the ambulance district itself is part of the reason for the longer response times, Kutsko said.
Physical barriers of distance and, at times, weather continue to complicate matters for ambulance crews. They face more traffic on the west side, particularly at shift changes for area industries in the Walesboro area.
Brown explained that some of the additional response time occurs when the ambulance serving the west side has delivered a patient to the hospital on the city’s near east side at 2400 17th St. The distance to return to the west side on another call from the hospital is greater than distances traveled by other ambulances within their districts, she said.
When an ambulance is called out on a run and another emergency call comes in for that district, an ambulance from a different zone covers it, Kutsko said.
Response times can be greater when ambulances substitute for each other and must travel farther, Brown said. The greatest variance in response times comes when other units must cover for the west side ambulance, the mayor said.
Columbus’ ongoing issues with slow-moving trains crossing State Road 46, a direct route west, was raised by Board of Works member Jayne Farber.
Trains create issues because, even if they don’t cause too much of a delay when crossing, the traffic backup caused by the train does cause a slower ambulance response time, Brown said.
On occasion, if the assigned District 4 ambulance can’t get to a call because of a train, another ambulance with better access will be sent, firefighters said.
When Farber asked if firefighters could get a schedule that would warn them about train traffic, Columbus Fire Chief Dave Allmon said train-masters haven’t been forthcoming with such information because schedules vary so much.
As a stopgap measure, the city has placed a paramedic firefighter at each fire station who goes out on ambulance calls, the mayor said. That paramedic is equipped with lifesaving equipment designed to provide emergency care until the ambulance arrives to transport, she said.
Columbus Fire Department has 22 certified paramedics on staff now, said Capt. Mike Wilson, the fire department spokesman. Twelve more firefighters are in paramedic training and should be eligible for certification by August, he said.
Contract terms, benefits
Columbus Regional Health’s contract for emergency ambulance service with Columbus and Bartholomew County took effect in mid-January 2013. The contract stipulates that designated Columbus Regional Hospital ambulances respond to 90 percent of the calls in the city limits within 9 minutes, and work toward responding to 90 percent of calls in the rural parts of the county within 18 minutes. The Bartholomew County ambulance runs hit the 18-minute goal at 95.62 percent for 2013, compared to 95.59 percent for 2012. The county service area is outside the Columbus city limits.
The new ambulance contract is saving taxpayers about $1 million this year, savings that continue through the life of the renewable contract, Brown said. In the final year of the old contract, the city and county jointly paid $954,000 in subsidies to the hospital system. Brown negotiated the new contract that called for the city and county each to pay $150,000 in 2013, with all subsidies ending this year.
Columbus Regional Hospital is now making up the city-county subsidy through non-emergency ambulance runs, said Dan Spartz, director of the hospital’s ambulance service. These runs involve transporting a patient from Columbus Regional to another hospital or care facility. For example, a trauma case could come into the hospital from a city-county contracted ambulance but then be transported by a hospital ambulance to Indianapolis, he said.
Two ambulances stationed at the hospital that are not part of the city-county contract also take patients back and forth from extended care facilities, or transport to different health care facilities when requested.
To make up for the subsidy, the hospital looks for efficiencies in supplies and staffing, and keeps the ambulance fleet updated to save on vehicle maintenance, he said.
“We have four ambulances contracted for 911 service — they are being paid for, runs or no runs, each day,” he said.
If there is a need, such as all four contracted city-county ambulances being in service, the two ambulances at the hospital are used for city-county emergency runs, he said.
Overall, Brown said, the city is pleased with the progress that has been made with response times and the hospital’s cooperation in providing data and strategies to improve response times.
She particularly was grateful for the hospital’s efforts during December’s westside flooding, when the hospital immediately moved an additional ambulance to the area to compensate for the flooding on Jonathan Moore Pike (State Road 46) and the need to detour to U.S. 31 and Interstate 65.
“The idea is to understand, on every run, what is causing a delay and to see if it is avoidable and preventable,” the mayor said.