Palo Alto advised to change its ambulance service
Consultant study recommends scrapping non-urgent transports, adding a full-time ambulance
Palo Alto's emergency medical services are already among the best in the region, but the city's program could benefit from a new leadership position, a second full-time ambulance service and elimination of the city's non-urgent "basic life service," according to a consultant study that was presented to the City Council Monday (Jan. 23).
The report from Systems Planning Corporation/TriData provided a broad overview of the city-run emergency medical services and while it offered a glowing review of the existing operations, it also included 23 recommendations for improvement. These included big-picture suggestions such as maintaining the local operation (as opposed to joining Santa Clara County's ambulance program) and increasing the Fire Department's participation in "community health improvement." They also included micro-level recommendations about staffing levels and organizational changes.
Monday's discussion gave the council its first look at a study that has been close to two years in the making. It is an addition to a broader Fire Utilization Study that TriData worked on last year, a broad analysis of the Fire Department that recommended consolidating some police and fire operations and merging two fire stations.
While the earlier study was in many ways critical of the Fire Department, pointing to its "leadership malaise" and poor coordination, the EMS report was mostly positive in its tone.
"The level of care delivered to the citizens and visitors of Palo Alto from the local fire-based system is quite good and exceeds national performance standards for response to an emergency scene and level of care delivered," the report states. "The benefit to the residents is they get multiple services from one public agency; in other words, the fire department provides fire/EMS/public assistance from multi-role trained personnel and equipment, distributed across the City of Palo Alto."
For this reason, the report states, Palo Alto should remain the only city in the county to provide its own ambulance service. The city's location in the northern part of the county and the county's management plan "would make a large-scale change unwise."
Harold Cohen, a consultant with TriData who presented the study to the council Monday, pointed to the department's fast response time and its high percentages of "excellent results" for different clinical skills (including different types of injections) — percentages that in 2011 exceeded the national average.
"When it comes to the patient care the citizens are receiving, it's very good — it's excellent," Cohen said. "I believe that you're setting a trend and setting an example for many things around the country."
But the city, he said, can also take steps to make things better. One such step is increasing the number of full-time ambulances from one to two (the city also has one part-time ambulance). Another step is scrapping of the BLS ambulance, which Cohen said is no longer necessary because the area has other companies that can provide non-urgent transport service.
"I believe the program is like banging your head against the wall — you feel so good when you stop," Cohen said. "The community has other means of providing medical transportation. That allows the Fire Department to focus on its mission and that is emergency services."
The study was commissioned to assist the city with its broader effort to overhaul its public-safety services — an effort that also includes consolidating the administrative functions of police and fire departments and working with Mountain View and Los Altos to link the three cities' respective dispatch services.
The TriData report noted that 60 percent of 911 calls the Fire Department responded to in 2011 were requests for emergency medical services. Given the increasing prominence of the service, consultants recommended creating the position of an EMS Chief and promoting the present EMS coordinator to the new position. The department's medical services are currently overseen by an acting deputy chief in the emergency operations division, a veteran employee who the report notes has "minimal EMS background."
Kimberly Roderick, the city's EMS coordinator, said staff largely concurs with the report's recommendations about organization changes.
"The Fire Department recognizes that the calls for service on the EMS side are rising while the fire calls, while still important to train and prepare for, are decreasing," Roderick said.
Councilman Larry Klein wondered about ways to get more revenue from the ambulance service, but Cohen said he didn't have any suggestions on this matter and said that the city "does pretty well" when it comes to collecting dues.
The council did not vote on or dispute any of the recommendations, which will now be referred to its Policy and Services Committee.
READ MORE ONLINE
Read the full report from Systems Planning Corporation/TriData at www.cityofpaloalto.org .
Staff Writer Gennady Sheyner can be emailed at email@example.com.