For 45 months, and as recently as last week, Denver Health and Hospital Authority administrators told anyone who asked — paramedics, union representatives, Channel 7, Westword — that they were correctly calculating the ambulance response times that they provide yearly to the city. Then, on Tuesday evening, as our story "State of Emergency" (which details how Denver Health's fuzzy math has resulted in ever-expanding waits for ambulances) was going to press, the hospital made a sudden realization.
At a City Council Safety Committee meeting Wednesday, Denver Health CEO Patricia Gabow said the hospital had noticed an error while gathering information for the city auditor's ongoing review of the Denver Paramedic Division. Apparently the hospital has been providing incorrect data with regard to paramedic response times for the past four years. Whoops!
But as the hospital explained, the problem wasn't how Denver Health has been reporting the data; it was simply that "the contract language about the calculation method was carried over from previous years and not updated," a press release said.
Ever since spinning off from city government as a quasi-public authority in 1997, Denver Health has maintained a contract with county regulators that holds it to certain standards in how fast paramedics respond to calls. The rate of compliance has changed — currently, 85 percent of calls must be below 8 minutes and 59 seconds — but the start time has always been clearly defined as "the time the call is received," and it stops when an ambulance arrives on the scene. Denver Health has been starting the clock when an ambulance is assigned rather than when the call is received, disregarding a patch of time that can last several minutes or longer when the supply of ambulances is low.
Denver City Council President Michael Hancock, who has long had concerns about the EMS system, says this revelation is just one more reason that the performance of the city's paramedic division should be reviewed by an outside consultant. "It's disappointing, and it makes me more motivated to pursue some improvements," he says.
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On Monday, Gabow offered further assurance to councilmembers that the hospital would fix the response-time discrepancy by updating the contract to reflect the hospital's current calculating processes, which she says were agreed upon in 2004. But that didn't fly with Councilwoman Jeanne Faatz, vice chair of the safety committee, who doesn't recall the issue of adjusting response times ever coming up in 2004.
"Why would policymakers relax those standards to have a different interpretation? I don't know," says Faatz. "I'm concerned about the fact that it has been. And I don't know who gave permission to allow it to be calculated that way."
The hospital says the new methodology came out of a September 2004 meeting with the Denver Department of Safety. But according to minutes of that meeting obtained by Westword, then-deputy manager Steve Browne was the only safety department official present. The purpose of the meeting was to define response times, but there was no discussion of changing the way response times were reported to the city. Such a discussion would have needed to occur with the Department of Environmental Health or with mayoral staffers. Mayoral staffer Katherine Archuleta confirms that no one in the mayor's office knew that Denver Health had changed the standard.
Paramedic union president Bob Petre says he believes the reason Denver Health avoided proper channels is obvious: "They didn't want to trigger the same kind of audit that they're getting now."