On Wednesday, June 4, administrators at the Denver Health and Hospital Authority admitted that they have been miscalculating the ambulance-response times of their paramedic division for the past four years. This admission came in the wake of a Westword investigation which revealed that Denver Health's ambulance system was failing to meet the basic response-time standards set by the city, and that these dramatically increased response times had gone unnoticed by municipal regulators. As the Westword story showed, since 2004 the hospital has been starting the clock on 911 calls at a later time than was stipulated in Denver Health's contract with the city.
In a press release issued on June 4, the hospital attributed this discrepancy to an “oversight, the contract language about the calculation method was carried over from previous years and not updated.” And as the Westword story was hitting the stands Wednesday morning, hospital administrators were meeting with the Denver City Council Safety Committee; they told councilmembers that the hospital had just discovered the error.
“We have gone back and reviewed the history of the response time reporting,” Stephanie Thomas, chief operating officer at Denver Health, said in the press release. “Based on a meeting held in 2004, we began reporting response times the same way as the Denver Fire Department. However, due to what was clearly an oversight, we did not go into the existing contract with the City, which had been in place since 1997, and update the language of the contract to match the decision....This discrepancy was not intentional, and we are surprised that it remained undiscovered until now.”
But if such a change had been made in order to match the fire department’s response-time reporting method, it was apparently unknown to the man responsible for running the paramedic dispatch operations. On May 19, Westword conducted a face-to-face interview with paramedic Assistant Chief James Azuero at the city’s 911 dispatch center. When asked if the response-time clock starts at the moment the call is received (as the city contract requires) or when an ambulance is finally dispatched, Azuero replied that the clock starts “as soon as the 911 call-taker transfers the call to paramedic dispatch.”
When asked if those figures are actually representative of what the hospital reports to the city, however, Azuero backed off his previous statement. “Bottom line is, when I am asked for the report, I supply the report,” Azuero said. “I say, ‘Here are the times.’ What the [hospital] decides to use is up to them.”
On May 9, Chris Colwell, the division’s medical director, made a similar assertion about when the response-time clock starts to 7News: “When I go ask for response times, the response times I’m getting are from when the time we get enough information to dispatch the call until the time we arrive.”
In an addendum to yesterday’s press release, Colwell admitted that this assertion was incorrect: “I misspoke about the methodology of response time calculation that is reported to the City,” he said. “My understanding was that we recorded the time when we ‘had enough information and sent the ambulance.’ I regret any confusion that may have resulted from this statement.”
This new calculation “methodology” explains how the division’s average response time went from 6 minutes and 34 seconds in 2004, before the change, to 5 minutes and 47 seconds in 2005. But in 2007, the average crept back up to 6 minutes and 10 seconds – which means that the actual average response time, when calculated correctly, could now be seven minutes or more. Much more, if the disgruntled paramedics and dispatchers interviewed by Westword are correct. – Jared Jacang Maher
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