Talk about a change in bedside manner.
In a presentation to members of City Council Wednesday, hospital administrators from Denver Health publicly acknowledged for the first time that their ambulance response times are not meeting national standards.
The admissions, however subtle, came as the task force convened by Katharine Archuletta, an aide to Mayor John Hickenlooper, laid out plans for how the hospital, fire department and Denver's 911 system will work together to meet goals set by the National Fire Protection Association.
Even some of hospital's harshest critics, such as local paramedic union president Bob Petre, seemed pleasantly surprised by the turn-around. After all, the task force was stacked with many of the same people who oversaw the systematic neutering of the annual contract that the city keeps with the hospital for ambulances services.
When the Auditor's Office released a scathing report of the city's emergency medical response times last December, Denver Health issued a 39-page rebuttal that, among other things, questioned whether the city even had the power to impose standards on the hospital, a public/private authority.
Three months later, Denver Health Medical Director Chris Colwell, COO Stephanie Thomas and CEO Patricia Gabow are no longer questioning the Auditor's findings that average response times have risen to nearly sixteen minutes 90 percent of the time for ambulances and 10.5 minutes 90 percent of the time for Denver Fire.
These results are not far from what Westword came up with last summer when we began looking into the hospital's fuzzy math with response times.
They are pledging to reduce the time it takes for Advance Life Support (ALS) ambulances to arrive on scene to ten minutes and 29 seconds 90 percent of the time. The fire department's Basic Life Support (BLS) services will be have a 90 percent benchmark of six minutes and thirty seconds. They hope to have reached these goals by the end of the year.
And rather than just measuring time from moment of an emergency vehicle is dispatched until its arrival at the scene -- as agencies did before -- the clock on the "Denver National Fire Protection Standard" will start the moment the call is answered at the 911 call center. This will allow analysts to monitor how the entire response system is performing as a whole and encourage inter-agency cooperation. The task force is also looking to save valuable seconds by streamlining the process by which calls are taken.
The most significant development, however, was Denver Health's pledge to do away with its BLS ambulances, which are staffed by Emergency Medical Technicians, and replace them with ALS ambulances staffed by two paramedics. The organization says it has already hired eight new paramedics at an extra cost of $500,000 and is beginning programs to recruit more.
Along with having an ambulance stationed at Denver International Airport, the hope is that more rigs on the streets will fill the gap during periods of high call volume, when it has sometimes taken ambulances thirty minutes or more to arrive on scene.
The agencies will be providing monthly reports to certain city council members and will give quarterly reports to the ERMS Monitoring Group, which is comprised of seven officials from the city council and the Department of Environmental Health. Archuletta says that ultimately it will fall to the Mayor's office to hold all the agencies accountable -- hopefully this oversight will be more significant than it has been in the past.
The media attention the subject has garnered -- particularly 7News' excellent thirty-minute special investigating ambulance response times to DIA -- has given would-be regulators the bureaucratic leverage to finally hold some feet to the fire.
Councilman Michael Hancock, who has long been pushing the issue, congratulated the task force on their progress. But he chided leaders of the group for essentially freezing out the Paramedic Union from the process. Apparently, some things take longer to thaw than others.
"I think that if [the hospital] does all the things they say, it will be good," says Petre. He hopes that the new contract, which is being drafted by city attorneys, should include the specific response times for Denver Health to meet and that all results should be made available to the public.
City Auditor Dennis Gallagher is also skeptical of Denver Health's many promises, given what he has perceived as the agency's "lack of transparency and accountability."
Which begs the question: If Denver Health is agreeing with the Auditor's findings that the hospital has been in violation of city contracts, utilized "data scrubbing" to jettison longer calls, and allowed its response times to bloat to unacceptable and dangerous lengths, then how is it that none of the people responsible for the numbers are being held accountable?
That would be one response worth getting.
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