Grady Dramatically Improves South Fulton County EMS Performance

Grady Dramatically Improves South Fulton County EMS Performance

By Michael Davis (michael@connectsouthfultonga.org)

 

South Fulton county is a large geographical area comprised of suburban and sparsely populated rural areas identified as rural metro. Over the years, South Fulton county has had a history of unreliable and inconsistent EMS ambulance response times had the resident’s complaints about unacceptable EMS ambulance response time grow into a crescendo.  Resident’s reported complaints included when a resident called 911, but ended up driving their own vehicle to the hospital when an ambulance was not available and another instance where an ambulance arrived on the scene an hour after 911 was called.

The state of Georgia does not have established EMS ambulance response time standards and requirements and allows jurisdictions to define their own EMS ambulance response time requirements. Across the US, the average response time target for emergency calls is eight minutes. Expected response times can vary depending upon the geographical population density (i.e. urban, semi-rural, and rural) and proximity to a hospital.  Generally, hospitals are located in more densely populated areas providing closer proximity and shorter EMS hospital and in turn lower EMS average ambulance response time.



For EMS ambulance response time, seconds and minutes count. The impact of delayed response time for on scene treatment or in transporting the person to the hospital can have an adverse effect on the patient’s short-term condition or survival especially in the cases of cardiac arrest, stroke, or heart attack.

When a cardiac arrest occurs, a person’s heart stops pumping blood around their body and they stop breathing normally. If CPR is administered immediately by a bystander it can double or triple a person’s chance of survival. The out of hospital cardiac arrest (OHCA) mortality rate is about 90%.  A study of 10,853 patients on the effect of ambulance response time on survival after resuscitation from OHCA, published in Deutsches Ärzteblatt International, concluded that rapid ambulance response time independent of whether a bystander provided resuscitation measures, has a significant independent effect on the survival rate and is associated with a higher rate of survival from OHCA with a good neurological outcome.

A stroke is caused by a blocked artery or the leaking or bursting of a blood vessel. If you are experiencing a stroke, immediate first response of the medical attention provided by EMS is absolutely critical. Immediate treatment may minimize the long-term effects of a stroke and even prevent death.  Stroke is the third leading cause of death and the leading cause of serious, long term disability in the United States.

After a heart attack, the critical act for treating the patient is how quickly the patient’s blocked arteries are opened in the first 90 minutes after arriving at the hospital. The risk of dying goes up 42 percent if care is delayed even half an hour beyond the 90 minutes that U.S. guidelines say patients should be treated after arrival.



To thoroughly understand the historical South Fulton county EMS ambulance response times, and to ascertain the outcome of the July 2018 EMS service provider change, and to provide a before and an after comparison of EMS service providers, a deep dive analysis was conducted on the 911 Computer Aided Dispatch (CAD) South Fulton county EMS ambulance response time data provided by the Fulton County Emergency Services Department. The analysis measure utilized was response time which is defined as the time elapsed from the gathering of sufficient information about the event to the arrival of health care providers at the scene of the event.

The average EMS ambulance response time results show consistently long response times for Chattahoochee Hills, Fairburn, Palmetto, City of South Fulton, and Union City with an average response time of 26 minutes and 13 seconds for all jurisdictions for August 2017 through November 2017. The results show the cities of Chattahoochee Hills and Palmetto experienced an average EMS ambulance response time of 30 minutes for the same time period.

The following table provides the average EMS ambulance response time performance for the five South Fulton county jurisdictions for August 2017 through November 2017 with American Medical Response (AMR) as the sole EMS service provider.

 

South Fulton County

EMS Ambulance Average Response Time Performance

August 2017 – November 2017

 

Aug-17 Sep-17 Oct-17   Nov-17 Total Avg. Response Time
Chattahoochee Hills 26:34:00 31:21:00 36:29:00 27:35:00 30:29:45
Fairburn 21:41:00 22:10:00 24:31:00 25:05:00 23:21:45
Palmetto 29:22:00 27:10:00 36:08:00 27:40:00 30:05:00
South Fulton 22:33:00 23:39:00 24:00:00 25:43:00 23:58:45
Union City 22:43:00 22:31:00 24:42:00 22:56:00 23:13:00
Total Avg. Response Time 24.34:36 25:22:12 29:10:00 25:47:48 26:13:39

In response to concerns from South Fulton county municipal leaders about unacceptable EMS response time, the regional EMS council released an RFP in early 2018 to select a South Fulton county EMS service provider. The regional EMS council recommended Grady as the new South Fulton county EMS service provider effective July 1, 2018.  Grady assumed responsibility as the sole EMS service provider for five South Fulton county jurisdictions.

The following table provides the South Fulton county EMS ambulance average response time performance for the five jurisdictions for August 2018 through November 2018 with Grady as sole EMS service provider.

 

South Fulton County

EMS Ambulance Average Response Time Performance

August 2018 – November 2018

(Post EMS Provider Change)

 

Aug-18 Sep-18 Oct-18   Nov-18 Total Avg. Response Time
Chattahoochee Hills 14:10:00 16:59:00 15:31:00 15:14:00 15:28:30
Fairburn 11:29:00 10:54:00 10:52:00 11:52:00 11:16:45
Palmetto 11:45:00 12:16:00  10:59:00 10:14:00 11:18:30
South Fulton 09:09:00 09:31:00  08:44:00 10:04:00 09:22:00
Union City  10:15:00 10:20:00 10:28:00 10:24:00 10:21:45
Total Avg. Response Time 11.21:36 12:00:00 11:18:48 11:33:36 11:33:30
 

Statistically, monthly call volumes are consistent year to year and provide a means of   comparable when comparing response time performance for the same month or time period for different years. The following table provides a comparison of the average response time performance for the two South Fulton county EMS service providers AMR and Grady for a comparative four-month time period.

 

Average EMS Ambulance Response Time Performance Comparison

 

Avg. Response Time

Aug 17-Nov 17 (AMR)

Avg. Response Time

 Aug 18-Nov 18 (Grady)

Chattahoochee Hills 30:29:45 15:28:30
Fairburn 23:21:45 11:16:45
Palmetto 30:05:00 11:18:30
South Fulton 23:58:45 09:22:00
Union City 23:13:00 10:21:45
Total Avg. Response Time 26:13:39 11:33:30

The EMS response time improvements were most pronounced for the cities of Palmetto and Chattahoochee Hills. Mayor Tom Reed of Chattahoochee Hills said, “The improvement in service levels to our Citizens has been huge – and will literally save lives.  Our response times have fallen in half – and we feel like we’re working with a real partner in the Grady team.”  “I can’t overstate the importance of the strong relationships we have with our fellow south side cities and Fulton County, as this change and the huge improvements its engendered would not have happened were it not for the incredible teamwork and alignment we all brought to the negotiations”.

The following table provides a comparison of emergency and non-emergency average ambulance response time results for the two EMS service providers for a comparative four-month time period August through November.

Average South Fulton County

EMS Ambulance Response Time Performance Comparison

 

Average Emergency

Response Time Performance

Average

Non-Emergency

Response Time Performance

AMR (Aug 2017 – Nov 2017) 17:33 20:25
Grady (Aug 2018-Nov 2018) 10:39 12:01
EMS Response Time Performance -6:54 -7:34

Every second of EMS ambulance response time is critical based on a person’s condition and it can literally be a matter of life or death. EMS ambulance response time is a quality of life issue that reflect the standard and livability of a community.  Based upon the aforementioned EMS ambulance response time performance analysis, the overall average emergency response time improvements for all five jurisdictions decreased by nearly seven minutes and the non-emergency average response time performance for all five jurisdictions improved by more than seven and a half minutes. The EMS ambulance average response time performance of two jurisdictions that had the highest response time averaging 30 minutes were cut in half.

The South Fulton county EMS new service provider change has produced a significant EMS ambulance response time improvement and drastically reduced the time before an EMS arrives after a 911 call.  The outcomes for the EMS new service provider will benefit all of the residents for the five South Fulton county jurisdictions. The significant improvement in average emergency response time potentially could save lives for South Fulton county residents.

The improvements in emergency and non-emergency response time in South Fulton county will restore resident confidence about EMS ambulance response times in the five jurisdictions being serviced.



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