Hospital moves to in-house nighttime ambulance staffing | CraigDailyPress.com

Hospital moves to in-house nighttime ambulance staffing

Michael Neary

Emergency Services Manager Elizabeth Metcalf

— The Memorial Hospital of Craig has changed the way it provides nighttime ambulance service, with emergency response personnel working from the hospital rather than responding on call.

"We were doing a 12-hour shift during the day to cover the busiest times, with backup on-call personnel during the night," said Elizabeth Metcalf, emergency services manager for TMH, as she described the hospital’s procedure before the change.

On Sunday, the hospital began to assign full night shifts to emergency response personnel.

"With a lot of discussion with the staff and the administration team, we worked out that by being in-house for two 12-hour shifts, we would be able to serve the citizens of Moffat County that much better," she said.

Metcalf said the shifts run from 6 a.m. to 6 p.m. and from 6 p.m. to 6 a.m., and include a two-person crew able to provide Advanced Life Support Services. Metcalf cited an uptick in emergency calls as a factor in making the change. She said the hospital received 1,377 calls in 2015, up from 1,230 in 2014.

Richard Nichols, a paramedic for the hospital, noted a reduction in response time when emergency personnel respond to a call from the hospital rather than from home, when they're on call.

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"I would suspect (a reduction of) eight to 10 minutes, on average," Nichols said.

Nichols said from the time personnel are paged to the time they begin the route, the average response time is about 1.8 minutes — if they are in-house. He said the average response "from the time the page goes off to the time we arrive on scene is right about five minutes" when personnel are in-house.

When personnel were on-call, Nichols said, the average time between receiving the page and beginning the route was about nine minutes. He said the response time between the page and the actual arrival was about 14 minutes when personnel were on call.

Nichols said the hospital used to use overnight in-house shifts, but went to a nighttime on-call arrangement in 2010. Jennifer Riley, chief of marketing and business development at the hospital, cited financial concerns that sparked the change to an on-call method at that time.

"2010 was a very tough year, financially, for us," she said. "We had to make a lot of changes. We changed staffing in a lot of areas."

Riley said a stronger financial position has enabled the hospital to return to the overnight staffing of emergency response personnel.

"The financial position of the hospital has gotten much stronger since 2010," she said, and she added analysis revealed the in-house method of emergency service creates more financial efficiency having personnel on call.

Riley also stressed the increasing numbers of patients using the hospital's ambulance and emergency-room services, creating an increase both in patient demand and in the revenue the hospital has been able to generate. She said expanded Medicaid coverage in the state may be contributing to the rising numbers of ambulance calls and emergency room visits.

Nichols, who's worked at the hospital for 21 years, said the change to in-house ambulance service also helps the staff members.

"When we were having the on-call and responding (duties) from home, we'd also have the full-time jobs," he said. "So some of us would be working in here for a 12-hour shift and then be on call, and get called out, in the middle of the night."

Metcalf said the hospital hired two full-time staff members to help implement the change, along with two paramedics and an emergency medical technician hired on an as-needed basis. The two new full-time staff members include a paramedic and an emergency medical technician.

TMH's Emergency Medical Services division's primary response area consists of about 2,500 square miles within Moffat County, said Metcalf.


Reach Michael Neary at 970-875-1794 or mneary@CraigDailyPress.com.