How San Francisco plans to resolve longer waits for ambulances
San Francisco doesn’t always have enough ambulances for medical calls, with delays of up to six calls sometimes. This means that an ambulance has been requested but is not immediately available.
While paramedics are already on scene to provide potentially life-saving care, and each delayed request can be resolved in minutes or even seconds, this can delay transportation to a hospital in situations where every minute might have its mark. importance.
While medical calls have increased nearly 16% since 2015, the number of paramedics has remained at 200, according to a note from the firefighters. The impacts of more calls may be increased wait times for patients to get ambulances in outlying areas and the use of overtime to meet staffing needs, according to the note.
London Mayor’s Breed and San Francisco mayor supervisors are proposing to increase the department’s budget to help fill in the gaps, though their proposals differ. While the department and Breed said more analysis was needed to determine whether to increase staff in the future, supervisors Matt Haney, Ahsha Safaí and Shamann Walton said on Wednesday they were using the budget savings. to add 10 more paramedics now.
“It is absolutely essential that paramedics are available to respond immediately to an emergency,” Haney said in a statement. “The addition of new paramedics will reduce response times, improve health and safety and save lives.”
In San Francisco, where elected officials compete for the budget and the size of the police, there is almost unanimous support for firefighters and in particular its community paramedics. The city has increasingly relied on them to respond to homelessness, mental health crises and drug overdoses, tackling some of the medical calls that don’t always require an ambulance.
An additional 57 paramedics are estimated to be part of the department’s community paramedics and new street crisis response teams, and the department has been approved to fill those ambulance positions.
The city has also added eight paramedics and emergency medical technicians on smaller trucks that aim to get medical staff on site as soon as possible, although they cannot transport patients to hospital.
The mayor’s spending plan proposes to increase the ministry’s current $ 412 million budget by 7% over the next two fiscal years. The increased funding will go to equipment, training, salaries and 35 new paramedics to replace those in the ambulance division moving to street teams.
“Our plan is to do everything we can to make sure that we can meet some of the challenges that we are experiencing,” Breed said Wednesday as he stood outside the city’s newly renovated ambulance center at Station 49 in the District of Bayview.
While the fire department’s memo to supervisors a few weeks ago described “problems with ambulance staff,” Breed and the service said this week it was not clear whether more staff was needed. The city plans to restart a staffing analysis that was halted due to the pandemic to guide hiring. The department said it would then return to the mayor’s office in the middle of the fiscal year, which begins July 1 or next year with budget needs.
“Put your foot down and say yes, we need more or no, we don’t need more – that would be a speculative and uncultivated decision,” said Lt. Jonathan Baxter, spokesman for the fire department, emphasizing the need for Analysis.
But the watchdog – and the firefighters union – want even more paramedics and funding now. Wednesday’s proposal pledges to use $ 1.9 million in budget savings to pay for 10 new paramedics – with possibly more to come. The total cost of a full-time paramedic for salary and benefits is just over $ 200,000. Ambulances require two paramedics or one with an emergency medical technician to complete a 12-hour shift.
The debate is not new. Over the past 15 years, calls to fire departments have steadily increased, largely due to calls to emergency medical services, according to the mayor’s budget. When a city report found that the city did not have enough ambulances or paramedics in 2014, the city increased the number of paramedics from 177 to 200 in 2015. The current number remains at 203 .
Last year, with fewer people living and working in the city, calls overall declined. Now that the city is emerging from the pandemic, the need is growing again.
Since most ambulance requests are made in the city center and at the mission, the impact of the increased call volume is most felt in the outskirts of the city, according to the memo of the fire department. Data shared with supervisor Gordon Mar shows average annual response times for medical transport calls in the Great Highway area on the city’s western outskirts increased 1% last year and 10% this year, almost 10 minutes away.
“Do I worry about the increased response times? Yes,” Fire Chief Jeanine Nicholson told Mar during a budget hearing last week. “It concerns me, absolutely – not just the ambulances but all of our units.”
The target response time for ambulance medical transport is less than 10 minutes. The ministry achieves this goal 89% of the time. Another first responder arrives within four minutes 91% of the time. This worker can provide care, but not transport a patient to the hospital.
Baxter said the reason for the sometimes longer call response times could be attributed to a number of factors – traffic, closed streets, construction – in addition to staff.
“There are times when we don’t have an ambulance to respond,” Baxter said. “Why is that the case? These are the things we need to assess to see what our needs are.”
The union believes the problem is with the staff. Sam Gebler, union manager of Local 798 representing nearly 1,700 fire department employees, said he was often the only paramedic on three fire trucks in the Richmond District. He said last week, while working overtime in the Sunset District, he responded to an older patient with a history of cancer who was ill with very severe symptoms. He had to wait 30 minutes to stabilize the patient for an ambulance to arrive, he said. In these cases, he is not able to answer other calls if they arise.
With an increase in appeals over the years, the department has been forced to increasingly rely on overtime shifts, including mandatory overtime, and per diems to meet minimum staffing levels, the note said. of the department. Gebler estimated that paramedics work mandatory overtime at least five times a month.
“We are doing our best to meet the safety needs of citizens,” said Shon Buford, fire captain and union president. “But it has a major impact on the mental health of our paramedics, and it’s not sustainable.”
Mallory Moench is a writer for the San Francisco Chronicle. Email: [email protected] Twitter: @mallorymoench
(c) 2021 San Francisco Chronicle
Visit the San Francisco Chronicle at www.sfchronicle.com
Distributed by Tribune Content Agency, LLC.