Editor's note: This story has been updated. After our original story aired, D.C. Fire & EMS provided revised statistics for "alpha holds."
The private ambulances now responding to non-life-threatening calls in D.C. mostly arrive on time, according to data on the first few weeks of the new program. But, as the fire chief says, it's a work in progress.
The third-party company American Medical Response (AMR) began responding to non-life-threatening 911 calls last month. AMR responds to calls from 7 a.m. to 1 a.m., seven days a week.
While D.C. Fire & EMS is continuing to transport patients withal life-threatening or time-sensitive conditions, such as cardiac arrest, stroke and major trauma, AMR is transporting patients with minor injuries or illnesses, such as colds or sprained ankles.
On an almost daily basis, D.C. Fire & EMS runs low on ambulances due to a high volume of calls for service. And even with the new private ambulances, it can still take 15 to 30 minutes for an ambulance to get a patient to the hospital.
"There will be hiccups; we are looking to correct those; AMR is looking to correct those," said Fire & EMS Chief Gregory Dean. "But patient care is not one of the hiccups."
Dean is referring to response times and ambulance availability. Data provided by the department shows D.C. still runs low on ambulances almost daily. At times, this has forced the department to reserve ambulances for life-threatening emergencies only, which is called alpha hold.
"Alpha hold kicks in when we get to about 10 to seven ambulances," Dean said.
From March 28 through April 12, D.C. Fire & EMS was on alpha hold six times.
"AMR still has resources available, so the definition of alpha hold has to be redefined," Dean said.
While private ambulances are available most of the time during alpha holds, they can transport only patients with non-life-threatening injuries or illnesses. And while the private ambulances are required to arrive within 10 minutes, the data shows that's not always the case.
Data shows that, during the first two weeks of service, private ambulances showed up within:
- 10 minutes or less: 75 percent of the time
- 10-15 minutes: 17 percent of the time
- 15 minutes or more: 8 percent of the time, with 11 of those transports taking 30 minutes
AMR's contract with the District requires the private ambulance company to arrive within 10 minutes of being dispatched 90 percent of the time each month. If AMR fails to meet that standard, the District can impose financial penalties.
AMR has not been transporting patients for an entire month yet, so Dean said it's too early to consider penalties.
"It’s good to look at the information, but conclusions should come later," Dean said.
He said the department has penalties in place but they haven't implemented any.
"We're in the implementation phase; they've brought on a number of people who are learning the District..." Dean said. "We have D.C. Fire personnel on the scene taking care of the patient. The person is in a non-life-threatening situation; we're there with the patient until they get there. This is about patient care, and the patient care has not been dwindled."
While Dean said the private ambulances have been freeing up his firefighters and paramedics for more training and the ambulances for more maintenance, the data also revealed that the private ambulances haven't been running as many calls as was hoped. In fact, the private ambulances are only transporting about half the eligible patients.
During the first two weeks, D.C. FEMS transported 1,638 patients, and AMR transported 1,308 patients.
"We're a little shy, as we get used to it...." Dean said. "We're allowing our members an opportunity to concentrate on patient care, if they're comfortable, and they'll get more comfortable as we're seeing, they'll turn the patients over. If they're not comfortable, they'll retain control of the patient. The nice part is that everyone is concerned about patient care."
Dean stressed that the most important things about these numbers are that this program is less than a month old and will improve over time, and that patient care has not been affected negatively.