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Hospital set to take over ambulances
Elmore Medical Center will officially assume control of the county ambulance service when the clock strikes midnight on March 31.
A few details remain, but with less than a month to go Hospital Administrator Greg Mauer is confident the hospital will be ready to launch the new service, which will be known as Elmore Ambulance Service (EAS).
Last year, the county commissioners contracted with the hospital to develop a "best practices" study of what an ambulance service should do. The contract with Northwest Paramedics was set to expire at the end of the fiscal year and the county wanted a better standard than it had previously had to determine what criteria should be included in an ambulance contract.
At that time, the hospital had no interest in running an ambulance service itself.
"Ambulances are a big loss leader," Mauer said. "With our volume, it wouldn't have paid for itself, and we didn't want to take away any resources" from the hospital itself.
But by the time the contract came up for renewal in September, the board of trustees of Elmore Medical, in part because of what it had learned in doing the study for the county, decided it would put in a bid for the contract.
With the county paying for the service, so it wouldn't affect hospital district revenues, and having identified what worked and what didn't work among a score of regional ambulance services it had studied, the hospital felt it could put together a competitive proposal.
The county commissioners agreed and awarded the contract to the hospital, while NPA agreed to a temporary extension of its contract to allow the hospital time to get ready to take over the service.
In part, the county commissioners also liked the idea of working with a local entity, such as the hospital district, rather than an out-of-county company, believing it would improve coordination with the county and would be able to focus is resources solely on local needs.
"We have a vested interest to make sure it works well," Mauer said. "We want our patients to arrive in the best possible condition."
In addition, he added, "all of the control will be local and there will be full disclosure and transparency so that the public can see what we're doing." A joint oversight committee, composed of a county commissioner, an Elmore Medical Center board member and Mauer, will provide financial and operational oversight for the new service.
One of the concerns that had been raised in the earlier study was coordination with other ambulance services. As part of its effort to improve ambulance service care when it takes over the contract on April 1, the hospital has created an emergency service advisory committee, composed of representatives from all the emergency service agencies in the area, that will analyze procedures and practices and help establish standardized equipment and training with other ambulance services in the area.
"For example," Mauer said, "if we're rendezvousing with the Pine/Featherville QRU, we want to make sure we're all on the same page so the handoff goes as smoothly as possible."
Dr. Tim Brininger will be the EAS medical director. He will develop, lead and monitor the standardized training programs, which will include not only patient care, but equipment and hospital procedures.
The new Elmore Ambulance Service itself will be run by Dale Crandall, who began his career as a Basic EMT in Elmore County in 1985, rose to become a supervisor by 1991, then eventually moved to Oregon to further his training and become a paramedic. He was glad to "come home," he said, to run the service for the hospital.
Crandall will lead a team of six other paramedics (a significant increase from those available from NPA), eight Basic EMTs, seven Advanced EMTs and several more part-time certified personnel who can fill in as needed.
A few of the NPA employees are staying on, but the hospital was able to choose from "a large pool" of "highly qualified" people in order to select those that it has hired. All of those hired either live in Elmore County, or have strong ties to the county, Mauer said, and all went through an extensive and comprehensive interview process.
Because all of them will be hospital employees, they will be trained in hospital procedures, which should improve the handoff from the ambulance to the emergency room, Mauer said.
Over the next month they'll all be receiving specialized training in all aspects of their jobs, including "ancillary things, like geography," said Curran, so crews will actually know where they're going when they are paged out.
The county has purchased two new ambulances for the new Elmore Ambulance Service and will retain three ambulances formerly used by NPA. Two will service as back-ups and the third will be an emergency reserve.
One ambulance will be stationed at the ambulance bay of the hospital in Mountain Home. The on-call crew for that ambulance, which will include a paramedic (a skill level needed on about five percent of all calls that allows the crew to dispense some medication and use more advanced equipment), will be housed in the basement of the clinic across the street from the hospital.
In Glenns Ferry, the county is building an expansion to the current site where its ambulance is housed. The ambulance stationed in Glenns Ferry will be manned with at least an Advanced EMT aboard.
The Mountain Home Fire Department has provided space for the two back-up ambulances to be housed at Fire Station No. 2, just up N. 6th East Street from the hospital.
All of the ambulances will be upgraded with new, standardized equipment.
And because the ambulance crews will now be hospital employees, they'll no longer simply hand off the patients to the emergency room teams. Instead, they'll continue their care, moving in with the patient to become part of the ER efforts, thus improving coordination and knowledge of the patient's condition and treatment to that point.
"We think we're going to be able to significantly improve patient care," Mauer said. "We're all very excited about this."