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Home > Topics > EMS Management
March 27, 2014

Chicago dispatchers asked to keep ambulance shortage quiet

A city-issued memo instructs them to “avoid terminology like we have no ALS ambulances available”

CHICAGO — A city-issued memo obtained by CBS Chicago asks dispatchers to watch what they say, calling shout-outs for available ambulances “not an acceptable practice” and instructing dispatchers to “avoid terminology like we have no ALS ambulances available” so as not to highlight the fact.

Written by a supervisor at the Office of Emergency Management, the memo also states, “We all realize that certain times we are inundated with runs and lack of resources.”

The document was issued in light of dispatchers repeatedly broadcasting requests such as “Anybody available downtown that can take a run?” in response to a medical emergency, followed minutes later by a similar, “Anybody available downtown?” when all ambulances are busy, CBS reports.

Paramedic Field Chief Pat Fitzmaurice said the aim of the memo is clear.

“They want to cover up the problem,” he said.

Better Government Association CEO and President Andy Shaw said the city should be addressing it.

“Instead of trying to muzzle the outcry they ought to be listening to what it means and taking steps to fix the problem,” he said.

A spokeswoman from Chicago’s Office of Emergency Management said the memo is an “informal internal document” that serves as a reminder to dispatchers to use “approved protocol and professionalism.”

CBS has continued coverage of long response times, including incidents where it took 16 minutes for an ambulance to respond to a woman struck by a postal truck while crossing the street, 22 minutes for an elderly patient complaining of chest pains, and 26 minutes for an ALS response to the home of an elderly woman having trouble breathing.

A spokesman for the Fire Department said the 26-minute response time was “unacceptable” and the incident is under investigation.

In a written statement, the Fire Department said it is conducting a review of its ambulances to ensure deployment meet the needs of Chicago.

“Sooner or later,” Fitzmaurice said, “they are going to have to come to the realization we need more ambulances.”

Comments
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Andrew Tucker Andrew Tucker Thursday, March 27, 2014 2:20:24 PM I don't think this is designed to cover up the problem. The problem is still going to be evident from the fact that a unit from BFE is being dispatched to a call. This memo strikes me as being more about professionalism on the part of the dispatchers. I've worked under a dispatcher who couldn't figure out where units were before and it's not pretty hearing them key up the radio and spend five to ten minutes asking each individual unit where they are prior to dispatching a call. If you're not sure who is closer, just pick someone and send them rather than wasting time. Not to mention that this is a violation of the ICS Standards in regards to self dispatching of units. "Heart attack at 5th and Main, who wants it?" Is not a dispatch. It's closer to being an announcement that pie is ready.
Duane Cerrito Duane Cerrito Thursday, March 27, 2014 4:40:50 PM Actually Andrew this is an ongoing problem in the fire department. It has nothing to do with protocol when ambulances are driving citywide to respond to calls. 60 als ambulances are not sufficient. New York has over 300.
Anna Menchaca Anna Menchaca Thursday, March 27, 2014 5:48:20 PM Andrew , they have been using that unapproved language for years , then a news investigation highlights shortages, and then a week later Boom. Shhh, don't use unapproved language.
Austin D. Pace Austin D. Pace Thursday, March 27, 2014 7:27:29 PM What I don't understand is why as big a Dept. this is they don't use AVL or deployment mapping system. My service only runs 33,000 a year yet had this technology since 2006.
Anna Menchaca Anna Menchaca Thursday, March 27, 2014 9:29:09 PM The problem is NOT, I repeat Not being able to locate a vehicle, Chicago has a state of the Art 911 dispatch center. They know exactly where every vehicle is, and can see them moving if need be . The problem is the ambulances are so busy , that many times a day , not one unit is available. When they broadcast " any available ambulance" they are basically asking if anyone is available to come up. Some ambulances are running 25 - 35 calls a day.
Jon Eiber Jon Eiber Friday, March 28, 2014 1:33:28 AM I don't think there would an ambulance shortage problem if people stopped calling for minor complaints like fever or finger pain, and if they didn't have to be called every time a person becomes drunk in public and the police decide to call the paramedics instead of locking the drunk up instead.
James Gaines James Gaines Friday, March 28, 2014 8:15:09 AM A lot of posters bring up good points - there should be no reason emergency ambulances are dispatched to non-emergent calls. It's time to prioritize emergencies, and stop letting important ambulance resources be used for mobile family clinics.
Anna Menchaca Anna Menchaca Friday, March 28, 2014 9:48:02 AM You all are clueless, it has nothing to do with a dispatcher being confused and not knowing where we are. They are begging for " any unit available" what part of that do you all not understand. We have a state of the art 911 dispatch center. . You all are back seat drivers . You have no clue.
Anna Menchaca Anna Menchaca Friday, March 28, 2014 9:52:19 AM What part of no ambulances are available, do you not understand ? They are requesting specific areas because a call just came in from that area. Unless you work her or a major municipality you will never have a clue.
Anna Menchaca Anna Menchaca Friday, March 28, 2014 9:57:38 AM Working in an emergency room as a tech has made you an expert. Come screen our calls, since you know what the solution is.
Andrew Tucker Andrew Tucker Friday, March 28, 2014 10:08:38 AM But this memo isn't designed to cover up that problem as the author of the article is insinuating. It can't be. What kind of moron thinks that changing the way a dispatcher talks on the radio will cover this up? People will still hear the unit being dispatched from across town, whether the dispatcher says there are no units available or not.
Andrew Tucker Andrew Tucker Friday, March 28, 2014 10:13:23 AM Then you send one that you think is closest! You do NOT sit there and ask who wants the call. It doesn't matter the size of the agency. And I've worked for the largest EMS provider in the nation, 400 units in service daily from Austin to Mississippi. No units available in a certain spot means you move units from another area to cover. Why weren't the dispatchers doing that? It's called posting and is a standard practice EVERYWHERE. And yes, I have worked for the largest EMS provider in the country. 400 units in service daily from Austin to Mississippi. And on more than one occasion I have been on the only unit available to cover two counties. One ambulance for 1,491 square miles and a population of 334,790 people. And if there are no units available you move them over and cover. It's called posting.
Anna Menchaca Anna Menchaca Friday, March 28, 2014 10:34:37 AM Again, nothing , no one , not one unit is available
Anna Menchaca Anna Menchaca Friday, March 28, 2014 10:36:03 AM How do you move units , that are not available and already on calls ?
David Guiel David Guiel Friday, March 28, 2014 11:42:33 AM Austin, We do over 300,000 calls a year. Like Anna said there simply isn't ENOUGH ambulances !!! We're all to busy. It's not uncommon for ambulances, here in the city to do more then 20 runs, as a daily routine.
Anna Menchaca Anna Menchaca Saturday, March 29, 2014 6:51:07 AM Currently the Chicago Fire Dept. Responds to over 550,000 calls 90 Percent of those calls are EMS related. On an average each of the 60 ALS ambulances are doing over 5,500 calls per year. This is an extremely high volume EMS system with very few resources. The 911 center is broadcasting any available ambulance in an attempt to find one clearing soon or available shortly. It has nothing to do with the 911 center not knowing where we are physically. Those broadcasts heard are are pleas for crews who are coming up.
Matthew Hill Matthew Hill Saturday, March 29, 2014 7:41:40 AM Not being totally knowledgeable about the specific practices for Chicago Fire, I would say that suggesting more units need to be added is just lazy without facts to back it up. A demand analysis needs to be done to figure out how much of a problem it is, and then look at ALL solutions like strategic deployment and utilizing one of the literally 100's of private services located in Chicago to provide mutual aid when no units are truly available. If more units need to be added, it needs to be units that are over a peak volume time period, not just anecdotal adding of 24 hour units. That is just wasteful. You cannot simply just add so many ambulances that you will get to every call in 5 minutes all the time. That is not fiscally responsible, and is quite frankly, lazy. This day in age all EMS agencies, fire departments included, need to jump into the 21st the century and utilize technology and expertise to develop a system that is both efficient AND financially responsible. Also, over saturation of paramedics leads to degradation of skills. This is well vetted research. I would add that in most organizations, comments like the one from the Chief Paramedic do nothing more but hurt the problem. Either provide FEASIBLE solutions (again adding more units without a comprehensive analysis is not FEASIBLE or responsible), or keep your mouth shut. Most people would be terminated for speaking this disrespectfully to the media about their organization.
Sean Ragusa Sean Ragusa Friday, April 11, 2014 9:24:05 AM Maybe you should stick to Law and let us take care of the medical side. Now, being enrolled at the Loyola University Chicago School of Law, you do quite a bit of research I assume, research the Tri Data Report. The report was complete in 1999, and call volume has increased dramatically since then. Scroll down to Chapter V, and educate yourself.http://www.cityofchicago.org/dam/city/depts/cfd/general/PDFs/TriDataReportJune1999.pdf
Matthew Hill Matthew Hill Friday, April 11, 2014 4:51:01 PM Sean Ragusa Thank you for this report. My question would remain, have any ideas that this third party consulting firm suggest been implemented? If they have, why failed? The ideas noted are (gasp) very similar to the discussion I pose in my original post. So, were additional peak demand units added? Was a deployment plan initiated to offset the UHU spread that exists between the busiest and slowest units? Were privates brought in to help transport during high demand times? If the answer to all these is no, then why do you wonder why you still have a problem. This report did mention one thing that is obvious - the culture and mission of CFD does not reflect what it actually does. A simple visit to the department website reflects this with nearly no mention of even providing EMS services, even though it is something close to 80% of your business. Also, although I do attend Loyola's Law School for a graduate program in Health Law, I am in EMS and still practice to this day, although my main role is within a quality department, looking at the a lot of the items noted in this report. Finally, nowhere did I ever say you didn't more units, I said that you need to look at ways to maximize and utilize both current and future resources better than it appears you are. Maybe I am wrong and your service is as efficient as it could possibly be, but I highly doubt it.
Sean Ragusa Sean Ragusa Friday, April 11, 2014 7:05:27 PM Matthew Hill Everything is in black and white in that report, plain and simple. If anything had been taken from that report and put into action, we wouldn't be having this discussion. Privates can't afford to take a chance at running our overload since so much of their budgets depend on collection rate. But since you are in EMS, you know that.
Matthew Hill Matthew Hill Friday, April 11, 2014 7:15:13 PM Sean Ragusa There are plenty of privates that are the sole 911 providers for various response areas. Perhaps if reimbursement is the issue they could be subsidized like the FD? I realize in your area of the country fire-based EMS is the main player, and privates are generally viewed as inferior. Never the less I digress, we are all suppose to be in this for the same reason. Private EMS is fraught with issues as well. I wish your department the best of luck as they strive to find the best ways to take care of their patients. I hope your leadership is able to successfully tackle the increasing challenges that face EMS.

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