Make this page my home page
  1. Drag the home icon in this panel and drop it onto the "house icon" in the tool bar for the browser

  2. Select "Yes" from the popup window and you're done!

Home > Topics > EMS Management
July 17, 2014
All Articles

EMS News in Focus
by Arthur Hsieh

Possible solutions to San Francisco’s EMS problems

There are plenty of options for a proactive agency to explore, evaluate and implement

By Arthur Hsieh

Earlier I had commented that the problems San Francisco faced in its EMS system were too large and complex to be fixed by merely throwing money at them. A combination of population changes, declining healthcare finances and rigid government thinking contribute to a problem that has been ongoing for three decades. 

I was taken to task by an EMS1 reader who felt that I offered no suggestions, which is true. There are folks who are far smarter than me who could weigh in on this issue.

But, I don’t have to; San Francisco itself has tried several innovative ways to manage its call volume:

  • It had a successful diversion program that reduced the number of high frequency callers to the 911 system. Using a medic/social services worker team, chronic 911 callers were identified and matched to appropriate resources within the health department. As a result, many of these patients reduced or even stopped calling 911. Unfortunately this program was eliminated.
  • A sobering center was established to divert those who were intoxicated, but not injured or ill, to a facility that could monitor them, freeing up precious emergency department beds.
  • For a while, city paramedics treated, then release acute asthma patients after a more detailed evaluation. A similar program provided alternative transportation to a hospital or clinic for patients who did not require ambulance transport.

Given the rapidly evolving nature of community paramedicine, there are other ways to adapt to field patients, rather than simply adding more workers to the department. That’s real change that is permanent and meets the needs of the community.

Then there is the need to closely look at how the city views its EMS system. Is it the primary role its fire department, or is it subservient to fire suppression services? A review of the department’s budget shows that the vast majority of money is spent on the latter. It’s also likely that the turnover rate of its EMS division is much higher than that of its fire suppression. Perhaps the department needs to be restructured so that resources are spent in a way that better matches resources to needs. 

There are plenty of options for a proactive agency to explore, evaluate and implement. It’ll be interesting to see if  this department takes a chance and remakes itself during this time of crisis.

About the author

EMS1 Editor in Chief Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at Art.Hsieh@ems1.com.
Comments
The comments below are member-generated and do not necessarily reflect the opinions of EMS1.com or its staff. If you cannot see comments, try disabling privacy and ad blocking plugins in your browser. All comments must comply with our Member Commenting Policy.

Sponsored by

We Recommend...

Connect with EMS1

Mobile Apps Facebook Twitter Google+

Get the #1 EMS eNewsletter

Fire Newsletter Sign up for our FREE email roundup of the top news, tips, columns, videos and more, sent 3 times weekly
Enter Email
See Sample

Online Campus Both

EMS Management Videos