Updated Jan. 8, 2015
May 4, 2007, is a day that will live in infamy for the residents of Greensburg, Kan. At 9:45 p.m. that spring night, an EF5 tornado, estimated to be nearly 1.7 miles wide, touched down, traveling for nearly 22 miles. After a harrowing 65 minutes, the twister finally dissipated, leaving 95% of the rural town leveled and 11 people dead.
Soon after, the people of Greensburg and the surrounding Kiowa County embarked on the rebuilding process. But with resources tight and a population base that would dwindle by nearly 50% in the following years, rebuilding would prove tough. To compound the challenges, the EMS director retired 1½ years later.
Enter Chad Pore. Coming from a larger metropolitan EMS system, Pore was commissioned as director of Kiowa County EMS in 2008 and tasked with helping to rebuild the system. “It was a real challenge,” he says. “In the beginning, our EMS system was still operating out of fifth-wheel trailers and first responder, EMT-basic and continuing education classes were being held in military tents. Volunteerism was low and resources were minimal. There was a lot of work that needed to be done to get back on our feet.”
Challenges aside, Pore had big plans on how to rebuild, and he knew exactly what he needed to get the job done.
He needed to analyze the data.
“The amount of data at an EMS system’s disposal is incredible,” Pore explains, “but it’s up to the director to be proactive in analyzing it. One of the first things we did when I arrived is pull data on every aspect of our system, from response times to medication usage to equipment—we looked at it all.”
For any EMS director, and especially one who manages a rural system, having the facts in front of you can make the decision-making process easier when addressing system shortfalls. The first things Pore looked into were response times and the overall coverage of Kiowa County. What he found was unnerving.
“In 2009, our average en route time to a call was 3 minutes, 48 seconds, and our on-scene time was 45 minutes, 5 seconds. We had to improve,” he explains.
After noticing that 30% to 35% of his calls were interfacility transfers, which were currently being run with a big box ambulance, Pore was able to make several recommendations to city leaders. That included the purchase of a new Sprinter Type 2 ambulance.
The Sprinter would provide the same service while costing $40,000 less than a box ambulance, double the mileage and cut maintenance costs in half. In addition to the new Sprinter, Pore proposed the relocation of an existing unit to better serve the rural community.
The result? By 2013, Kiowa County EMS’ en route time was cut to 2 minutes, 54 seconds, and the on-scene time was slashed to 15 minutes, 59 seconds.
“What I found in the data I pulled helped me make the decisions that would benefit our community and raise the bar on the level of service we provide,” Pore says. “I never would have known where we were falling short if I hadn’t pulled the data and analyzed it on my own.”
In addition to improving response times and coverage area, Pore drilled down deeper. He used the data to identify obsolete medications and to determine what type of equipment was (and wasn’t) being used on calls on a routine basis.
“Having the dataset in front of me when talking with my medical director and city leaders was invaluable,” Pore says. “Having rock-solid information allowed me to speak confidently and accurately about exactly what changes needed to be made to our system.”
The result? Pore was able to dump more than 20 medications that had not been administered in more than five years and lighten first responder bags by more than 20 pounds—all without sacrificing patient care or arriving unprepared.
This was accomplished by creating three different bags: first-in bag, airway bag and the critical-patient bag. None of the bags weighs more than 10 pounds and all are still on the ambulance in case additional supplies are needed.
Pore also decreased the number and sizes of various bandages and fluid bags (among other things) that were carried, further lightening the weight of the packs for his first responders.
Though Pore is currently pulling his data through patient ePCR records and at the state level, he’s both excited and optimistic about moving toward a more robust, comprehensive national data set, known as the National EMS Information System (NEMSIS).
“In an era of tight resources and high expectations, EMS directors should take the time to pull data on their systems from every available angle and analyze it,” he suggests. “That was the biggest benefit to me and my organization: being able to say, ‘Hey, here’s our data—here’s what’s going on.’ Now let’s work to make it better.”
And while the residents of Kiowa County will never forget the disaster that hit their hometown in May 2007, they can rest a bit easier knowing that if another disaster does happen, Kiowa County EMS is prepared to respond better now than ever before—thanks to data, leadership and confident decision-making.
— Greg Gayman
