By Rich Lord
Pittsburgh Post-Gazette
Copyright 2008 P.G. Publishing Co.
PITTSBURGH — Understaffed and overtaxed Pittsburgh paramedics aren’t getting to the scenes of emergencies as quickly as national standards suggest, and their response times dipped from 2006 to 2007, according to an audit released by city Controller Michael Lamb yesterday.
“One or two [more] units would bring [workloads] down, probably to acceptable levels,” said Mr. Lamb. Another option is trying to reduce the number of non-emergency calls coming to the Emergency Medical Services Bureau, and he has contacted the city’s two hospital systems and dominant insurer about developing a public awareness campaign to tell people when to call 911.
EMS Chief Robert McCaughan agreed that response times are a concern, and some people — like a woman who called 911 because her surgical stockings were tight — use the transport service like a doctor that makes house calls.
“We have, by and large, become the safety net for the health care industry,” he said.
National standards for paramedics and firefighters say that from the time the dispatcher assigns them to an emergency, they should get to the scene in under nine minutes 90 percent of the time. Mr. Lamb found that city ambulances made it to the scene in under nine minutes 60.4 percent of the time last year, down from 64.5 percent in 2006.
“In our audit, we didn’t find any instance of a fatality related to slow response time,” he said.
Tony Weinmann, president of the Fraternal Association of Professional Paramedics, said the problems stem from the 2003 layoffs of 21 emergency medical technicians who used to handle lower-priority calls. Now those calls fall to the paramedics.
The audit found around 18,000 top-priority calls — like cardiac arrests or choking — each year, out of around 64,000 total ambulance runs.
Mr. Weinmann said a public awareness campaign might not trim call volume much.
“People want things done right now,” he said. “Dial 911, you get help immediately. There’s no waiting. There’s no appointment needed.”
Cities have to be careful about telling people when to call 911, and when not to, said Chief McCaughan.
“People [with legitimate needs] may then not call, because they feel they might be abusing the system,” he said.
The average city ambulance went out on 4,904 calls last year, the audit found, which is nearly double the volume that would allow paramedics enough time to refuel, get supplies, wash up, and eat and rest when needed.
In 2003, the bureau employed nearly 200 paramedics and EMTs. Now it is budgeted for 163 paramedics, but usually has a few posts unfilled. There are nine vacancies and nine paramedics in training to fill them.
Low staffing led to more than 375 hours of overtime work per paramedic last year, according to the audit, at a cost of $2.4 million. Last year the three top-paid city employees were paramedics, each grossing more than $130,000 by working around 80 hours a week.
“Unfortunately, I think [overtime] is necessary given the staffing and the call volumes,” Mr. Lamb said. “We’ve got EMS workers out there now who are over 50. The fact that they’re working overtime could lead to greater mistakes on the job.”
The audit didn’t say whether EMS should be merged with the Fire Bureau. That’s one of the issues the Intergovernmental Cooperation Authority, appointed by the state to improve Pittsburgh’s finances, has asked Virginia-based System Planning Corp.'s TriData division to look at in a plan likely to be released late this month.
That plan will deal, in part, with improving response times, said ICA Executive Director Henry Sciortino.