Normally the fights associated with Las Vegas are within the casino boxing ring, but those pale in comparison to the battle brewing within the EMS system.
Charges of call inequity, call-skimming and nonresponse have been raising tensions between the city and private ambulance firms, specifically AMR, since the fire department took over the majority of patient transport calls under a new policy approved in March. In many ways, Las Vegas is a case study of the complexities of an EMS system.
While measuring the operating cost and revenue is one way to understand how well the system is functioning, it is limited. The financial picture must be seen within the framework of service coverage, delivery and effectiveness.
Would more lives be saved with the new model? Can it better accommodate future developments in out of hospital care? How does it impact other aspects of the public safety system?
Ultimately, what is the reason for the abrupt change?
If the fire department is seriously evolving its role as a public safety service, so be it. It should. The fire service industry continues to evolve as well; any organization has to adapt, or it may perish.
But major changes that impact multiple facets of the system set it up for instability and uncertainty.
Uneven delivery creates gaps in service, and the risk of a catastrophic failure looms as those gaps grow. Given how public these issues have become, if such a failure occurs the system will not be able to avoid a major loss of trust by its community.
