In the presentation “Whose Prehospital Care System Is It,” at Fire-Rescue Med in Henderson, Nev., Chief William McDonald, Las Vegas Fire and Rescue, highlights the success of a pilot program to increase patient transports.
In March 2014 the department launched a controversial patient transport policy change for Las Vegas Fire and Rescue to increase its patient transports from 30 percent to 50 percent, and eventually up to 75 percent of patients, as a way to increase revenue for the department. The patient calls were previously handled by American Medical Response (AMR), which opposed the policy change.
The decision to increase the number of patient transports was based on an International City/County Management Association report that suggested both the city and private ambulance companies were responding to the same incidents, and Las Vegas Fire and Rescue needed to stop responding to medical and trauma calls or increases its involvement. A consultant, hired by the department, developed a change in transport policy.
Media attention focused on a number of complaints and accusations that Las Vegas Fire and Rescue was “cherry picking” calls. McDonald said he made it a point to address all the complaints, and used data to show the actual timing and locations of responses to discredit accusations that the department was discriminating against poorer parts of the city.
The dispute with AMR was eventually resolved as a result of strong communication with the president of the company. It was ultimately decided that the fire department would respond to a higher percentage of serious calls and handle between 60 percent to 65 percent of all transports (as opposed to 75 percent) while AMR would respond to less serious calls.
Most memorable quotes from Chief McDonald
“There’s a broken ankle on the soccer field, and you would see two ambulances pull up to that scene. There was a lot of redundancy.”
“Not knowing who I was and what my intentions were, there was the impression I wanted to take it all.”
“We dealt with the [AMR] company president, and I think that was a key to our success. The outcome is we have an agreement. It has all the things we talked about, and you’re not hearing about us in the media anymore.”
Key takeaways for transport policy change
- Frequent communication. McDonald said Las Vegas Fire and Rescue met with AMR every three weeks to keep the private ambulance company updated on proposed changes, but it wasn’t well accepted initially. “I’ll be the first to admit I got to a point where I said ‘we’re done talking,’” McDonald said.
- Strong community support: Las Vegas Fire and Rescue had strong community support to begin with, and because the public was “not buying in to all the negative media attention,” the department was able to maintain a positive image.