No one has to tell the Chaffee County Emergency Medical Systems (EMS) crews that their work volume is up over a year ago….Their day-to-day workload confirms it. While their overall call volume is up two percent year-to-date, the numbers involve not just regular county emergency calls, but the Chaffee EMS contract with Heart of the Rockies Regional Medical Center (HRRMC). Those statistics tell a different story.
“We’re up about 17 percent for transfers and 25 percent over what we proposed to HRRMC in our original agreement when it was set up in 2017,” said EMS Director Josh Hadley. “In the cumulative since Oct. 2017, over five quarters of volume, we saw a significant increase in call volume. We did 255 transfers in the first five quarters [of the contract]. This year just three quarters of the year, we are at 215 transfers. That’s a 30 percent increase in just those transfers alone.”
That agreement covers a relationship where Chaffee EMS is contracted to transport HRRMC patients requiring medical attention at other medical facilities, most often on the Front Range. Transfers can take 10 to 12 hours including pickup, transport, hand-off and return trip. The contract contains a description of services that includes it’s volume projections and expected wait times for transfers.
Earlier this year, HRRMC CEO Bob Morasko pointed out that HRRMC was not pleased with wait times on mental health transfers, which were requiring patients to wait in the hospital emergency services area. This was seen as unacceptable, given that the hospital does not have its own security staff.
But a review of the causes of those wait times revealed that those waits are related both to completing patient assessment by Solvista Health, and the availability of an inpatient mental health facilities bed and mental health services located outside the county (Chaffee County does not have an inpatient mental health facility).
During that discussion, Hadley pointed out that regular ambulances are not safe transport vehicles for mental health cases – either for the patient who might harm themselves, or for the EMS crews. He said a secured transport vehicle with a grid between the patient and the transport staff, such as those used by police and sheriff departments, is the wiser choice and represents less county liability.
Communications between HRRMC and Chaffee EMS appears to have improved. “HRRMC has been thoughtful in when they are sending our crews.” said Hadley.
“Our equipment is all running, all the time. We just had our state inspections last week. But we have to protect the crews from crew fatigue,” said Hadley.
He added that there have been lots of studies on crew fatigue and cautioned that with volume running high, he carefully coordinates sending crews on all-night transfers and always makes sure the county has the EMS staff available to respond to in-county situations.