Guilford EMS takes new approach to 911 calls

Feb. 4—GUILFORD COUNTY — What started as brainstorming by Guilford County Emergency Services employees on how to deal with the rising demands on ambulance crews and resources turned into a novel approach to some 911 calls.

Guilford County Emergency Services is using crews in vehicles such as SUVs, rather than ambulances, running out for 911 calls that aren't likely to require taking someone to the hospital, what's referred to as lower-acuity calls. The calls include people who dial 911 reporting dental pain, a fall that doesn't involve a serious injury or automated calls from personal emergency pendants, which often are false alarms.

After testing the approach as a pilot program, Guilford County Emergency Services recently created the Interagency Medical Provider Assessment and Care Team, or IMPACT. Each IMPACT crew is composed of two emergency medical technicians in a quick-response vehicle.

IMPACT is designed to allow lower-acuity patients to be seen more efficiently and preserve higher-level Guilford County Emergency Services resources, such as paramedics and ambulances, for more serious calls such as heart attacks and strokes, Guilford County Emergency Services Manager Justin Hargett said.

"This is a great example of our continual mission to ensure that we are sending the right resource to the right patient at the right time," he said.

The IMPACT program has received attention from emergency medical services agencies across the country. Last month, Guilford County Emergency Services leadership gave a presentation at the National Association of EMS Physicians conference in Tampa.

Some other counties in North Carolina, such as Caldwell and McDowell counties in the western part of the state, previously have implemented programs meant to address lower-acuity calls. But Guilford County Emergency Services officials say they think that the agency is the first in the state to roll out a unit staffed solely by emergency medical technician-credentialed personnel with the specific mission of handling such calls without taking patients to a hospital, allowing each team to run from call to call.

The impetus for the IMPACT program was that an increase in ambulance service calls strained the department's resources.

"In an effort to look at many different ways to reduce demand on the system and increase our availability to make sure we are providing safe and effective 911 services, we started exploring multiple options," Hargett said.

Guilford County Emergency Services management examined 275,000 calls, looking for patterns of calls that didn't result in someone being taken to a hospital.

"We identified about 8% to 10% of our call volume fit that criteria," Hargett told The High Point Enterprise.

Since the program started last September, more than 1,000 calls have been diverted to IMPACT teams instead of a traditional ambulance crew.

Hargett said a team can call in an ambulance if it finds one is needed or the patient wants to go to a hospital, but so far the vast majority of patients haven't pursued an emergency room visit.

During the initial pilot program, 92% of people assisted didn't request or receive transport to a hospital, Guilford County Emergency Services Public Information Officer Scott Muthersbaugh said.

The IMPACT program frees ambulances so they are more quickly available for life-threatening emergency calls and also allows faster treatment for people with lower-acuity problems, Hargett said.

The program has a financial benefit as well: The county can purchase and stock an IMPACT vehicle for about one-fourth the cost of buying and stocking an ambulance, Muthersbaugh said.

Guilford County Emergency Services has enlisted other agencies, such as the High Point Fire Department, in the effort as well. For 911 calls such as medical alarms, unknown problems or motor vehicle accidents with unknown injuries, the High Point Fire Department will send an engine company with three emergency medical technicians to assess the patient to determine whether an ambulance is needed, said Michael Foster, emergency manager for the department. Most calls haven't required an ambulance.

"One benefit to the High Point Fire Department is that our on-scene time has been shortened due to not having to wait for an ambulance to arrive," Foster said.

pjohnson@hpenews.com — 336-888-3528 — @HPEpaul