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Tuesday, July 21, 2009

Should Muhlenberg advisory group take up ambulance issue?




Now that Plainfielders finally have an advisory group to monitor Solaris' compliance with the terms allowing it to shut down Muhlenberg as a critical-care hospital, the question arises whether one of the first items it should take up is the 'ambulance issue'.

After Sunday's fatal accident in front of his house involving a motorcycle stolen in New York City and driven by a Plainfield man, Councilor Rashid Burney circulated an email (addressed to 'the political leaders of Plainfield') describing the length of time it took to get ambulances for the fatally injured rider and three passengers in the car which the motorcycle struck.

Burney reports the North Plainfield Rescue Squad responded first within minutes of the accident and tried to resuscitate the rider; they took him away toward Muhlenberg.

The Fire Division extricated two of the car's occupants and put them on stretchers. According to Burney, the Watchung Rescue Squad arrived about 40 minutes after the accident and took the driver, while a Somerset MC ambulance came along minutes later and took the minor away (Burney seems not to account for the third occupant of the car).

This whole scene underscores one of the problems that was pointed out when Solaris first proposed closing Muhlenberg -- that the extra distance involved in transporting by ambulance to JFK or other hospitals would impair the quality of emergency response services in Plainfield.

Not to worry, we were told. All the bases will be covered, it was said. Other ambulances will pitch in and service will not suffer.

Unfortunately, Burney does not address the probability that the Plainfield Rescue Squad was simply already occupied and could not be in two places at once.
Keep in mind that mutual aid between rescue squads is a long-established, highly reliable tactic given the limited resources available to any one community.

The most recent metrics on the Muhlenberg SED indicate that ambulance times from the SED to another hospital have crept up from 60 minutes to 67 minutes. That would mean that if the Plainfield Rescue Squad were transporting a patient to JFK when the motorcycle fatality happened it could be 'out of the water' for up to two hours -- more if the hospital were further away than JFK. Whose fault is that?

What ever happened to the second ambulance that Muhlenberg supporters believe was promised as part of the closure terms?

The issue has not be resolved, as far as I know, with Solaris claiming that no ambulance was ever promised to be provided to the Plainfield Rescue Squad.

Burney is looking for the Robinson-Briggs administration to bring forth a proposal to the Council on the EMT situation in Plainfield since, he says, the Rescue Squad is in a shaky financial position.

He is right that something should be done.

Volunteer rescue squads everywhere are always scrambling for money (recall that North Plainfield's was actually shut down briefly this past spring). Getting insurers to reimburse is one of the chief sources of funding, but as anyone knows, nothing is easy or automatic about reimbursements in the healthcare system.

Volunteer rescue squads generally have a high level of enthusiasm and dedication to providing EMT services (why would anyone volunteer otherwise?), but a low level of administrative, management and marketing savvy. That's one extreme positive trait and one negative.

If the city were to propose abolishing the Rescue Squad and instituting paid services provided by city employees, everyone would do well to take a deep breath and think that one through.

That would mean replacing ONE POSITIVE (volunteer enthusiasm and dedication) and
ONE NEGATIVE (thin administrative and marketing skills) with THREE NEGATIVES:
the cost of city employees (and their benefits and pensions), the loss of that volunteer enthusiasm and no improvement in management or marketing savvy.

I am not convinced this administration, which has yet to discover the value of detailed memoranda (as opposed to glitzy PowerPoint presentations), is up to the task of inventorying the positives and negatives of the Rescue Squad, prioritizing the issues and proposing reasonable and effective means for dealing with the issues.

Instead of looking to the Robinson-Briggs administration to simply tear down what is here, why not look to the new Muhlenberg advisory committee for pointers on what to do, keeping in mind
President Obama's mantra when he spoke to the AMA recently about his healthcare proposals (see here): "Fix what is broken; build on what works".


-- Dan Damon

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5 comments:

Anonymous said...

Who are "the political leaders of Plainfield" if not the mayor and the council? Why would an email be adressed in such a strange way?

Anonymous said...

First, those power point presentations are anything but glitzy.

Second, when will the people of Plainfield figure out that until we take control of the city - vote out those who have been in office for 4 - 20 yeard - things will not change.

And the council, I hope, will start taking a more hands on approach with running this city. Leaving it up to the administration is a scary thought.

Anonymous said...

First of all, I’d like to thank you for bringing the situation of the Plainfield Rescue Squad to the attention of Plainfield’s blogging community. If you don’t mind, I’d like to take the opportunity to clear up some factual errors you made or repeated in your post.

I am a Plainfield resident and member of both Plainfield and Watchung Rescue Squads. Additionally, I was among first EMTs to arrive on scene last Saturday (I was the white teen wearing a light blue shirt, for those of you who were there). However, to comply with squad procedures, I am posting this anonymously

The first EMS unit on scene was Mercy paramedics from Muhlenberg. Next was me in my own car. Third was North Plainfield’s ambulance, then Watchung and Somerset. I can guarantee you that all patients were transported to area hospitals.

Although you are correct in suggesting that it was probable that the PRS was on another call, in this case it wasn’t true. Plainfield Rescue Squad did not have a full crew on duty at the time, as is usually the case on Saturdays.

Finally, I would like to make clear the organization of the Plainfield Rescue Squad. Specifically, PRS is not a volunteer rescue squad, although some members do give time for free. PRS is a non-profit entity which hires EMTs to provide emergency medical services to Plainfield residents who are billed individually whenever they use us. This is unusual for a local rescue squad; most actually provide their services free to the community with significant support from donors and municipal governments. Donations to PRS are light and the city government contributes absolutely nothing. This is the reason why PRS often has no crew on duty. We just can’t afford to hire enough EMTs and can’t attract qualified volunteers due to the stress of operating in Plainfield.

As I see it, the best way to solve this problem would be for the community and the city to increase their level of contributions to the rescue squad. This would allow us to hire enough people to cover the city 24/7.

Dan said...

Thank you, 5:05 PM!!!

First, for laying out the sequence of responses.

Second, for pointing a way the city can help.

Anonymous said...

In reply to the last anonymous there should be some further clarification on this.

Firstly I do remember you being on the call and possibly a junior member of Plainfield correct?

Second. Somerset was second on scene after a 15 min response from Somerville. Watchung was being requested at the time of Somerset's arrival. 2 patient were transported by SMC to JFK with Watchung 5 minutes behind us.

Third. It is quite common for larger or busier rescue squads to bill insurance companies but not the patient. If the person has insurance, money is collected. If the person does not, its charity. Also lack of staffing during the day has led to hiring of supplemental paid staff. Yet another increased cost justifying billing.