Medical response times on increase

WINDSOR - How long an Aiken County resident waits for an ambulance is a crapshoot.

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The time can vary based on staffing levels in the county's Emergency Medical Services division, where the resident lives and how many calls for help the county is handling at one time, officials say.

Whatever the cause - some point to the county's growing population and a increased number of calls - statistics show the wait is getting longer.

In 2000, based on a two- to three-month sample of response times, it took county EMS professionals an average of 12 minutes, 20 seconds to respond to emergency calls, South Carolina Department of Health and Environmental Control officials report.

Last year, it took the county 14 minutes, 48 seconds, according to 2005 figures, which included all of the county's dispatches. The state average, meanwhile, was about 13 minutes, 30 seconds, according to a sample of calls in 2005.

While officials have identified factors that affect response time, they can't say what caused the county's increase. And while arriving as fast as possible is an obvious plus, it remains unclear where the county's EMS team stacks up next to many of its peers.

Few agencies closely track response times, officials say.

"EMS has so many barriers to getting a perfect response time," said Victor Grimes, a program manager with DHEC who monitors EMS statistics. "Yeah, we need more resources. But first of all we need a proper data collection system so we could see what those barriers are."

Experts say agencies across the U.S. are under-performing because of staffing shortages and a lack of money. Changing the situation has been slow going because the industry lacks a unified front and the data to show what needs to change, they say.

"There is very little science behind EMS, and it's mainly because we don't have data," said Daniel Patterson, a doctoral student at University of North Carolina who is researching emergency response.

Slower response times in Aiken County aren't necessarily because of barriers but rather a lack of them. Paramedics and emergency medical technicians have to juggle calls from the county's metropolitan areas with those from rural areas miles away.

Dispatch records show that responses to the county's metropolitan areas generally are faster.

On a random day in 2005, the EMS unit responsible for the city of Aiken handled 11 calls, dispatch records show. The longest it took EMS responders to reach someone was 12 minutes, while the fastest response was 3 minutes.

The same day, in one of the county's under-populated EMS districts east of the city, EMS handled two calls - one took six minutes, but the other took 26 minutes, dispatch records show.

A lack of personnel is one reason for longer response times in the eastern part of the county, officials said. The EMS division is battling turnover and often times leaves its substation unmanned.

Cheryl Hasley, 43, lives in Windsor, about three miles from the station that is often left abandoned. The next closest station is at least 14 miles from her home, and given her history of diabetes and high blood pressure, she fears what might happen if she were to call for an ambulance.

"This is the forgotten part of Aiken County," Mrs. Hasley said. "The county is talking about a multimillion-dollar administrative building. I just can't see putting money into a building when you can't supply the basic needs of the county."

At the local level, the Aiken County Council has approved a pay increase for some of its EMS personnel, and there are plans to build to more sub-stations. And slow response times to rural areas are buffered to some extent by first responders, typically police officers or firefighters who have basic life-saving skills and can arrive faster.

But the county also should consider hiring part-time EMS workers who live in rural areas, said County Councilwoman Kathy Rawls, who represents the understaffed eastern part of the county.

"I really think we could solve a lot of our problem by hiring paramedics already living in the area," she said.

To better understand the situation across South Carolina and the country, there is a move afoot to implement a National EMS Information System. The goal is to have agencies everywhere enter information about EMS response, from details about patient care to factors that affected the response time, such as traffic jams.

Aiken County already has technology in place to easily track response times, one area where it is ahead of the pack.

EMS officials say that with data in hand they'll better be able to make their case for more funding from the state and federal government.

While it wants to start collecting more complete sets of data, South Carolina doesn't have the money yet. Georgia doesn't collect the data, either.

"We all want to talk from the same sheet of music," said Mr. Grimes, of South Carolina DHEC.

Reach Josh Gelinas at (803) 648-1395, ext. 110, or josh.gelinas@augustachronicle.com.