Organization’s Scope Broadened By Addition Of Ambulance
By Andrew Skaras
Last year, Eagle EMS (EEMS) obtained a specially outfitted 2012 Ford Explorer to serve as a class five, non-transporting ambulance. Since then, EEMS has provided more EMS coverage on BC’s campus than ever before. Part of the added benefit of having the vehicle has been an increase in data recorded and kept by EEMS Director of Operations Gus Godley, A&S ’13.
"Part of [Gus’] role as Director of Operations is to keep track of our data as well as oversee our Quality Assurance/Quality Improvement (QA/QI) process," said Alex Warshauer EEMS president and A&S ’14. "I started this tracking program last year as Director of Education. Whenever we have a patient contact, we fill out some form of documentation. Once a week, Gus, as well as our ambulance coordinator and our special events coordinator, sit down together and do a review of all the calls from the week before."
As they review the calls, they upload the non-identifying information into a Google doc that tracks a whole host of information. Included in this is the nature of the call, when the call happens, the graduation year and sex of the subject, and the outcome of the call.
Each incident is grouped into one of two broad categories, vehicle coverage or special events coverage. The vehicle coverage represents the time that the ambulance is on call—three night shifts and two day shifts every week. The night shifts occur on Thursday, Friday, and Saturday nights from 8 p.m. until 4 a.m. The day shifts occur on Friday and Saturday afternoons from 2 p.m. until 8 p.m. The special events coverage, on the other hand, represents when EEMS works standby shifts at sporting events and other activities on campus.
The second breakdown is into medical calls versus trauma calls. Medical calls represent 78 percent of the call volume for vehicle coverage since the beginning of the school year, while trauma calls only make up 16 percent. Medical calls cover instances such as cardiac problems, allergic reactions, alcohol incidents, and respiratory problems. Trauma calls include sports injuries, broken bones, sprained ankles, and other physical injuries.
In addition to the type of call, the data tracks graduation year of the patients seen and shows a higher number of freshmen being seen than any other class. Over the course of the year, freshmen represent 44 percent of the call volume for vehicle coverage. This is reinforced by looking at the location of the calls—Fitzpatrick-Gonzaga received 20 calls, or .04 calls per resident, while Walsh received 17, or .02 per resident, and the Mods received 17, or .03 per resident.
"Part of it there [in Fitzpatrick-Gonzaga] is you have the four-mans upstairs," Warshauer said. "It’s a bigger space and there tends to be more things going on there."
The data also shows a decline in calls during vehicle coverage since the beginning of the year—while there were 74 in September, there have never been more than 45 per month since then.
"I think our call volume has gone down a little bit, but we are still getting calls to the more serious incidents,"Warshauer said. "We aren’t getting calls for the people who really don’t need to be going [for treatment], which is a really good thing. We definitely see a decline in the number of calls because there are fewer incidents. We have a larger call volume early in the year, especially to Upper Campus and other freshman areas."
One of the statistics that has varied greatly has been the treatment decisions made. How serious the incident is and what kind of incident it is determines whether the patient is sent to the hospital, the infirmary, or not transported at all. For alcohol incidents, if the patient is under 21, then the patient will be transported to either the infirmary or the hospital, depending on the patient’s level of intoxication. If the patient is over 21 and under a certain level of intoxication, the patient can sign a Refusal of Medical Assistance (RMA) and not be transported.
Since the beginning of the academic year, 71 percent of the cases that have been seen during vehicle coverage have been sent to the hospital, 13 percent have been sent to the infirmary, and 15 percent have been RMAs.
"Second semester of last year, there was a higher percentage [of cases] going to the hospital over the infirmary [compared to this year]," Warshauer said. "As the year goes on, everybody gets the feel of what they should be calling for—what’s serious enough that we need EMS and what’s not. We have RAs who are learning their position. We have roommates who are learning whether they need to call or not."
In addition to these statistics, EEMS also keeps track of when the incidents occur to the nearest half hour. Since the beginning of the year, they have seen noticeable patterns develop, with two spikes in calls, one around 12:30 a.m. and another around 2:00 a.m.
"Midnight to 2:00 a.m. tends to be our busiest period,"Warshauer said.
While vehicle coverage on the weekends represents a lot of what Eagle EMS does, over the past year, they have also expanded their special event coverage. For this coverage in the fall semester, 57 percent of the cases were trauma cases. Football games and club sporting events made up the largest segment of these cases, representing 50 percent and 25 percent respectively. For special events coverage, 66 percent of the cases resulted in EEMS treatment and an RMA.
With all of the data collected and statistics compiled, Warshauerand Godley both emphasized its importance within the organization for educational and training purposes.
"The point of doing the statistics is so we can improve our services," Warshauer said. "If we see that our busiest night happens to be Saturday, we can put extra resources on. If we see that a large portion of our calls are alcohol related, we can do extra training on responding to alcohol related incidents. If we have a streak of sports injuries, we can throw in an extra class on splinting. It’s a tool for us to focus our training, improve our skills, and change our deployment patterns to better fit the needs of the University."
Going forward, this information has helped EEMS determine what they want to pursue next—that is, a method for creating files electronically.
"One of our goals for next year is to move to an electronic charting system," Warshauer said. "There is a bunch of different software out there. It forces you to do better documentation, because it won’t let you submit the form until the record is completed. It makes the record keeping a lot easier. It also makes the QA/QI process much more effective. It is in the planning stages right now. It’s a matter of figuring out which software we want and looking at the associated costs."