Analysis: Disfunctional Buckeye Lake EMS needs change NOW
BUCKEYE LAKE – Mayor Rick Baker took a couple of baby steps Monday night toward addressing the well-documented failures of the village’s EMS program.
He named four of the five members of an advisory committee. They are:
• Hebron Mayor Clifford Mason who has served as a full-time fire chief for several central Ohio fire departments;
• Buckeye Lake resident Paul Clark who has served as a deputy sheriff in Franklin County;
• Buckeye Lake resident and Columbus Division of Fire employee John Julian;
• Lancaster Safety and Service Director Mike Courtney; and
• Someone recommended by Newark Mayor Jeff Hall, possibly Safety Director Bill Spurgeon.
Baker also issued a list of “administrative directives” dated Sept. 6, 2012, to Fire Chief Pete Leindecker. The one-page letter included 17 directives, including “take meetings seriously,” but apparently it’s still OK to scream profanities at a resident in council chambers.
With no disrespect intended to Baker’s committee members, the continuing failures detailed by The Beacon over the last four weeks don’t require a committee of experts to resolve. Many communities similar to Buckeye Lake Village have provided efficient and professional emergency medical services to their residents and visitors for many years. It is not rocket science!
Our database now covers six months – March through August 2012. We have identified three criteria that demonstrate the department’s failure.
• Unscheduled shifts: If a shift is left unscheduled by Leindecker, it is very unlikely that it will be filled. The number of unscheduled shifts ranges from a low of 10 in June to a high of 21 in August. The six-month average is 15.8 shifts or 17.2 percent of shifts aren’t scheduled.
• Unfilled shifts: This is the total of unscheduled shifts never filled PLUS no shows. Unfilled shifts range from a low of 18 in March to a high of 30 in August. The six-month average is 23.8 shifts or 25.9 percent of shifts unfilled.
Unfilled shifts mean no one is on duty or just one person is there. Two are supposed to be on duty from 8 a.m. to 6 p.m. which is considered two shifts. Ohio law requires a minimum of two EMT-Basics to transport a patient. No one on duty means that seven minutes could pass from the initial unanswered dispatch before mutual aid is dispatched.
Delays can actually be longer if one person is on duty. Precious minutes tick away as a single EMT or paramedic asks the 9-1-1 Center for additional tones in hope that another EMT will respond. The department’s focus on preserving “runs” rather than lives can lead to lengthy delays. One-person crews have been told to respond to the scene to assess the patient BEFORE seeking mutual aid. That does reduce mutual aids calls, but significantly delays treatment to seriously ill or injured patients.
That’s what happened on an August 21 “heart problems” call. Some 16 minutes after the call came in, the lone EMT-Basic requested mutual aid. Help arrived a whopping 24 1/2 minutes after the call for help was received.
We have analyzed the 30 EMS runs that Buckeye Lake handled by itself from Aug. 1 through Sept. 9. Only one person was on duty for 16 runs while two were on duty for 13 runs. The average response time for a one-person crew (9-1-1 Center dispatch to arrival on-scene) was seven minutes, 48 seconds. That is almost three minutes slower than the average of four minutes, 50 seconds for a two-person crew. One run was handled when no one was on duty after a crew suddenly materialized after failing to respond to a critically injured person on Dockside Drive.
• Crew capability: Response time is obviously very important. The make-up of the responding crew is also critical, particularly for cardiac and serious injury calls. For example, an EMT-Basic can NOT interpret a cardiac monitor strip, perform manual defibrillation, administer cardiac medication, do a cardioversion, start an IV or perform carotid massage. These procedures have saved the lives of countless heart attack victims but can only be done by paramedic. The scope of practice outlined by Ohio law for EMT-Basics is similarly limited relative to paramedics for other serious medical conditions.
Buckeye Lake Village patients are seriously disadvantaged TWICE – response times are unnecessarily long AND often treatment options are severely limited since a paramedic is not on the crew that eventually responds.
Our six-month analysis found that shifts with a paramedic on duty ranged from a high of 24 shifts (25.8 percent of the shifts) in March to a low of 17 shifts (18.9 percent of the shifts) in April. The average for the last six months was 20.3 shifts per month or 22.1 percent of the shifts. That means a paramedic isn’t available on nearly 80 percent of the shifts, severely limiting treatment options.
Delay endangers residents
Organizing a committee and enduring weeks of meetings is an unnecessary delay that further endangers residents and visitors. The failures that we have documented in detail have been occurring for years AND were explained to Baker by this writer before he was elected mayor. Several firefighters, both part-time paid and volunteer, have also expressed their concerns directly to him.
These failures may have already cost some lives and each day they are tolerated increases the likelihood that someone will die prematurely or be permanently handicapped due to treatment delays.
Baker’s administrative directives may be a plan to set up Leindecker for failure. We don’t need to wait for him to fail again. He has already done it many times.
The most significant directive was to “Send a letter to county to call for mutual aid after 3 minutes.” We checked with the 9-1-1 Center Tuesday afternoon. Deputy Director Kevin Carver responded, “To my knowledge we have not received this notification.” We asked Carver to notify us if and when it is received. We have not heard anything from Carver as of midnight Wednesday.
Leindecker’s excuse for the staffing failures isn’t supported by time cards. Only one parttimer worked in March or April that hasn’t worked since then. Kyle Weekly worked a total of two shifts in those months. Leindecker’s claim that three people have quit since May is fiction.
Leindecker and EMS Coordinator Captain Dave Ruton have forfeited the public’s trust to use taxes to provide emergency medical services. Both have long been aware of the failures that have been documented and did NOTHING to improve service to residents and visitors. They did take steps to reduce mutual aid runs and “save” Buckeye Lake runs. Those steps have furthered endangered residents.
An immediate fix is available
Residents and visitors can receive the protection they deserve and that lake area neighbors already receive in a matter of hours. This is an elderly community; we don’t need to risk anyone’s life or health while we wait weeks and maybe months for Baker’s committee to recognize the obvious.
Here’s our three-step plan that can be implemented in a matter of hours, not weeks or months.
• Give Leindecker 24 hours to resign. If he refuses, immediately suspend him for the purposes of terminating him for cause. Pick from a long list of “causes.” Appoint Assistant Chief Rod Riley to the position of Acting Chief.
• Call Hebron Mayor Clifford Mason to negotiate a contract through the end-of-the year for Hebron to immediately respond to all Buckeye Lake Village calls for help. No more seven or more minute waits to dispatch mutual aid. Hebron has at least one paramendic on every run. That means residents/ visitors will get state-of-the-art emergency medical treatment without built-in delays. Hebron is just two miles away from the Buckeye Lake Fire Station.
• Negotiate a longer term contract for EMS with Hebron or perhaps Millersport.
• Encourage volunteers to join the Buckeye Lake Fire Department to provide fire protection. Volunteers still respond to fire runs.