San Joaquin County Emergency Medical Services Agency

Transcription

1 San Joaquin County Emergency Medical Services Agency Memorandum TO: All Interested Parties FROM: Rick Jones, EMS Analyst DATE: January 3, 219 Mailing Address PO Box 22 French Camp, CA Health Care Services Complex Benton Hall 5 W. Hospital Rd. French Camp, CA Phone Number (29) Fax Number (29) SUBJECT: American Medical Response (AMR) Exclusive Operating Area Ambulance Contract Compliance The s (SJCEMSA) Report on the Exclusive Emergency Ambulance Provider Contract Compliance for AMR for the months of September and October 218, provides an in-depth review of AMR s performance. The contract establishes accountability for meeting specific standards and provides the SJCEMSA with complete access to data and information on AMR s operational, clinical, and administrative performance. The process for determining response time compliance includes a review of late response exemption requests to determine if a delay in response may be attributed to factors outside of the control of the ambulance provider. If an exemption request is approved (e.g. fog, train crossings, road construction, and delays in off-loading patients at hospitals) those responses are not included in response time compliance calculations. This report provides a clear picture of response time performance and contract compliance with and without the application of exemptions for late responses. While this report provides detailed compliance information for each of the eleven -Zones, it is important to note that ninety percent (9%) of the urban Red Lights and Siren (RLS) calls, when combining data for all -Zones, have a response time of less than 8 minutes and 2 seconds during the two-month period. This response performance is achieved without considering any late exemption requests. The complete compliance report for September and October may be viewed or downloaded from the SJCEMSA website:

2 Exclusive Emergency Ambulance Provider Contract Compliance American Medical Response Response Time Compliance Report - Red Lights and Sirens (RLS) September 1, 218 through September 3, 218 Non-exempted Compliance Compliant Compliance Zone Total Responses Responses Percentage Yes No % 85.32% -3* % * -7 1,11 1, % 9.46% 1.% 81.75% -8* % -9-1* % 87.36% -11* % All Zones Combined 3, % 3 3 * Minimum of 1 responses used for calculation of compliance. See below for calculation of rolling compliance zones. Rolling Compliance Zones Requiring Multiple Months to Attain > 1 RLS Responses September 1, 218 through September 3, 218 Rolling Compliance Zones Compliant (with Multiple Months for Rolling Compliance Rolling Compliance Total Non-exempted Compliance 1 Call Minimum). Period From Period Through Responses Responses Percentage Yes No -2 August 218 September % -3 September 218 September % -6-8 July 218 August 218 September 218 September % 81.68% -1 September 218 September % -11 September 218 September % 1 of 16

3 Response Time Compliance Report - Red Lights and Sirens (RLS) October 1, 218 through October 31, 218 Non-exempted Compliance Compliant Compliance Zone Total Responses Responses Percentage Yes No -1-2* % 85.23% -3* , % 88.82% -5-6* -7 1, % 1.% 84.96% -8* % -9-1* % 92.41% -11* % All Zones Combined 3, % 3 2 * Minimum of 1 responses used for calculation of compliance. See below for calculation of rolling compliance zones. Rolling Compliance Zones Requiring Multiple Months to Attain > 1 RLS Responses October 1, 218 through October 31, 218 Rolling Compliance Zones (with Multiple Months for Rolling Compliance Rolling Compliance Total Non-exempted Compliance Compliant 1 Call Minimum). Period From Period Through Responses Responses Percentage Yes No -2-3 October 218 September 218 October 218 October % 82.69% -6 July 218 October % -8-1 October 218 September 218 October 218 October % 89.76% -11 September 218 October % 2 of 16

4 Response Time Compliance Report - No Red Lights and Sirens (NRLS) Compliance Zone September 1, 218 through September 3, 218 Total Responses Non-exempted Responses Compliance Percentage % -2* % -3* % % % -6* 4 1.% -7* 71 1.% -8* 7 1.% % -1* % -11* % All Zones Combined 2, % * Minimum of 1 responses used for calculation of compliance. See below for calculation of rolling compliance zones. Rolling Compliance Zones Requiring Multiple Months to Attain > 1 NRLS Responses September 1, 218 through September 3, 218 Rolling Compliance Zones (with Multiple Months for 1 Call Minimum). -2 Rolling Compliance Rolling Compliance Total Period From Period Through Responses August 218 September Non-exempted Responses -3 September 218 September May 216 September August 218 September August 218 September September 218 September 218 September 218 September Compliance Percentage % 95.24% 1.% 97.73% 1.% 96.15% 94.74% 3 of 16

5 Response Time Compliance Report - No Red Lights and Sirens (NRLS) October 1, 218 through October 31, 218 Compliance Zone Total Responses Non-exempted Responses Compliance Percentage % -2* 41 1.% -3* % % % -6* 4 1.% -7* % -8* % % -1* % -11* 11 1.% All Zones Combined 2, % * Minimum of 1 responses used for calculation of compliance. See below for calculation of rolling compliance zones. Rolling Compliance Zones Requiring Multiple Months to Attain > 1 NRLS Responses October 1, 218 through October 31, 218 Rolling Compliance Zones (with Multiple Months for Rolling Compliance Rolling Compliance Total Non-exempted Compliance 1 Call Minimum). Period From Period Through Responses Responses Percentage -2 August 218 October % -3 September 218 October % -6 October 218 October % -7 October 218 October % -8 October 218 October % -1 September 218 October % -11 September 218 October % 4 of 16

6 Response Time Compliance Report - Interfacility Transfer (IFT) September 1, 218 through September 3, 218 Interfacility Transfers ALS-IFT CCT-IFT Current Month Total Rolling Total Rolling Total Period From August 218 April 218 Rolling Total Period Through September 218 September 218 Rolling Non-exempted Rolling Compliance Compliant Responses After Exemptions Yes No % 92.31% Response Time Compliance Report - Interfacility Transfer (IFT) October 1, 218 through October 31, 218 Interfacility Current Rolling Total Period Rolling Total Period Transfers Month Total Rolling Total From Through ALS-IFT October 218 October 218 CCT-IFT 9 74 April 218 October 218 Rolling Non-exempted Rolling Compliance Compliant Responses After Exemptions Yes No % % Response Time Compliance Report - Combined RLS and NRLS September 1, 218 through September 3, 218 Nonexempted Compliance Zone Total Responses Responses Compliance Percentage % % % -4 1, % -5 2, % % % % % % % All Zones Combined 5, % Response Time Compliance Report - Combined RLS and NRLS October 1, 218 through October 31, 218 Nonexempted Compliance Compliance Zone Total Responses Responses Percentage % % % -4 1, % -5 2, % % % % % % % All Zones Combined 5, % 5 of 16

7 Fines and Penalties Report Type of Penalty September 218 October 218 Out of compliance response zones $155, $115, Code 2 and Code 3 Late response minutes $38,4 $37,1 ALS IFT or CCT-IFT Late response minutes $8 $4 Out of compliance monthly response ALS-IFT or CCT-IFT $ $ Failure to provide data $ $ Preventable mechanical failure $ $ Failure to meet staffing and clinical standards $ $ Failure to respond $ $ Failure to submit documentation at hospital $ $ Other minor breach $ $ Totals $194,2 $152,5 6 of 16

8 Detailed Response Time Analysis without Exemptions Applied - RLS September 218 Compliance Zones -1 Urban -2 Urban -3 Urban -4 Urban -5 Urban -6 Urban -7 Urban -8 Urban -9 Urban -1 Urban -11 Urban Response Response Time Response Time Time Interval Interval Interval 9th Responses Maximum Mean Std Deviation Percentile :1 5:15 2:34 8: :36 6:54 2:12 8: :34 7:9 3:17 1:58 1,11 18:56 5:31 2:17 8:16 1,43 15:3 5:3 2:17 8: :4 6:7 2:3 9: :45 5:56 2:49 9: :6 5:16 3:35 8: :3 8:33 5:38 17:44 7 8:46 6:16 1:36 8:46-2 Suburban -3 Suburban -7 Suburban -8 Suburban -9 Suburban -1 Suburban -11 Suburban 12 12:27 7:38 2:28 1:39 8 9:55 5:14 2:45 9: :27 8:43 3:4 13:8 3 6:4 4:24 2:1 6:4 8 9:55 6:5 1:32 9: :44 1:22 1:49 11: :55 8:41 4:2 18:55-1 Suburban-Moderate 32 25:33 11:24 3:46 15:5-2 Rural -3 Rural -5 Rural -6 Rural -7 Rural -8 Rural -9 Rural -1 Rural -11 Rural -6 Wilderness -1 Wilderness -11 Wilderness All Urban Compliance Areas All Suburban Compliance Areas All Suburban-Moderate Compliance Areas All Rural Compliance Areas All Wilderness Compliance Areas Total Responses 35 24:35 1:51 5:8 16: :22 9:58 4:5 16:38 1 9:51 9:51 : 9: :6 8:6 2:24 12: :8 16:52 7:41 27: :19 9:25 6:12 16:43 1 6:28 6:28 : 6: :27 1:38 5:35 19: :11 11:58 5:1 17: :9 13:44 3:3 18: :2 2:23 11:24 42:2 1 14:4 14:4 : 14:4 3,48 32:6 5:32 2:31 8: :55 7:42 3:24 11: :33 11:24 3:46 15: :8 11:1 5:48 18: :2 15:45 7:26 2:9 3,675 7 of 16

9 Detailed Response Time Analysis without Exemptions Applied - RLS October 218 Compliance Zones Responses Response Time Interval Maximum Response Time Interval Mean Std Deviation Response Time Interval 9th Percentile -1 Urban 36 17:4 5:3 2:32 8:26-2 Urban -3 Urban :49 11:13 6:13 6:8 2:25 2:41 8:35 8:57-4 Urban 1,154 2:12 5:36 2:18 8:28-5 Urban 1,384 22:36 5:2 2:13 7:54-6 Urban -7 Urban 15 1:12 5:19 2:11 8:15-8 Urban 84 14:39 5:34 3:8 1: -9 Urban :53 4:54 2:42 7:22-1 Urban 14 12:25 6:37 2:23 1:47-11 Urban 6 8:5 5:38 1:44 8:5-2 Suburban 16 11:11 7:39 2:1 9:16-3 Suburban 14 13:52 7:43 3: 1:42-7 Suburban 14 14:19 8:3 3:27 13:2-8 Suburban 4 9:59 5:18 2:45 9:59-9 Suburban 13 1:4 5:43 3:1 1:23-1 Suburban 3 6:4 4:1 2:41 6:4-11 Suburban 13 1:22 7:24 1:54 9:3-1 Suburban-Moderate 3 16:9 1:4 2:45 13:43-2 Rural 27 2:32 1:15 3:39 15:1-3 Rural 2 21:4 1:34 4:42 15:43-5 Rural -6 Rural 6 1:4 8:56 1:14 1:4-7 Rural 14 22:25 12:7 6:14 2:18-8 Rural 8 1:15 9: :54 1:15-9 Rural -1 Rural 22 32:38 13:35 6:18 19:41-11 Rural 42 21:1 12:24 3:26 16:39-6 Wilderness 2 24:13 2:14 3:59 24:13-1 Wilderness 1 27:9 17:29 6:17 23:41-11 Wilderness All Urban Compliance Areas 3,433 22:36 5:23 2:22 8:12 All Suburban Compliance Areas 77 14:19 7:6 2:58 1:23 All Suburban-Moderate Compliance Areas 3 16:9 1:4 2:45 13:43 All Rural Compliance Areas :38 11:32 4:39 17:18 All Wilderness Compliance Areas 12 27:9 17:57 6:3 24:13 Total Responses 3,691 8 of 16

10 Detailed Response Time Analysis without Exemptions Applied - NRLS September 218 Response Response Time Response Time Time Interval Interval Interval 9th Compliance Zones Responses Maximum Mean Std Deviation Percentile -1 Urban :24 7:36 4:33 13:16-2 Urban 22 22:45 1:54 5:32 17:8-3 Urban 8 18:4 9:3 6:7 18:4-4 Urban :26 8:21 4:13 13:37-5 Urban :11 8: 3:47 12:58-6 Urban -7 Urban 55 14:59 7:34 3:38 13:21-8 Urban 57 18:36 6:27 4:2 12:38-9 Urban :15 8:11 5:46 15:27-1 Urban 6 46:16 16:46 13:43 46:16-11 Urban 5 23:5 11:5 7:27 23:5-2 Suburban -3 Suburban :46 9:38 1:15 7:8 2:5 2:14 12:46 9:38-7 Suburban 12 18:8 8:8 4:56 14:35-8 Suburban 5 14:7 9:2 3:5 14:7-9 Suburban 5 19:1 1:3 5:4 19:1-1 Suburban 1 1:54 1:54 : 1:54-11 Suburban -1 Suburban-Moderate 17 25:34 13:5 5:29 19:3-2 Rural 11 28:45 13: 7:56 21:13-3 Rural 1 28:28 15:48 6:18 22:9-5 Rural -6 Rural 1 11:38 11:38 : 11:38-7 Rural 4 26:7 2:28 7:23 26:7-8 Rural 8 25:19 15:6 6:8 25:19-9 Rural 1 11:23 11:23 : 11:23-1 Rural 2 12:9 1:51 1:18 12:9-11 Rural 14 24:11 14:35 6:4 24:2-6 Wilderness 3 25:26 21:33 5:4-1 Wilderness -11 Wilderness 25:26 All Urban Compliance Areas :16 8:7 4:23 13:26 All Suburban Compliance Areas 29 19:1 8:39 4:3 14:35 All Suburban-Moderate Compliance Areas 17 25:34 13:5 5:29 19:3 All Rural Compliance Areas 51 28:45 14:45 6:57 24:11 All Wilderness Compliance Areas 3 25:26 21:33 5:4 25:26 Total Responses 2,99 9 of 16

11 Detailed Response Time Analysis without Exemptions Applied - NRLS October 218 Response Response Time Response Time Time Interval Interval Interval 9th Compliance Zones Responses Maximum Mean Std Deviation Percentile -1 Urban :34 7:39 4:33 13:5-2 Urban 28 24:19 9:4 4:1 12:2-3 Urban 8 17:48 7:23 4:16 17:48-4 Urban :45 8:32 4:3 14:27-5 Urban :38 7:49 3:47 12:48-6 Urban -7 Urban 65 17:3 7:5 3:29 12:31-8 Urban 51 19:8 7:11 4:25 12:39-9 Urban :13 7:32 4:34 13:2-1 Urban 5 25:4 12:19 7: 25:4-11 Urban 4 1:56 9:52 :46 1:56-2 Suburban 4 11:27 8:1 2:14 11:27-3 Suburban -7 Suburban 14 23:8 13:48 4:16 19:19-8 Suburban 4 11:35 7:6 2:51 11:35-9 Suburban 3 13:25 11:2 2:4 13:25-1 Suburban -11 Suburban 2 16:11 12:14 3:56 16:11-1 Suburban-Moderate 7 23:32 12:57 6:13 23:32-2 Rural 9 24:16 14:5 6:38 24:16-3 Rural 13 34:41 15:53 8:33 25:16-5 Rural -6 Rural 3 14:41 12:36 2:43 14:41-7 Rural 3 17:26 1:41 5:23 17:26-8 Rural 4 3:2 17:33 7:57 3:2-9 Rural -1 Rural 7 15:3 12:38 1:51 15:3-11 Rural 5 27:15 15:4 6:5 27:15-6 Wilderness 1 2:11 2:11 : 2:11-1 Wilderness 1 4:28 4:28 : 4:28-11 Wilderness All Urban Compliance Areas 2,47 53:45 8:2 4:16 13:3 All Suburban Compliance Areas 27 23:8 11:33 4:3 17:57 All Suburban-Moderate Compliance Areas 7 23:32 12:57 6:13 23:32 All Rural Compliance Areas 44 34:41 14:42 6:56 24:29 All Wilderness Compliance Areas 2 2:11 12:19 7:51 2:11 Total Responses 2,127 1 of 16

12 Comparison of Compliance with and without Exemptions - RLS September 1, 218 through September 3, 218 Number of Number of Late Late Calls Compliance Calls After Prior to Prior to Exemptions Compliance After Compliance Zone Total Responses Exemptions Exemptions Approved Exemptions % % % % % % -4 1, % % -5 1, % % % 1.% % % % % % % % % % % All Zones Combined 3, % % * Minimum of 1 responses required for calculation. True compliance shown in rolling compliance zone tables. Comparison of Compliance with and without Exemptions - RLS October 1, 218 through October 31, 218 Number of Number of Late Late Calls Compliance Calls After Prior to Prior to Exemptions Compliance After Compliance Zone Total Responses Exemptions Exemptions Approved Exemptions % % % % % % -4 1, % % -5 1, % % % 1.% % % % % % % % % % % All Zones Combined 3, % % * Minimum of 1 responses required for calculation. True compliance shown in rolling compliance zone tables. 11 of 16

13 Comparison of Compliance with and without Exemptions - NRLS September 1, 218 through September 3, 218 Number of Number of Late Late Calls Compliance Calls After Prior to Prior to Exemptions Compliance After Compliance Zone Total Responses Exemptions Exemptions Approved Exemptions % % % % % % % % % % % 1.% % 1.% % 1.% % % % % % % All Zones Combined 2, % % * Minimum of 1 responses required for calculation. True compliance shown in rolling compliance zone tables. Comparison of Compliance with and without Exemptions - NRLS October 1, 218 through October 31, 218 Number of Number of Late Late Calls Compliance Calls After Prior to Prior to Exemptions Compliance After Compliance Zone Total Responses Exemptions Exemptions Approved Exemptions % % % 1.% % % % % % % % 1.% % % % % % % % 1 95.% % 1.% All Zones Combined 2, % % * Minimum of 1 responses required for calculation. True compliance shown in rolling compliance zone tables. 12 of 16

14 Comparison of Compliance with and without Exemptions - IFT September 1, 218 through September 3, 218 Interfacility Transfers Total Responses ALS-IFT 89 CCT-IFT 1 Number of Late Calls Prior to Exemptions 3 Number of Late Compliance Calls After Prior to Exemptions Compliance After Exemptions Approved Exemptions 96.63% % 1.% 1.% Comparison of Compliance with and without Exemptions - IFT October 1, 218 through October 31, 218 Number of Number of Late Late Calls Calls After Prior to Unadjusted Exemptions Compliance After Interfacility Transfers Total Responses Exemptions Compliance Approved Exemptions ALS-IFT % % CCT-IFT 9 1.% 1.% 13 of 16

15 Exemption Request Reports Types of Exemptions Exemptions Approved September Exemptions Denied Exemptions Approved October Exemptions Denied Bad Location / Address 2 3 Delays in Transferring Care at ED Duplicate Record 1 False Report of Emergency 2 1 Freeway Access 4 3 Location Change 1 Other 42 4 Reduced/Upgraded Response 6 1 Road Closure 2 Road Construction 1 2 System Overload 3 1 Traffic Secondary to Call 6 5 Train Zone Assist of 16

16 Mutual Aid Compliance Zone Provider September 218 October Manteca District Ambulance Manteca District Ambulance 8-5 Escalon Community Ambulance 1-8 Manteca District Ambulance Manteca District Ambulance Ripon Ambulance 1-1 Manteca District Ambulance 1-11 Manteca District Ambulance MOD Manteca District Ambulance 3 1 Failure to Provide Data Event Type N/A September 218 October 218 Mechanical Report Event Type N/A Date Preventable Community Service Report Event Type See Appendix A. 15 of 16

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