EMS study shows problems with system


By Stan Welch

First responders, of all sorts and kinds, share one mantra. Communications – Communications – Communications. It doesn’t matter how many police cruisers, fire trucks or ambulances you have if you can’t get them to the right place at the right time.

In 2015, the Williamston EMS Squad collapsed due to financial problems and mismanagement. That event spurred a study by Fitch & Associates to review the emergency medical services system in Anderson County. The results of that study were delivered to the Anderson County Council and the first responder community last week.

This is the first in a series of reports on that study and its findings. To no one’s surprise, inadequate communications, both its causes and effects, were a key element in the report and its findings.

The study states baldly that the 911 center’s medical dispatch system is inconsistent, failing to produce demonstrable, reproducible results. Computer assisted dispatch (CAD) supported call taking results far too often in calls being dispatched as “hot” emergency responses, resulting in far too many “sirens and lights” responses.

The study describes that situation as a “critical risk management and safety issue”, affecting responders, caregivers and the community itself. The study calls for the immediate implemented, which would more appropriately match the method of transport with the actual medical need at the time.

One major factor in the confused communications across the county is the fractured nature of the emergency medical infrastructure. The study declines to call the network of squads and providers a system, calling them a “diverse mixture of dedicated personnel and entities.” The study also points out that non-emergent services form enough of those organizations’ activities to qualify them as small businesses.

The study further points out that this loose collection of private, non-profit suffers from ineffective county governance. The loose collection of policies, ordinances and contracts between the county and the various providers are inadequate, as is the level of expertise or guidance provided by the EMS commission.

One example of the issues existing due to this somewhat jumbled approach is the fact that the closest ambulance may not be dispatched to a scene,due to territorial disputes between the various squads or providers. The fact that MedShore, the largest single provider in the county system, dispatches its own ambulances further complicates the matter.

None of the emergency medical service providers consistently meet the response times defined in the contract with the county. In fact, the response times are “captured” or recorded in such a way that the response times cannot be adequately compared with those in other systems, or that facilitates internal improvements in meeting those standards. The study calls reliable data in that regard “significantly lacking’.

Inconsistent levels of patient care were reported by medical personnel at various hospitals that receive patients transported by the various providers. The issue of medical accountability across the county is a major issue addressed in the study.

The county, coincidentally, is not required by state law to provide any EMS services. The state law defines the nature and structure of such services if they are provided, but they are not mandatory. Anderson County Council has made it clear they fully intend to continue providing such services. This study is the first step in attempting to modernize and improve those services.

No actions have been taken on the recommendations in the study, and further review is expected,