D.C.’s emergency services department sees improvement one year later

The District has improved its ambulance availability, emergency response times and employee training a year after the city’s nationally-recognized medical director quit, calling the department’s culture “toxic.”

“The progress we’ve seen allows us to set a baseline for where were are,” D.C. Fire and Emergency Medical Services (FEMS) Chief Gregory Dean said Tuesday at a mayor-D.C. Council breakfast.

Call times over the last year have decreased dramatically, said Chief Dean, adding that part of that success results from third-party ambulances handling much of the less serious calls.

Before the city contracted with American Medical Response in April, response times for the most serious cases — “advanced life support” calls — averaged around 8 minutes. That dropped to about 6 minutes, 30 seconds by the end of January.

Among longtime FEMS critics, training has been one of the biggest problems. On Tuesday, Chief Dean noted a variety of training over the last year. Between April and December, training of emergency workers increased by 33 percent over 2015’s mark.

In addition, the department has instituted team-based, on-site training in the field and at hospitals to replace “biannual classroom cramming sessions for recertification,” the chief said, adding that one new course includes pediatric training in partnership with Children’s National Medical Center.

The District fields the highest number of 911 calls per-capita of any U.S. city, and the number of calls grow with the District’s population. On any given day, the department will field about 500 calls.

Chief Dean said too many residents still are calling emergency services for nonemergencies, noting about 160 calls a day are for problems outside his agency’s purview.

But there’s little that FEMS can do, as city law requires ambulances to transport residents who call for one.

“[It’s] currently red lights and sirens for every call,” the chief said.

A “nurse triage” line could become part of the city’s 911 system to reduce the number of less-serious calls that tie up ambulances. It would be the first such program in the area and one of a few across the country.

For a 911 minor call, the caller is routed to someone who can evaluate what kind of care the person needs and arrange alternate transportation or an appointment at a clinic.

Dr. Robert Holman, FEMS interim medical director, called the program “groundbreaking.” Currently Reno, Nevada, and Fort Worth, Texas, run similar triage programs.

Mayor Muriel Bowser and Chief Dean received mostly praise from the council members.

Former Judiciary Committee chairman Kenyan McDuffie called the progress “notable.” And current Chairman Charles Allen, who will hold a FEMS oversight hearing Thursday, said: “This is nothing short of systematic change.”

“We were a little concerned a few years ago, but this is a complete change,” council member Anita Bonds said.

A year ago, Dr. Jullette Saussy, the former emergency medical director, hammered the fire department’s top brass, telling city lawmakers that she wasn’t given access to basic data to assess medics’ performance.

“The situation is grim,” Dr. Saussy wrote in her Jan. 29, 2016, resignation letter to Miss Bowser.

She said the District’s plan to use a third-party ambulance service to take low-level calls and free up city ambulances for emergencies was “as unlikely to fix the situation as placing a Band-Aid on a gushing artery.”

At the time, Chief Dean said the changes could not be rushed.

“When we start talking about change — change is very difficult,” he told lawmakers last year. “The challenges we are facing did not materialize overnight. It will take time to get where we want to go.”