HILLSBOROUGH - If you call 911 in Orange County, Emergency Medical Services is still trying to get to you faster.
The county has been trying to improve its response time for at least four years but still lags behind its goal of getting to a patient within 14 minutes 90 percent of the time.
The Orange County commissioners gave the department $9 million for the 2012-13 year, about $1 million more than last year, to improve its technology and communications systems and add paramedics and telecommunicators.
There is no required national response benchmark, but most agencies follow standards and set goals based on the National Fire Protection Association. The NFPA calls for an average response time of 12 minutes. Wake County hit that mark 90 percent of the time. Orange County’s average response time is between 16 and 18 minutes, said Kim Woodward, Orange County EMS operations manager.
Creating standards for response times is tricky, said Patrick O’Connor, a paramedic and supervisor with Orange County EMS.
“They’re problematic,” he said. “How do you determine what’s acceptable and what’s not acceptable, because there’s so many variables.”
Saturday nightOn a Saturday in May, EMS staffers are preparing for what they think will be a busy night. It’s right before UNC’s graduation and Mother’s Day, and lots of families are in town for the weekend.
Jeff McVey, a telecommunicator, sits at one of the pods in the county’s 911 call center. He has three computer screens in front of him, showing him where ambulances are and alerting him to calls.
As soon as someone calls 911, McVey can dispatch an ambulance with a keystroke. As the person talks, he’s putting codes into the computer, dispatching either an ambulance, firetruck or both and sending those crews information about the call.
His computer dings and clicks to connect to a caller: It’s a woman in the Booker Creek neighborhood in Chapel Hill complaining of chest pain. As he asks questions, his mouse flies, clicking open new windows to dispatch the EMS team. The call takes 2 minutes, 5 seconds.
“While I’m talking to them, somebody else is sending somebody,” he said.
There are at least six dispatchers working most shifts, McVey said, but there’s always the potential to have more calls than people available to answer them.
“It’s a juggle sometimes, and you got to know how to do that,” he said.
Spending upThe department has been asking Orange County commissioners for more money to update their 911 call center computer system and add EMS staff and vehicles on the road for years.
Last month, county commissioners approved $419,722 for 11 new full-time positions for the EMS department, including an assistant fire marshal, four telecommunicators and six paramedics, which will come online throughout the 2012-13 fiscal year.
Commissioners also approved $227,848 for another ambulance and $53,171 to replace and update two other EMS vehicles to be taken out of an internal service fund, separate from the budget’s general fund.
The county also is spending $30,000 for new equipment for the department’s radio systems and is purchasing additional channels on cell towers to create more space for 911 calls.
Response timeResponse time is broken down into several events: the time it takes to dispatch the ambulance; the time it takes the crew to get into the ambulance, start it and get it on the road; the time it takes the ambulance to get to the scene; and the time it takes paramedics to reach a patient once they’re on the scene.
Orange County has improved its time in nearly all these categories over the last three years, and decreased its overall response time by two minutes since 2009.
In 90 percent of all calls, the county responded within 17 minutes in the 2009-10 fiscal year. That dropped to within 15 minutes in 2010-11 and stayed there in 2011-12. The state average for those years is also 15 minutes. Orange County’s 90 percent response-time goal is 12 minutes.
These times take into account the geographic layout of the county and significantly differ from the average response time in Orange County because the majority of calls come from the Chapel Hill-Carrboro area, and most patients are transported to UNC Hospitals in the southeast corner of the county, Woodward said.
“It’s like trying to find the right combination of things to get that up,” O’Connor said.
EMS dispatches from five stations across the county, South Orange rescue in Carrboro, at UNC-Chapel Hill off of Mason Farm Road, Elfland on Mount Willing Road, Chapel Hill on Eubanks Road and Hillsborough on Revere Road.
There are ambulances available 24/7 but there are more on the road during 12- hour peak times from 6 a.m. to 6 p.m.
Outdated technologyThe county currently uses a computer system running software that is 20 years old, said Frank Montes de Oca, Orange County’s emergency medical services director.
“We’re really playing catch-up,” Woodward, the operations manager, said.
Earlier this year the county installed Automatic Vehicle Locator software so dispatchers could better track emergency vehicles on the road, which has made a big difference, Woodward said.
The new software displays a map of the county with dots showing where emergency vehicles are headed or currently parked. Before, when a 911 call came in, dispatchers had to find the appropriate emergency vehicles and then send it to the scene, which increased response times.
“Overall, this is definitely helping us,” O’Connor said. “You can see it’s going to make a difference in a lot of different ways.”
The county still needs faster computers to process calls, and a new radio system and more radio towers in the county to implement the system. The improvements are expensive but worth it, he said.
“It pays for itself over the long end because it saves lives quite honestly,” Montes de Oca said.