In response to a request and recommendation from supervisors Kevin Jeffries (District 1) and Chair Jeff Hewitt (District 5), the Riverside County (RC) Board of Supervisors unanimously agreed to broaden the scope of its Fire Ad Hoc Committee, which has traditionally worked with RC Fire Department and Cal Fire at the board’s Tuesday, Jan. 11 meeting.
The committee will now be responsible for addressing the delays in transferring patients from ambulances to hospital admissions. Ambulance crews cannot simply deposit a patient at the hospital door and then head to the next call. The hospital has to take official responsibility for the patient’s care. When the patient comes off the ambulance gurney and is physically moved into the hospital on a bed or chair is when the offload time ends.
“Paramedic and first responder delays are inefficient and limit overall capacity of first responders,” Trevor Douville, administrator at the county’s Emergency Medical Services Agency (EMSA), stressed to the board.
Recently, time from arrival until the ambulance leaves for another call has been increasing. While all of the county’s hospitals have had offload delays, based on the EMSA’s monthly reports, Hemet and Riverside Community hospitals have consistently been near the bottom.
For example, in 2021 through November, nearly 53% of the ambulance visits exceed the county standard of 30-minute delays at Hemet Valley and Riverside Community hospitals.
“This problem has gotten worse over the year,” Jeffries said.
For instance, at Hemet, the number of transports that meet the 30-minute standard for the patient to be transferred to the hospital has been steadily decreasing since April’s high of 70% transports. In November, Hemet bottomed at 40% of the ambulance patient transports requiring more than 30 minutes for the hospital to assume responsibility and care for the patient.
The consequence is that fewer emergency vehicles and staff are available to respond to new 911 calls. But Douville emphasized, “The majority of specially care patients — stroke, trauma and cardiac — are being off loaded immediately. What we’re seeing are patients with low acuity and general weakness have responsible triage.
“But the paramedic at the hospital could be responding to the cardiac arrest down the street, but they’re just not available,” he warned.
“The system is beyond capacity and additional measures are needed to stabilize the system and ensure readiness,” Douville told the board.
With the help of the Emergency Management Department, of which EMSA is a division, and the Fire Department, the board’s ad hoc committee will now try to identify and recommend solutions to this persistent and dangerous problem.