One of the interesting statements in this news article is that their transport rate “climbed to 48% in 2023”, up from 35% in 2021.
While every community is different, even with our multiple programs designed enhance patient experience and reduce healthcare expenditures by avoiding preventable transports to the ER, MedStar’s average transport rate is 80.3%, compared to the referenced national data from ESO of 83%.
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In 'doorbell recording' case, Phoenix firefighters violated ambulance refusal policy
ABC15 Investigators: Why Phoenix firefighters convince people not to use the city ambulances and what's changing now
Mar 06, 2024
https://www.abc15.com/news/local-news/investigations/in-doorbell-recording-case-phoenix-firefighters-violated-ambulance-refusal-policy
PHOENIX — A Phoenix fire crew, caught on a doorbell camera video dissuading a sick woman from taking an ambulance to the hospital, violated multiple city policies, according to the fire department's administrative investigation.
ABC15's airing of that video prompted the investigation about the August 2021 medical call to Haydee Pate's south Phoenix home. She had COVID and was having difficulty breathing at the time of the 911 call.
Pate was sitting outside on a bench when the Phoenix fire captain, a paramedic, and a firefighter/EMT arrived in a fire engine.
"Do you just want to take her to the hospital?" Paramedic Caleb Kountz asked Pate's son who was standing in the driveway.
"Yeah, she wants to go to the hospital," the son replied.
"Do you want to take her?" the paramedic asked.
Pate later explained to ABC15 that her son needed to remain at home to care for her young daughter. Both were also sick with COVID.
As minutes pass, the crew takes Pate's vital signs but doesn't call for an ambulance.
"That ambulance is $1,500 bucks," Captain Gerald Ingallina said. "I mean, we'll take her, but if you have $1,500 bucks, I know what I'd like to do with $1,500 bucks."
After the firefighters left, Pate's son ended up driving her to the hospital, and she was admitted for pneumonia.
"It's been over two years, and not even once did I receive any apology," Pate said in an interview with ABC15 last month.
But she did receive a copy of the administrative investigation, which found all three crew members violated multiple fire department rules including failing to follow a 2021 memo about refusal of treatment and transport, as well as not protecting the public.
Pate still has questions about who signed the medical report as the patient "refusing" ambulance service because she says it wasn't her.
"That's not even close, that's not my initials, that's not my signature," Pate said.
The fire captain who responded to Pate's house retired before the investigation was completed, but the firefighter and paramedic remain with the department. Phoenix fire officials would not say what discipline they received, if any. A spokeswoman did write to ABC15, saying the department "strives to address any complaint consistently within our policies and values" and "necessary corrective actions are taken".
"Very bad," Pate said about her experience. "I don't want that to happen to [anybody] else."
ABC15 has covered multiple cases of ambulance denials in Phoenix over the past two years, including at least one death, despite the city's longstanding policy that everyone who wants an ambulance gets one.
The administrative investigation in Pate's case also included an explanation from one firefighter about why they would persuade a relative to drive a patient instead of using a city ambulance.
"It takes time for an ambulance to get to them, it takes time for us to load them up, and it takes time to get them to the hospital," firefighter Christopher Flores told investigators, according to the PFD report. "Sometimes, time is crucial."
When the investigator asked, if time was crucial, wouldn't it be wiser to have a medic versus someone who is not trained, Flores responded, "Yeah."
"They contradict themselves back and forth with their comments," Pate said after reading the report. "It just made me wonder 'what's going on.'"
In a statement to ABC15, the Phoenix Fire Department said it wants to assure the public that the department "is committed to providing the highest levels of customer service."
At the same time, PFD data may partly explain why firefighters may feel time pressure. There have been an increased number of 911 medical calls and longer ambulance response times in recent years.
The ESO EMS Index, which looks at the big-picture performance of emergency medical providers across the country, calculated nationwide data from 2021 finding, on average 83% of people who called 911 for medical help got an ambulance ride to the hospital. Just 17% were non-transport cases. But Phoenix's ambulance transport data, which the agency provided to ABC15, showed a much lower ambulance use rate. In 2021, patients made hospital runs on just 35% of calls.
When questioned about the disparity, a Phoenix Fire Department spokeswoman responded that patient transport percentage rates can vary significantly from one jurisdiction to another. As a result, any comparison of Phoenix to any other reported percentage would require a thorough review to ensure that all variables are consistent.
Phoenix's data shows the city's ambulance transport rate climbed to 48% in 2023 after firefighters were trained on a new state law saying paramedics and EMTs "may not counsel a patient to decline emergency medical services transportation."
"I've been thinking, maybe, there's not enough ambulances," Pate said.
Trying to increase the available ambulances and reduce response times, the fire department is asking Phoenix City Council this week to approve a plan to convert 10 part-time ambulances to 6 full-time ambulances. More than 50 jobs would be added to staff those ambulances.
