My BIGGEST pet peeves

[fafinaf]

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[exodus]

You're confusing financially appropriate for medically appropriate.


A patients insurance might be accepted at hospital A and not hospital B, but if hospital B is a cath lab and the hospital A is not, then going to hospital A is not smart OR appropriate.

Totally true. And in those instances the insurance will pay back their full amount of their normal reimbursement, as well as the transfer costs. But if someone goes to the ER for 'flu like symptoms' which get's dx'd as PNA so the DR keeps them over night for IV meds. Especially if it's Kaiser, they will want to get them to their own hospital. Thankfully kaiser will pay for everything. But many ER's will require a transport to a direct admit to the insurances hospital.

Edit: Maybe we should venture into a new thread? I have a feeling I've seen EMS: Healthcare Vs. Customer Service before somewhere around here ... Hm.

 

[Sasha]

the ambulance company i work for has more than enough ambulances to cover the area while i take the patient to his home hospital. and yes, ems is customer service at the company i work for.

Yeah you have worked for ONE company. You have a small snapshot of ems and you do not speak for the system as a whole. Some places have one truck for their entire county

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[fma08]

Yeah you have worked for ONE company. You have a small snapshot of ems and you do not speak for the system as a whole. Some places have one truck for their entire county

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We're lucky enough to have two

 

[Shishkabob]

Not to mention seeing his location my money is on his agency doesn't do 911, therefor it's a non-issue to be level zero for hours on end as no one has the potential of having a bad outcome because of a delayed response.

 

[Sasha]

Not to mention seeing his location my money is on his agency doesn't do 911, therefor it's a non-issue to be level zero for hours on end as no one has the potential of having a bad outcome because of a delayed response.

Not true. We often have emergent cath lab txf

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[Shishkabob]

Not true. We often have emergent cath lab txf

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While true, are there also not other transfer agencies in the area?


When I worked at AMR and a time sensitive call came in to which we couldn't make it in reasonable time, dispatch would call another transfer company to take the call.



Plus the patient is already receiving medical care, as opposed to a 911 response where they most likely aren't.

 

[JPINFV]

So you would rather take an ambulance out of service for an hour or more to transfer a stable patient to a facility when transfering them to a closer facility would be adequate?

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Not all hospitals are 30 minutes or further away. Heck, I grew up within 5 minutes of 3 separate hospitals.

 

[Shishkabob]

Not all hospitals are 30 minutes or further away. Heck, I grew up within 5 minutes of 3 separate hospitals.

Again, which is why this is a non-issue for urban providers.



I have 30ish minute transports to a couple of hospitals that can handle most complaints.


Most patients want to go to hospitals over an hour away... even though they are affiliated with the hospitals that are closer. If we transport to Dallas or Tyler, you're taking a truck out of service for a minimum for 3 hours... 3 hours for a single call that is non-critical and could have taken a POV.


I will run calls all day without issue, it's not a problem of 'being lazy'. However, asking resources to be taken out of service for that length of time for no change in benefit for the patient is ridiculous.

 

[JPINFV]

You're confusing financially appropriate for medically appropriate.

Once the medical screening exam is complete and no "emergent" condition exists, then those are one in the same.

A patients insurance might be accepted at hospital A and not hospital B, but if hospital B is a cath lab and the hospital A is not, then going to hospital A is not smart OR appropriate when the patient needs a cath lab.

...and what about the vast majority of patients who do not need a specialty center?

Plus you keep saying 10 minutes. 10 minutes is a non-issue. We're speaking of the ones that want a 1+ hour transport when another appropriate facility is much closer. Another truck in our county had a patient the other day request to be taken to a hospital 1.5 hours away. That's retarded.

...and you keep on saying 1 hour plus, which is not always the case either.

 

[JPINFV]

We are not even talking about ten minutes further, thats fine... but half an hour? Where do you draw the line? "oh i live in gains

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That's an issue (maximum time one way) that needs to be set up by the system administrators or 911 contract and not something decided on an ad hoc basis by field providers.

 

[fafinaf]

I'm not trying to come across as a jerk and I can see how I did. I see all of your points and I understand that not every company is the same. I think we can all agree that there needs to be a time when you draw the line where we try our best to meet the expectations of the patient, and make the best judgement based on availability of ambulances and higher priority calls in the area.

I do believe that EMS is a customer based service, that is my opinion. I feel that meeting and exceeding the expectations of patients not only makes a happy patient, but also generates positive reviews and attitudes towards the company you work for. Can you satisfy every request that a patient has? No. Can you try to do everything you can to make your patient happy while doing what's best for your co-workers and city? Yes.

Some ambulance companies have more ambulances than others, some have less. Some ambulance companies have contracts with fire and some don't. It's a situation to situation based thing. There are many factors that would play into what hospital you would take a patient to. A patient showing signs and symptoms of an MI is not going to go to a hospital further than the closest one. Sorry to everyone for sounding ignorant. Must have been having a bad day!

Peace & Love

 

[Sasha]

Not sure where you work but i dont have customers, i have patients.

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[JPINFV]

When I worked at AMR and a time sensitive call came in to which we couldn't make it in reasonable time, dispatch would call another transfer company to take the call.

However not all companies are going to do that nor are they going to do that for all calls that have potentials to be an "emergency." Additionally, using that logic, provided all of the calls holding are low grade calls under EMD, what's the problem with being at level 0 under the same reasoning?

 

[JPINFV]

Not sure where you work but i dont have customers, i have patients.

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Sure you do, who ever your company is contracted with is your customer. If it's a 911 company, than the citizens in your jurisdiction (especially if your company receives any tax substitutes) is your customer. If it's private pay, then that patient is your customer. If it's out of a health care facility, then the health care facility is your customer. If it's event standby, then the event organizers are your customers. I'm assuming that your service gets money from somewhere, after all.

 

[fafinaf]

I treat my patients as patients, not customers. And secondly, they ARE customers..

 

[Sasha]

Sure you do, who ever your company is contracted with is your customer. If it's a 911 company, than the citizens in your jurisdiction (especially if your company receives any tax substitutes) is your customer. If it's private pay, then that patient is your customer. If it's out of a health care facility, then the health care facility is your customer. If it's event standby, then the event organizers are your customers. I'm assuming that your service gets money from somewhere, after all.

The only customers are the hospitals/nursing homes. Patients are patients, not customers.


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[JPINFV]

The only customers are the hospitals/nursing homes. Patients are patients, not customers.


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If I'm paying out of pocket for care, then I'm both a patient and a customer, and if I don't like the care I received from a transport I set up, I'm free to take my business elsewhere in the future. Similarly, if, as a tax paying citizen, I'm unhappy with the service provided by the contracted ambulance provider, I'm free to work towards the city (the customer) finding a different provider.

 

[Sasha]

If I'm paying out of pocket for care, then I'm both a patient and a customer, and if I don't like the care I received from a transport I set up, I'm free to take my business elsewhere in the future. Similarly, if, as a tax paying citizen, I'm unhappy with the service provided by the contracted ambulance provider, I'm free to work towards the city (the customer) finding a different provider.

I dont work for the city, you are free to refuse care as is someone who isnt paying for care. You can campaign against hospitals contracts if you want but they come down to who does it cheaper and how happy their staff is. A patient is a patient and not a customer.

I dont do billing and dont differentiate between who is paying how and who isnt. So theyre all treated equally.

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[JPINFV]

I dont work for the city,

So you're not running 911 calls? (Honest question, just checking, NTTTAWWT)