Savannah's EMS emergency deserves lights and sirens. Community must call for system overhaul

This commentary is written by opinion columnist Adam Van Brimmer.

Ask those who live in remote places how they deal with health issues, and they’ll tell you, “Don’t get sick.”

Here in Savannah and Chatham County, EMS response time statistics warrant similar advice. With ambulances taking more than 15 minutes to arrive and assist the dying and seriously injured, the best approach is “don’t have a medical emergency.”

As the “EMS emergency” special report published earlier this week highlighted, the local EMS system is on life support - and Savannahians are dying because of it. The emergency response process is diseased with multiple failure points involving several agencies and organizations.

The county’s designated EMS provider, Chatham Emergency Services, gets most of the blame.  Over the course of the last 25 years, the privately held nonprofit has bought out the county’s other ambulance services and is now the sole provider.

They made some bad deals along the way - they received no taxpayer subsidy in serving the areas inside the Savannah city limits and undercut themselves to win a bid with Chatham County. The county contract fails to cover the costs to operate even one ambulance for a year.

If financial struggles were the single root cause of the Savannah area’s EMS emergency, it could be fixed easily. But Chatham Emergency Services is only one underperforming player in this life-and-death game.

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A 911 for 911

Look deeply into EMS response, and the 911 and ambulance dispatch process might just put you into cardiac arrest.

Savannahians treat 911 like an internet search engine - they call the emergency line for help with any mental, emotional or physical ailment, not just those involving grave danger. A bead stuck in a toddler’s ear. An obstinate teenager who has stressed out a parent. Hungry folks in search of a meal. An itchy rash that won’t go away.

As Chatham Emergency Services COO Phil Koster put it, the days where people once called 911 only when they “had a pitchfork sticking out of” them are over. Now, the emergency line is one of convenience for the public, with deadly results.

Beyond the trivial calls, the 911 and dispatch process here is unnecessarily complex. Ambulances are dispatched not by Chatham 911 operators but by the ambulance service itself. The 911 staffers take the info and relay it to Chatham Emergency Services, who then send the EMTs and paramedics.

As a result, in the time it takes to get an ambulance rolling, police and fire are often already on the scene.

'911, what's your emergency?' EMS dispatch process in Savannah plagued by antiquated system

Soon, the process will be streamlined, with 911 transferring calls for EMS directly to the ambulance provider. But even that is cumbersome - consider how many calls come in that require attention from other agencies, such as police or fire, as well as EMS.

Chatham Emergency Services justifies the redundant dispatch teams as protection against litigation. Kearns also highlights how much better the dispatch process has gotten in recent years as the 911 infrastructure has improved.

Still, when seconds count, any inefficiencies should be examined and addressed. Chatham Emergency Services officials estimate the 911 and dispatch process often delays response by 1 to 4 minutes. Seems like a good place to start.

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Hospital ERs facing bed shortage

As if the front-end challenges with 911 and dispatch weren’t enough of a response time bleed for the Chatham Emergency Services, the local EMS provider also needs a tourniquet at the end point, the local hospitals.

Emergency rooms at Memorial, St. Joseph’s and Candler are seeing more and sicker patients these days. Once the ERs fill up, ambulances become stranded at the hospitals - they can’t answer another EMS call until after they hand off the patient they transported to the medical center.

The delays average 63 minutes - and can stretch for hours, according to Chatham Emergency Services.

St. Joseph’s and Candler have expanded ERs to handle the uptick but still experience what’s known as “bed delays” - situations where every treatment space is occupied and new arrivals must wait for an open bed.

Memorial, the region’s trauma center, is facing capacity issues as well. When the hospital was publicly owned, the ER handled overflow by putting beds in hallways. But that practice ended with Memorial’s sale to a private operator, HCA Healthcare, in 2018.

Memorial leadership responded to queries about bed delays by issuing a statement that referenced its petition to open new ERs at sites other than its main campus in midtown. They’re waiting on state approval.

Keep pointing fingers to yourself

Deflecting blame is the current treatment strategy when it comes to the EMS response time emergency. But here’s the diagnosis: Pointing fingers is not curbing the infection’s spread, and people are dying in the meantime.

This community must demand comprehensive action. Members of the public need education on 911 - and face consequences when they abuse the system. Chatham 911 and Chatham Emergency Services must get together on the dispatch process. The hospitals should implement a triage system for ER surge times to get ambulances back on the streets. And Chatham County ought to invest more taxpayer dollars in EMS.

“Don’t have a medical emergency” is a punchline, not a plan.

Contact Van Brimmer at avanbrimmer@savannahnow.com and via Twitter @SavannahOpinion.

This article originally appeared on Savannah Morning News: EMS ambulance response times Savannah Chatham County deadly delays