SAN BERNARDINO >> Over the next six months, San Bernardino County staff members will be reviewing possible action on grand jury recommendations to shorten the length of time it takes for an ambulance crew to release its patient to hospital emergency staff in the High Desert.
On Tuesday, county supervisors unanimously agreed on a response to the grand jury’s report, released in July, which recommended a public education plan, enhanced 911 screenings, and a new public hospital for the High Desert.
In addition to accepting the grand jury findings, the response says the county will further analyze the issues during the next six months, the legally stipulated time period, said David Wert, a San Bernardino County spokesman.
Although the Inland Counties Emergency Medical Agency developed a plan, in 2015, to deal with some of the High Desert issues, San Bernardino County government has not wrestled with the issue on its own, Wert said.
ICEMA, which is legally distinct from San Bernardino County, oversees ambulance services in San Bernardino, Inyo and Mono counties. The Board of Supervisors is its governing board.
For 2016, the grand jury report said there were 11,695 hours of ambulance patient off-load delays at the three High Desert hospitals which operate emergency rooms.
This total is in addition to a 25-minute grace period for each ambulance patient delivery — a wait time when ambulance vehicles and their crews are in a holding pattern with the clock not running.
Following the grand jury report, American Medical Response spokesman Jason Sorrick said that the High Desert issue for ambulance delays is the worst among the company’s California operations.
“AMR is pleased to see that the county will continue to investigate the bed delay issue in the High Desert, and we are hopeful that this review will ultimately result in finding solutions to the problem,” Sorrick said after Tuesday’s vote.
Wert said county staff would engage all the stakeholders in potential decisions to get their input before reaching any conclusions.
“Hospitals need to be in the conversation,” said Jennifer Bayer, vice president for external affairs of the Los Angeles-based Hospital Association of Southern California. That has not happened so far, she said.
“A lot of the bottleneck is a direct result of staffing and a lack of ability to recruit high-level (hospital) staff” given the geographic and demographic issues of the High Desert, she said.
Building another hospital in the High Desert won’t by itself, solve the problem, she said.
To compensate for the delays in turning patients over to hospitals, AMR is paying to put EMT’s through paramedic school, flying in personnel from other parts of the state to run calls, offering $10,000 signing bonuses and increasing compensation, Sorrick said.
There are many reasons for the bed delays in the High Desert, said Randy Bevilacqua, spokesman for St. Mary Medical Center in Apple Valley.
“We are seeing sicker and sicker patients with more complications,” he said. There is an increase in 5150 patients, which are involuntary psychiatric holds, and these tie up hospital beds, preventing ambulances from unloading their patients, he said.
“There is definitely a problem finding somewhere to hand them off,” he said.
There are more patients coming in with drug-related issues and there is a physician shortage, which means many are using the emergency room for primary care, Bevilacqua said
Bevilacqua, the Grand Jury report and ICEMA all recommend a public education campaign to address appropriate use of emergency medical services.
September 14, 2017
The San Bernardino Sun
By Jim Steinberg
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