The Macomb Daily — COVID-19’s local impact in terms of service and sacrifice was detailed for the Macomb Township Board of Trustees on July 14, when Medstar Ambulance CEO Kolby Miller made his 2020 report presentation.
Miller said COVID-19 impacted both interfacility and critical care work at Medstar and detailed personal sacrifices the pandemic caused his employees to make.
“I want to take a minute as I have and will continue to recognize the people at Medstar, the fire departments that we work with, law enforcement agencies. There were a lot of people that walked away from these careers last year. And there are people who still struggle with staying in these careers today because of the year that we have been through. So as I start my report for you I can’t do it without reflecting on the sacrifices that, that the team made to keep the services going in the communities. We had people who did not go home from work for weeks on end. I spent a week on the couch in my office for a little while early on because we did not know what we were getting into,” Miller said.
Medstar obtained a year and a half’s worth of PPE as soon as there was an indication that a pandemic was coming, according to Miller. It took up two full ambulance operation bays, and Medstar employees never went without proper PPE.
“So we got through it, we are coming out of it now. But I could not start a presentation without reflecting on their sacrifice during the year. During the year due to the pandemic we had about 18,000 hours of our personnel, clinical personnel, lost hours due to infection or clinical restrictions,” Miller said.
Medstar chose not to put these employees on workers compensation policies, but continued their wages and benefits at full cost throughout the pandemic.
“We let people work up to 96 hours. We put additional units into the system and many of our personnel took advantage of staying in hotel rooms so that they would not go home after a shift to their families. Especially early on, not knowing what we were taking home with us. Or not knowing what was in our clothing, or our uniform. So I am thankful again that we were able to do that for our personnel,” Miller said.
Miller described 18 hospital admissions of clinical staff, including four who landed in the ICU – one person twice.
“We did lose one of our service members. Almost a million dollars in additional PPE in the year, and although we had the infrared light early on and we have had it for many years, when the pandemic started we offered our light to any public safety agency within our service area including other ambulance companies. To come by and have their vehicles deconned with the UV light,” Miller said, adding that in 2020, emergency department utilization dropped significantly in April, May and June.
“And to be quite honest, it has not come back to full capacity yet. We are almost back but the bars that you see here are the 12 months of 2020,” Miller said.
He also said turnaround times at hospitals went up, as Medstar went from dropping a patient off in five or ten minutes to dropping a patient off up to about an hour.
“Turning the truck around, making a clinical report and then getting our personnel back in service. Scene times were longer because of PPE, decontamination at the hospital was longer because of putting the truck back in service. So the volume dropped. But the service time extended to far beyond what the drop would have accommodated.” Miller said.
Response patterns continued about the same throughout the year, and Miller described the majority of responses as emergency but the majority of transports as non-emergency.
“We rely or we lean towards emergency even if we think it might not be. But once the paramedics are on the scene, most of the patients that we see are non-emergency patients going to the hospital. The reasons for requests in Macomb Township are pretty standard that we see throughout the rest of our service area,” Miller said. “Difficulty breathing obviously, during the COVID year was a little more than it would normally be. Most of them are a little bit more evenly distributed. Sick person is usually the leading request.”
Patient satisfaction surveys showed Medstar was rated good or very good at 97 percent of survey responses, based on Miller’s report.
“During the time of 2020 our contract calls for eight minutes or less 90 percent of the time. The 2020 performance was 91 percent and the that generated a 5.49 minute average response time throughout the county, or throughout the township during 2020,” Miller said.
Although paramedic and EMT courses went online, capital spending remained on track, the report indicated.
“Although the year was very difficult financially for us, we did not abandon any of our capital plans. We continue to make our investments,” Miller said.
Miller also explained his team was selected to staff state COVID-19 hospitals, providing emergency responses into these facilities. Medstar’s mobile health paramedic program continued to see township patients that are homebound or at high risk of hospitalization, he said. Miller also described the Medstar plans to start an AED shock and save fundraising initiative.
“Macomb Township was the recipient of one of our donated AEDs several years ago. We have continued to make these donations across the communities that we serve. And now we are looking for public and business support so that we can buy more and give them out to more communities so that they can be more impactful,” Miller said, adding Medstar would match community funds raised.
He also discussed the EMT academy, indicating July 30 will mark the 100th paid graduate.
“So it is difficult to recruit in this business. It is difficult to recruit during a pandemic. And we decided that instead of asking people to join after getting their license we now pay them as full-time employees to go to EMT training full-time,” Miller said.
He discussed the initiation of the Knock and Check program, which includes Macomb Township. It involves a free monthly check by paramedics for homebound seniors and those at high risk for hospitalization. Paramedics will run vitals, a 12 lead EKG, check medication and provide information to doctors and family members. He also mentioned a project Medstar has with a university, as well as plans to reengage community quality committees and physician innovation committees to examine things being done to provide care in communities and how to improve safety of response as well. Treasurer Leon Drolet asked about how demographic changes in the township have affected response times. Miller said in general they do increase when community density goes up, but this is not an indication of a risk factor in a community. Medstar has encouraged drivers to slow down, while still meeting contractual response times and good clinical outcomes.
“There is no national data that supports ALS response time having an impact on patients. The data supports that ambulances driving fast cause accidents. So what we are looking at is what can we do with our first response partners, the fire department partners, how can we make sure that there is appropriate first response on scene, that the ambulance arrives in a safe amount of time quickly but not dangerously, quickly, and then transports the patient to the hospital,” Miller said.
Trustee Frank Cusumano asked about the anticipated contract, and if it had changed since it was negotiated and executed five years ago. Miller said the previous contract had a descending subsidy but the anticipated contract is a zero subsidy agreement, and that Medstar tries to do five-year contracts with municipalities when possible.