Working out the kinks of a part-time ER
LAKE PLACID – Local emergency services have been dealing with complications caused by Adirondack Medical Center switching its Lake Placid emergency room to part time.
Two weeks after the switch was made, Larry Brockway, president of the Lake Placid Volunteer Ambulance Service, said they were working out the kinks with AMC Lake Placid.
“The first night, it was a little rough,” Brockway said. “It’s just an odd bottle of circumstances, how it happened. People showed up at 11 o’ clock, and it put us in a little bind. The rest of the week has been all right.”
The hospital is open 15 hours a day, from 8 a.m. to 11 p.m. seven days a week.
Brockway said the first night of the part-time ER switch, on June 16, the ambulance service received two transport calls from AMC Lake Placid after 11 p.m. The first call was for basic life support, and the second was for advanced life support. A transport call from the Lake Placid hospital to the larger Saranac Lake AMC hospital takes roughly one hour to complete, including paperwork and other duties an emergency medical technician must perform, Brockway said.
Brockway has been in daily conversation with AMC’s ER director since then, working out a new way to handle transport calls. The hospital will give the ambulance service advance notice of any night transports, and the calls will be scheduled for around 9 to 9:30 p.m.
“The patient with the higher level of care will go first,” Brockway said.
24 hours for big events
In Lake Placid, the biggest events draw in thousands of people, which can increase call volumes for the ambulance service. AMC Lake Placid is planning to be open 24 hours daily during some big events in Lake Placid, like the recent Fourth of July weekend, but they have not been open around the clock during the horse shows, which are starting their third week.
The Lake Placid Volunteer Ambulance Service is required by contract to post an ambulance at the North Elba Show Grounds during the horse show competitions. That ambulance usually has three EMTs, one advanced life support EMT and two others on standby. The ambulance service has three full-time EMTs, two part-time EMTs and 11 paid responders who fill in on occasion. There are also 14 volunteer responders.
AMC officials are looking at upcoming events in Lake Placid and whether or not to keep the ER open 24 hours at those times.
Town of Wilmington Supervisor Randy Preston, who is also the Wilmington Fire Department’s assistant fire chief, said Wilmington EMTs were not told that AMC-Lake Placid would be open around the clock on Fourth of July weekend. That statement turned out to be incorrect.
“They were open this weekend, but they failed to tell any of the squads they were open,” Preston said. “Another member of the community called and told us they were open.”
A member of the Lake Placid ambulance service, however, said Tuesday morning that they were aware the hospital was open, and AMC spokesman Joe Riccio said Wilmington’s ambulance squad had been notified, too.
Preston corrected himself later, saying AMC-Lake Placid’s notification to Wilmington’s ambulance squad was in a community “transition task force” meeting minutes and that he had been unaware of that. He said in the future, for something as important as that, he would expect a phone call directly to the fire chief or assistant chief of rescue. The ER’s overnight opening was also discussed at the task force’s meeting, which Preston said he did not attend.
Preston said his ambulance service transports Wilmington patients to the hospital of their choosing, but he added that others will be taken to either Elizabethtown Community Hospital or Champlain Valley Physicians Hospital in Plattsburgh.
“That certainly increases our turnaround time,” Preston said.
The average transport used to go to Lake Placid, with the exception of cardiac cases, Preston said. The transport time took about an hour, but now that figure has doubled.
Riccio said an offer was extended to all rescue squads in the area to attend the transition task force meetings.
“We’ve been meeting on a regular basis,” Riccio said. “If there are large events, we will be open 24 hours. For example, Ironman weekend we will be open 24 hours.” During the annual triathlon, AMC has medical tents set up to provide care for the athletes, Riccio added.
Preston said he doesn’t attend the task force meetings “because it was a lot of hot air going on there.”
Riccio said AMC will continue to work with local ambulance squads during this transition period.
“Over the years we’ve had a strong relationship with all the local EMS crews,” Riccio said. “We will continue to meet with them throughout the process.”
Village and town to fund new EMT position
Inside Lake Placid’s 2014-15 village budget there is $28,100 in new funding for the ambulance service, Lake Placid Mayor Craig Randall said.
“There primary concern of many is they don’t have backup drivers and the resources to pay them,” Randall said.
The town of North Elba is not working on its budget until the fall, but the town board members are discussing doing the same thing, giving around $20,000, according to town Councilman Bob Miller.
“Our goal with that money now is to fill in the empty slot for people at night,” Brockway said.
Randall said this is the best thing the municipalities can do to help alleviate the situation in the short term.
“That is the least we can do,” Randall said. “Obviously, the leadership of the town and village want to be in the position where we can offer assistance that’s going to be useful.”
The contract agreement will be written between the town, village and ambulance service.