ASHVILLE — First responders are letting the public know that they’ll try to get them to their hospital of choice in the event they’re injured or sick, but due to regional Emergency Patient Transportation Plan, they might not get their first choice.
The EPTP establishes a course of actions for hospitals and public/private emergency medical services so that patients’ medical care needs are met, and healthcare partners share the load in periods of peak activity in the emergency healthcare system.
It is ultimately intended to promote emergency department access to care for patients in Central Ohio when three or more adult Franklin County hospitals have currently declared a divert status to public and private EMS agencies.
Harrison Township Fire Department Chief Chad Noggle explained the situation and why this has come up in recent months.
“The Emergency Patent Transport Plan falls under the Central Ohio Trauma System (COTS), who are a regional third party that works with EMS and hospitals to set some standards,” Noggle said. “It’s been in existence for 22 years.”
Noggle said he wanted to get information out on the system because because they’ve had some instances where people were unhappy with where they were taken.
“It’s something that not only Harrison Township is dealing with, but something that is happening all over Central Ohio,” Noggle said. “Every hospital and all the fire departments that transport into those hospitals are affected.”
Noggle said the transport plan has been activated 26 times between May 4 and Sept. 9.
“In the email I got, it said that was a record,” he said. “The plan is needed now more than ever in the 22-year history.”
Noggle said when the plan is not active, they take people where they want to go without much issue, but if the case is non-critical, then they may be diverted.
“If three or more hospitals go on diversion, which means they’re not accepting stable patients, then the transport plan is activated and a robocall goes out to all the communication centers, including Pickaway County, and they notify us we’re on the emergency transport plan.
What that means for us is if we go to a scene and you say you want to go to Grant Hospital, as an example, we’ll change over to Columbus Fire and we’ll request Grant Hospital,” he said.
“They can say, ‘That’s good, we’ll check them off the list.” Or, in a recent situation, they said we could have Mount Carmel Grove City or OhioHealth Grove City, we can’t give you Grant. Then it becomes up to the patient which hospital they go to.”
Once the plans are enacted, they are then reviewed twice a day, at 8 a.m. and 8 p.m. It’s happened in at least one case where someone couldn’t go early in the day to one hospital, but later in the day, that hospital would open up.
“Classically, over the 26 times it’s been enacted early afternoon, 2 p.m., 3 p.m. 4 p.m.,” he said. “As long as it’s still enacted, it stays enacted. If they call at 4 p.m. and say it’s activated, they’ll review at 8 p.m. by calling the hospitals and then they’ll review it at 8 a.m.
Classically, it’s been 8 a.m. that they come off the plan. It’s also happened that it’s come off at 8 a.m. and gone right back on that afternoon because they hit that threshold to get it off activated and then here we come back with more patients.”
Noggle said there has been one such case where they weren’t able to take a person to their desired hospital and then the plan was lifted later in the day and someone the family knew went to that hospital and it caused some people to be upset.
“The family couldn’t understand it and they were upset, which I understand,” he said. “They didn’t have all the information and it generated a good conversation, but it lead me to believe that we needed to get information out.”
When it comes down to it, Noggle said they’ll take critical patients to the closest available hospital and in those extreme cases, they can still go.
“It becomes stable versus unstable,” he said. “We’ll talk about specialties, trauma and strokes versus general illness. If you are unstable and they are the closest facility, then we just call them and say we’re coming and they can’t refuse an unstable condition. If you’ve had a heart condition and had a recent surgery at Grant Hospital, we’ll take you there and let them know of it.
If we have a level one trauma, we can still go to Grant Hospital. Grant and OSU are the only level-one trauma centers in Columbus.”
Steve Sabine, community liaison officer for Harrison Township Fire Department, said these medical emergencies are a stressful time for not only the patient and families and this is something they don’t need to focus on in the moment.
“The last thing you want them to have to worry about is if they can get to the hospital or not,” he said. “If we can help the community understand this process and protocol, it’ll help alleviate part of the anxiety that comes along with it for not only the staff and the patient, but the patient’s family.”
Noggle said it’s not the ICU beds for severe COVID-19 symptoms that are the problems, it’s the amount of people going to the hospital for any and all illnesses.
“Anyone who has any ailment right now, the first thing that comes into their mind is COVID,” he said. “People will call us when they feel bad and in the last 30 years, we’ve been trending for a long time that EMS is their primary health care. I would say if you’re under 60 years old, that a majority of people don’t have a primary care physician, but if you’re over 60, then you do. That’s how it goes today.
For us, it’s often free healthcare to them because we don’t charge them if they can’t pay and a lot of people we see don’t have insurance, which is why they don’t have a primary care physician. If they get ill, they just call 911 and we come and help them figure out what’s going on, versus calling their doctor. That’s a big trend of why hospitals are clogging up. Physician offices are already full and now the next barrier down is us and we’re starting to clog up the ERs.”
Noggle said they want to provide the best service to the community that they can.
“It’s generated some phone calls to me,” Noggle said. “Scioto Township and us transport to Columbus the most, Circleville does it on occasion, Pickaway Township does it on occasion and Clearcreek does it on occasion, so it’s even starting to effect them. The small occasion they may want to go to Grant and the plan is enacted, they might not be able to.”
Noggle said he doesn’t want the public to be discouraged by the transport plan and that if they need help to still call and get it.
“We will help you figure it out and get you the care you need; unfortunately, it might just not be at the specific hospital of your choice,” he said.