Tri-State Ambulance Delivers  “High Performance” Emergency Medical Services to the Coulee Region

High Performance emergency medical services (EMS) is defined as[1], [2] the simultaneous achievement of:

  • Clinical Sophistication
  • Response Time Reliability
  • Economic Efficiency

Does Tri-State Ambulance meet the definition of a “High Performance” EMS provider?

Tri-State Ambulance meets or exceeds these criteria in the following ways:

Clinical Sophistication

  • Dual paramedic ambulances staffed by paramedics certified by the National Registry of EMTs, and the States of Wisconsin and Minnesota
  • Paramedic:Patient encounter ratio two times better than the national average
  • A cardiac arrest survival rate three times better than the national average
  • An average paramedic patient care experience level of 6,400 patient encounters
  • Paramedics are authorized to administer enhanced ALS procedures such as Rapid Sequence Induction for Airway Management, Nitroglycerine infusions and numerous controlled medications for pain management
  • Externally monitored skills proficiency levels are measured on both a procedural and outcome basis

Response Time Reliability

  • Response times measured and reported using “fractile” reliability standard at a 90% confidence interval
  • Urban and Suburban average response times are twice as fast as the national average
    • 4 minutes, 32 seconds for urban areas
    • 5 minutes, 8 seconds suburban
  • Response time results are published to all stakeholders and on Tri-State’s web site

Economic Efficiency

  • No taxpayer subsidy for any community serviced
  • An average net patient charge of $462.16 per transport

The following grid measures the clinical, operational and fiscal performance achieved by Tri-State Ambulance as compared to nationally published reports and studies, with attribution.

There is little published data comparing EMS systems of similar size serviced by Tri-State Ambulance.  Consequently, many of the clinical, operational and fiscal comparisons have been derived from the Journal of Emergency Medical Services (JEMS) survey of the 200 largest cities in the United States which is conducted and published annually in JEMS. 

[1] Kuehl, et. al.: Pre-Hospital Systems and Medical Oversight, National Association of EMS Physicians, Mosby Pub. 2006

[2] A Guide to Effective System Design; American Ambulance Association; 2005

 How Does Tri-State Ambulance Compare to National Standards?

Performance Criteria Tri-State Performance National Average Notes

 

Cardiac Arrest Survival Rate (to hospital discharge)

 

 

14.4%

 

5.2%[1]

 

Tri-State’s cardiac arrest survival rate is nearly 3 times the national average

 

Cardiac Arrest Cases per Medic/yr

 

 

3.08

 

1.74[2]

 

Tri-State’s cardiac arrest encounter rate per paramedic is nearly twice the national average

 

 

Endotracheal Intubation Success Rate

 

89%

 

75%[3]

 

Tri-State’s intubation success rate is 20% higher than the national average

 

 

Two paramedics on every 9-1-1 ambulance

 

 

100%

 

36%4

 

Most ambulance configurations are 1 EMT and 1 paramedic

 

Closest unit sent to every call

 

100%

 

55%[4]

 

45% of top 200 cities in the U.S. do not send the closest unit to an EMS call

 

 

Average Response Time – Urban

 

 

04:32

 

08:324

 

Tri-State’s response times are nearly twice as fast as the national average

 

 

Average Response Time – Suburban

 

05:08

 

09:374

 

Tri-State’s response times are nearly twice as fast as the national average

 

Emergency Medical Dispatch available?

Yes

84%4

 

16% of the largest 200 cities do not offer EMD

 

 

Rapid Sequence Induction

 

 

Yes

 

24.0%4

 

Only 24% of the largest 200 cities allow medics to perform RSI

 

 

Surgical Cricothyrotomy

 

 

Yes

 

32.3%4

 

Only 32% of the largest 200 cities allow medics to perform Surgical Cricothyrotomy

 

 

Analgesics other than morphine

 

 

Yes

 

45.8%4

 

Only 45.8% of the largest 200 cities allow medics to administer analgesics other than Morphine

 

 

% of Budget from Public Subsidy

 

0%

 

56%4

 

56% of governmental EMS agency’s budget comes from a public subsidy

 

 

Average Net Patient Charge

 

$462.16

 

$626.584

 

 

Tri-State’s net charges are 27% lower than the national average

 

 

Pen-Based electronic patient care reporting in the field

 

Yes

 

8.2%4

 

Less than 10% of the EMS systems in the largest 200 cities in country are using the technology Tri-State is using

 


[1] American Heart Association; Circulation. 2005;112:IV-1 – IV-5

[2] ACAD EMERG MED  May 2006, Vol. 13, No. 5, Suppl. 1

[3] Wang HE, Yealy DM. Out-of-hospital endotracheal intubation where are we? Ann Emerg Med 2006;47:532-41

[4] Jour Emerg Med Svcs Feb 2007, 200 City Survey

 

Technology at TSA

As a forerunner in Emergency Medical Services, Tri-State Ambulance continually strives to offer our patients and other stakeholders the most appropriate and timely medical response .  A large part of providing such a service is the implementation and integration of various components of information technology of which some of these are outlined below....read more...


TSA Medics Participate in Blue Planet Run
The 2007 Blue Planet Run Relay started at the United Nations building in New York on June 1st, 2007 and continued on schedule for 95 days ending back in New York on Sept 4th.  Medical support for this round-the-world event was primarily provided by TSA paramedics Kevin Kuchar, Mark Tweet, and Rick Barton.



Learn more about the Blue Planet Run and the Tri-State Ambulance connection here.