To get to patients faster, ambulances roam Camden

Medics stand outside the firehouse on 909 N. 27th Street in Camden, NJ, Friday morning, Jan. 27. Pictured (L-R) Gary Miller, 54, Operations Manager Steve Hare, 54, Matthew Scalia, 26, Zachary Ewan, 38. Cooper EMS services began stationing ambulances at several locations in Camden, last year to expedite services. BRIANNA SPAUSE / Staff Photographer

After Cooper University Hospital began providing paramedic and ambulance services in Camden a year ago, some residents didn’t need to call 911 to notice a difference. They said they saw ambulances roaming the streets and sometimes stationed on corners, and paramedics chatting with neighborhood residents.

“You see them driving all the time,” said longtime activist and East Camden resident Angel Cordero. “Ambulances are like cops now. At first I thought, is God trying to tell me something?”

Cooper Hospital officials announced last week that they had improved ambulance-response times since Gov. Christie signed a law allowing Cooper University Health Care to begin providing paramedic and ambulance services. Though the action led to a legal battle with Marlton-based Virtua Health System, which deemed the law unconstitutional, Cooper officials say their results — faster response times and a reduced reliance on mutual aid from other communities — speak for themselves.

Cooper has not provided a detailed list of calls and response times. Officials said Tuesday that they improved times by adding an advanced-life-support unit and ambulance.

Another factor in the results, however, is that ambulances are now closer to many of the city’s residents. Cooper’s advanced-life-support units regularly roam the city, said Steve Hare, operations manager for Cooper EMS. Additionally, a basic-life-support unit was assigned to East Camden after officials determined that getting there from Cooper took too long.

“This is about being responsive to people’s needs, but members of the community also need to know that we’re here,” said Rick Rohrbach, EMS director of Air and Ground Services at Cooper. “We want the city to know that we’ve got them covered.”

Two EMTs interviewed for this story confirmed that Cooper has encouraged crews to take a more proactive approach to covering the city, but both asked not to be named because they were not authorized to speak for the program.

“It depends on the crew, but I know a lot of the families in the city, and I really thrive on being able to go out and make contact with them,” one man said.

The approach is similar to strategies that have been employed in recent years by the Camden County Police Department. Chief Scott Thomson, who has led the agency through the dissolution of the city police department and the creation of the county force in 2013, put foot patrols in place, and has said it is crucial that officers engage with city residents in nonemergency situations.

Known in the medical world as “dynamic deployment” or “system-status management,” the ambulance system involves using call data to determine when ambulances should be deployed. In Camden, for instance, most medical calls start coming in around 8 a.m. and taper off by the evening, Hare said.

“We invested a lot of time in analyzing data, knowing when the city was busy so that we could direct resources according to that metric,” he said.

Dynamic deployment is used in a number cities around the nation, perhaps most notably in Richmond, Va., which implemented the system in 1991 and boasts on the department’s website of a response time of less than nine minutes in 90 percent of calls.

Cooper officials say they responded to 90 percent of advanced-life-support calls within eight minutes in 2016, up from 70 percent of calls responded to within eight minutes under Virtua in 2015.

While some EMS departments have a goal of getting paramedics on the scene within eight or nine minutes in at least 90 percent of cases, emergency-medicine experts say there isn’t one standard. The National Fire Protection Association recommends that advanced-life-support services arrive at an incident within eight minutes of dispatch, according to Cooper.

Before Cooper’s takeover of EMS last January, Virtua had provided paramedic services to Camden for more than 30 years.

Virtua sued over the law that allowed Cooper to begin providing paramedic and ambulance services in Camden last January. The measure authorized Cooper to provide the services because of its status as a Level 1 trauma center within the city limits.

While a lower court agreed with Virtua that the law was unconstitutional, an appellate panel upheld the law in August, writing that “it is conceivable that a Level 1 trauma-care center, with its greater resources, university affiliation, and clinical advantages, could provide these services in a more capable and cost-efficient manner.”

Cooper has also argued that patients will be better-served if Cooper oversees the continuum of care, including treatment at the scene, in the hospital, and even after discharge.

Critics of the dynamic-deployment model have argued that it can be stressful for EMTs and costly for providers due to wear and tear on vehicles.

And Cooper officials acknowledged that Camden’s relatively concentrated geography — about nine square miles of city streets —perhaps makes the approach more manageable than many sprawling suburban areas.

But Rohrbach said the model’s reliance on data makes it scalable to any municipality.

“We feel like we’ve hit on the correct way to do it here, and what resources it takes,” he said. “But you have to tailor it to your needs.”