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Sanford, Florida

Keywords: Ambulance Service, Failed Contract

Ambulance Service

Like many places around the country, emergency medical service in Seminole County, Florida, used to be provided by two teams of emergency technicians. The first team, usually employed by the municipal fire department, was responsible for the initial emergency response. Their job was to provide paramedic services to those in need as quickly as possible. The second team, a privately-provided ambulance service, was responsible for transporting patients to area hospitals after the first team had stabilized the patient.

The rationale behind the two team approach was that patients could be served more efficiently since paramedics could spend more of their time on emergency calls and less time transporting patients. Rather than improve quality of care, however, having two teams provide the service resulted in duplication of services and slower response times. Often the ambulance service was slow to arrive on the scene, which meant that valuable time was wasted for both the paramedics and the patient. When the ambulance crews did arrive, they were then required to perform the same treatments and ask the patients the same questions that the paramedic team had done only minutes before.

About three years ago, the City of Sanford, along with a majority of municipalities in Seminole County, chose to eliminate the second team altogether and have only one team responsible for both initial treatment and transportation of the patient. This way one team would be responsible for the care of the patient from the time of arrival at the scene of the call to the time the patient entered the hospital emergency room.

In order to keep response times low, the city had to hire eight additional paramedics and purchase some new equipment. These additional expenses are paid for by revenues generated from ambulance service fees. The new system costs about the same as the previous two-team system (if not slightly more), but quality of care for patients has improved significantly.

The city did not have a long-term contract with the private ambulance provider, which meant that there were no major barriers to bringing the service in-house. It is also worth noting that the ambulance service was never publicly provided until the program was redesigned three years ago.

Case based on interview with Anthony Vanderworp, Chief Administrative Officer, July 7, 1999.