A year after Multnomah County and American Medical Response Northwest, Inc. reached a settlement to improve ambulance response times, an update last Tuesday shows mixed results. Response times are moving closer to the 90% target, and "Level Zero" events, where no ambulances are immediately available, have decreased. The number of ambulances on the road rose from 46 to 67 per day in July. However, Teamsters Local 223 says EMTs and paramedics are under increased pressure, and some aspects of patient care are being affected, according to the Multnomah County.
Hillary Davis, an AMR paramedic, told Multnomah County, "Over the past 18 months, the focus of my work has shifted away from providing high-quality, compassionate care — our true mission — and toward meeting seemingly arbitrary metrics and navigating layers of oversight that often work against efficiency and safety." EMT training has been shortened to eight days, and paramedics are taking leadership roles earlier than usual. Although American Medical Response Northwest, Inc. reports more full-time hires, the total number of paramedics has decreased. Staff turnover is 22–24%, and public complaints and vehicle incidents have increased. County data and EMS Director Dr. Matt Neth show a decline in patient care levels.
Performance targets for stroke and trauma patient care are not consistently being met. AMR Regional Director Rob McDonald told the Board, "While we've made incredible improvements, we've not met the contract requirements and to be completely transparent with you all, this has been harder than we anticipated." The County plans to increase training and mentorship, hire more paramedics, and improve oversight. Commissioners noted that focusing on faster response times may have had drawbacks, called for input from four cities in the Ambulance Service Plan review, and recognized the effort to improve both response times and care quality. Chair Jessica Vega Pederson said addressing issues will require a collective effort, as reported by the Multnomah County.
