NORTH ADAMS -- More than two months after Berkshire Medical Center opened its satellite emergency facility in North County, the three ambulance companies that serve the area continue to feel the strain caused by the closing of North Adams Regional Hospital.
The situation has improved somewhat with the opening of the ER in May, according to Shawn Godfrey, general manager of Village Ambulance in Williamstown. But with limited support services in North Adams, many patients still need to be sent to Pittsfield.
"We're still transporting the majority of our patients to the BMC main campus," Godfrey said. "That still ties up an ambulance for a longer period of time, and we're still at the same staffing levels we had after the [hospital] closing."
After NARH closed with three days' notice on March 28, all emergency medical calls were transported to BMC in Pittsfield. The longer trip meant that each ambulance call would take longer and cost the agency more money. Because of the longer trips, the ambulance services had to bring more vehicles and employees into service to handle the additional load, further taxing their financial sustainability.
Since BMC opened the satellite emergency facility May 19, hospital and ambulance service officials have been working with a "point of entry" protocol, which defines which types of cases can be handled at the satellite facility and which ones need to go directly to BMC in Pittsfield.
According to the guidelines, any high trauma cases, stroke patients, pregnancy complications, significant blood loss requiring emergency transfusion, and patients requiring critical care services should be taken directly to BMC in Pittsfield.
"Outlining every clinical scenario and point of entry is not possible," the guidelines note. "Patients with breathing, circulation or obstetrical emergencies that cannot be supported in the field to enable additional transport time will enter at North Adams Satellite Emergency Facility for emergency stabilization."
Transporting so many patients directly to Pittsfield means more fuel, more wear and tear on the vehicles and the medical equipment, and the need for more employees.
"We are still transporting a lot of our patients down to Pittsfield," said John Meaney, general manager of North Adams Ambulance Service. "So there is still a turnaround-time issue there."
In addition, the three North County ambulance services in Adams, North Adams and Williamstown used to garner a significant portion of their annual revenue from inter-hospital transfers from NARH to other hospitals in Albany, N.Y., Springfield or Boston.
But now that all inter-hospital transfers originate at BMC in Pittsfield, the Pittsfield-based ambulance services have picked up most of that business.
Godfrey said the three North Berkshire ambulance services "about two months ago" submitted to BMC a proposal asking that they be allowed to transport patients that originated in North County, provided they do not require immediate transfer. They have yet to hear a response.
Mike Leary, spokesman for BMC, said the company does not enter into agreements with any ambulance services.
"BMC does not have inter-facility transfer agreements with any ambulance provider in the county," Leary said. "For patient discharges to home, we make all efforts to use the same ambulance company that brought the patient here to take them home. For patients transferred to another hospital, like Albany or Baystate, the health status of the patient can often dictate what service is used as many health issues would require the most rapid access to transport."
He added that BMC officials value their working relationship with all of Berkshire County's ambulance services.
Some patients who are transported to the satellite emergency facility are later transferred to BMC in Pittsfield, and that is a "billable" trip, which helps, Meaney said.
Meaney said North Adams Ambulance transports three to five patients directly to BMC daily, with a total of 12 to 15 calls per day. The service had to increase their ambulance count from four to five when the hospital closed to facilitate the additional transfer time, and increase staffing as well. Those increases remain due to the turnaround time.
Leary noted that in June, according to BMC records, the satellite emergency facility had 1,700 patient visits. Of those, 74 required ambulance transport to BMC.
"The vast majority of patients seen in the satellite emergency facility experienced relatively minor illness or injury," he said. "There were just under 200 direct transports to BMC from North Berkshire during that same period."
To reach Scott Stafford:
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