This letter is in response to the article “Durham County Sidelines Duke EMS. Will patients suffer?” (Dec. 5) by correspondent Matt Riley. This letter is to provide accurate and complete information on the reasons Duke EMS was removed from Durham County EMS System Plan in August 2017. First, I need to clarify the City of Durham Fire Department is dispatched to Duke’s campus as first responders, not Durham County Fire Department.
As stated in my July 2017 letter to Mr. Jeffery Ord, current Duke EMS director, there are three primary reasons for the removal decision. Dr. Sue Schreffler, Durham County’s medical director appointed by Duke University Medical Center, supported and approved the decision to remove Duke EMS for the system for the following reasons:
▪ Inability to respond to calls 24/7/365
▪ Challenges in maintaining operational and educational requirements due to leadership and membership changes, and
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▪ Failure to meet county system’s continuing-education requirements.
The expectation of the Durham County EMS System is to provide a consistent level of response throughout the system. Duke EMS is held to the same system expectations as all other first responders in the system.
Being part of the system requires full-time availability throughout the year which has proven challenging for Duke EMS. Due to these challenges, the Durham City Fire Department also responds and will continue to respond with Durham County EMS on Duke’s campus.
Mr. Kevin Labagnara, the former Duke EMS director, Dr. Schreffler and I met in April 2016 to notify Duke EMS of the system’s requirements and to discuss options for becoming compliant.
After this meeting, Duke EMS requested they be given until the beginning of the 2016-17 school year to develop a plan to meet the requirements. Follow-up information to address the compliance issues were not provided in the fall of 2016; therefore, I contacted Mr. Labagnara in January 2017 to schedule a meeting to discuss the future of Duke EMS. The January meeting was postponed until Duke EMS could meet with its leadership to discuss. To date, the compliance issues have not been resolved. Durham County EMS has tried to work with Duke EMS to develop a plan to address the concerns since January 2017 with minimal response from Duke EMS.
All County EMS System agencies are required to ensure providers are meeting the EMS continuing-education requirements which includes keeping accurate training reports and maintaining an agency roster. In November 2016, Ms. Jackie Holmes, assistant chief with Durham County EMS met with Duke EMS to discuss training. The training records that had previously been requested by Dr. Schreffler were not provided during this meeting and we were advised that Duke EMS had not held required EMS continuing-education sessions in the past four years. The information provided to County EMS and lack of documentation supports the concerns that educational sessions were not being completed as required under the System Plan.
Finally, the notion that County EMS dislikes Duke EMS or was looking for a reason to take them out of the countywide system is not accurate. Durham County EMS has provided part-time jobs and ride-a-long opportunities for many of the students over the years. The opportunity to work in the field alongside an experienced EMS professional provides valuable experiences, increases the students’ knowledge of prehospital medicine, and allows them to develop their clinical skills. Durham County EMS tried to work with Duke EMS to bring them into compliance with the system’s requirements for over a year. The decision to remove Duke EMS from the System was a patient safety decision.
The Durham County EMS System is committed to providing excellent emergency medical and related care in a safe, compassionate, and timely manner to all we serve. I welcome the opportunity to talk with members of the media about Durham County EMS. Thank you for the opportunity to respond and share additional details on this difficult decision.
Kevin Underhill is Durham County’s interim EMS director.