Randolph County Emergency Medical Services wants to convert from 24-hour to 12-hour shifts for its ambulance crews. Such a move would add an estimated $1,359,470 per year to salaries.
Emergency Services Chief Donovan Davis revealed the figures during the county commissioners' annual retreat on Feb. 19. He said the 24-hour shifts are affecting recruitment and retention of emergency personnel.
"Paramedics are not applying for 24-hour shifts," said Davis. "Many of our experienced paramedics are now working in surrounding counties. We're the only county in the Triad with 24-hour shifts."
He explained that a trainee can come on board for six months, receive training and then leave for a county that has 12-hour shifts. The result is a loss of $27,042 to the county.
"Why do we need (12-hour shifts) now?" Davis asked. "We cannot get paramedics to apply (even with higher pay rates), retention is at an all-time low, employee attitudes are less appealing between midnight and 8 a.m., and morale is greatly affected."
Another serious reason, he said, is "safety, for our employees and patients alike."
To address the problem, Davis said he has eliminated non-emergency transfers from Randolph Health to other hospitals between 11 p.m. and 9:30 a.m. If a patient needs to be transferred between those hours, he said, hospital staff must call the receiving facility to arrange transport. Critical patients continue to be transported at all hours.
Alternatives that have been looked at include moving busier ambulances to a less-busy district, Davis said. But that causes logistical problems because employees park at a certain base when they arrive to work.
EMS has considered taking ambulances out of service for breaks, but the call volume and locations are unpredictable. It can create much longer response times when an ambulance is out of service.
"We've looked at scheduling different shift hours, but that greatly affects the employees' personal life," said Davis.
"We've looked at scheduling employees to work a reverse 24-hour shift, which would mean they come in at 8 p.m. and work until 8 p.m. the following day. This schedule would still not allow them to get adequate rest during shift."
The only practical solution, Davis said, is to move to 12-hour shifts by adding a new shift with a shift supervisor, assistant shift supervisor, two paramedic field training officers and 16 paramedics. That would involve adding an assistant operations officer to help manage 114 full-time and part-time EMS employees; and three additional paramedics to move assistant shift supervisors to quick-response vehicles.
Davis looked at the pros and cons of converting to 12-hour shifts.
* Improves employee physical health, mental well-being and overall morale.
* Helps with recruitment and retention.
* Improves employee reaction time, motor skills, attention, memory and immune system.
* Reduces the risk of accidents.
* Lessens future need for physical base locations that include bedrooms.
* Improves attitudes and patient/family interaction.
* Will cost an additional $1.3 million in salary and benefits per year.
* Employees will work five additional shifts per month.
* There will be more employees to guide, manage and counsel.
Davis said the annual cost of 24-hour shifts is an estimated $3,879,530. Shifting to 12-hour shifts would cost the county a projected $5,239,000, for a difference of $1,359,470.
Finally, Davis said he believes the 12-hour shift will eventually become a federal requirement for EMS workers. "We truly and sincerely want to be the best, most efficient and effective, most admired EMS system in the state."
In addition to the possible 24 new EMS positions, Davis also addressed the need to add four telecommunicators to the 911 Center. He said sheriff dispatch radio transmissions increased by 25 percent from January 2018 to January 2019, from 34,119 to 42,685. Traffic stops increased from 286 to 936, or 227 percent. There was a radio log increase from 30,638 to 41,903, or 36 percent.
Davis said, "The routine radio traffic and transmissions on Channel 1 is causing delays for telecommunicators to dispatch calls for service because the radio is tied up. This is not likely to decrease and is more likely to increase with all the great programs Sheriff (Greg) Seabolt has started and his future programs that he plans to begin."
Four new telecommunicators would cost the county $206,565, Davis said.
The requests for 12-hour shifts and new telecommunicators will be brought to the commissioners during their budget meetings with county department heads in June.