Across the USA, the 911 utilization rate has been increasing. Unfortunately, resources haven\u2019t grown at the rate needed to meet the demand. There was a time when people thought 911 was rarely called, an ambulance tires remained mostly unworn. Those days are long gone.\u00a0<\/p>\n\n\n\n
The rise in 911 calls (combined with staffing shortages) has left EMS, fire, and police scrambling for answers. This article highlights three reasons your 911 utilization rate is high and provides steps to fix it. In addition, we\u2019ll discuss super-utilizers, chronic diseases, and underserved populations.<\/p>\n\n\n\n
Why are 911 utilization rates rising? How do we answer the increase in calls? Let\u2019s talk about the issue and discuss solutions.<\/p>\n\n\n\n
911 utilization rates have been rising for a while. There may be specific reasons your 911 rates have risen, or it may be part of a more significant trend of calling 911 for non-emergencies. To fix the problem, we need to uncover the reasons for the increase in 911 calls. <\/p>\n\n\n\n
First, look at the people calling 911. Are they from a similar area? Is there a single patient that’s doing most of the calling? Is there a change in the healthcare infrastructure or laws creating this issue? <\/p>\n\n\n\n
Before we get into some of the most common reasons for 911 calls, take a moment to pinpoint why 911 calls are rising in your area. Healthcare and public safety has unique needs that require a nuanced approach. While there are undoubtedly universal pain points in EMS and healthcare, going forward without looking at your program would be unwise. <\/p>\n\n\n\n
Here are a few things to do: <\/p>\n\n\n\n
These questions should offer a starting point to uncover a rise in call volume. Once you know the cause, you can start working on solutions. <\/p>\n\n\n\n
911 calls rise steadily in some areas and rapidly in others. It comes down to an aging population, with many dealing with more chronic conditions. However, it might also result from increased drug use or a rise in mental health emergencies.<\/p>\n\n\n\n
Sometimes, the local hospital or physicians have become overloaded, or there has been another significant change to public health. These changes can disrupt any semblance of equilibrium healthcare, driving more people to call 911. In these cases, some patients who might have driven nearby in the past now want an ambulance to transport them to an out-of-county clinic. <\/p>\n\n\n\n
It could be all these reasons, but let’s talk about three of the most common: <\/p>\n\n\n\n
Let’s look at each of these in more depth, then talk about ways you might combat the issues.<\/p>\n\n\n\n
As any EMS manager knows, a small portion of the population often makes up the majority of local 911 calls. There have been instances where a single patient has called 911 hundreds of times over a relatively short period. <\/p>\n\n\n\n
Super-utilizers form a relatively complex health picture. Some might call the ambulance so much that it’s impossible to blame the issue solely on a lack of primary care. However, there is likely a deficiency in their needs. These patients, though they often call for minor reasons, strain the 911 systems – particularly those areas without the resources for a tiered response. <\/p>\n\n\n\n
Sometimes, there might be little you can do to curb this behavior. For example, the patient wants to continue calling 911 and being transported to the ER, and they don’t want anything else. However, often, if the patient can go to an alternative destination that provides a better experience, they will choose the alternative. <\/p>\n\n\n\n
A good alternative is a coordinated response from a mobile integrated healthcare model. How does this work? A healthcare team will go to these patients and attempt to uncover the root of the frequent calls. After that, they make a plan to address the patient\u2019s health needs \u2013 this could mean regular visits, transport to alternative destinations, or reconnecting the patient with primary care.<\/p>\n\n\n\n
You can read our article covering models to reduce 911 calls if you want more information.<\/p>\n\n\n\n
Some chronic diseases don’t seem to let up. And, when patients live alone or don’t have a healthy lifestyle, they are likely to call 911 more. Many EMS organizations choose to throw up their hands and “deal with it,” however, others have taken a more innovative, proactive approach – many with excellent results. <\/p>\n\n\n\n
What have they done? Many have instituted mobile integrated healthcare. These programs seek to contact the patient with their physician in the out-of-hospital environment. Many times, these interactions are facilitated with a video call. A community paramedic assists with the assessment and acts as a go-between for the patient and the physician. <\/p>\n\n\n\n
These interactions are almost universally positive, making the patient feel comfortable and safe in their own home and reducing their need to call 911 frequently. Also, with a provider actively checking on them (often weekly or monthly), it’s easier to manage their medication schedule and ensure they are following any recent hospital discharge instructions. <\/p>\n\n\n\n
Overall, this method leads to healthier, happier patients who are less likely to call 911 for all their needs. If you’re curious to see some numbers, you can look at this report from the Colorado Springs cares program<\/a>. <\/p>\n\n\n\n Unfortunately, groups of patients are often swept under the rug. Mobile integrated healthcare and community paramedicine seek to provide care to all patients \u2013 no matter their situation. Among these groups are those with substance abuse struggles, mental health issues, and homelessness.<\/p>\n\n\n\n These patients often have little social protection, and when their health begins to fail, they rely on EMS, fire, and PD \u2013 increasing the 911 utilization rate. However, instead of a constant police or ambulance response, it’s much more efficient to have a mobile health team that understands the problem, as they will be in the best situation to provide a long-term fix, not just a temporary band-aid.<\/p>\n\n\n\n Many areas have specific task forces that address drug use, including post overdose response.<\/a> These teams specifically reach out to overdose patients, offering them help if they want it. To reduce 911 calls, there must be dedicated programs that can deliver teams of professionals to address the needs of these populations. <\/p>\n\n\n\n Here’s a brief overview of these programs: <\/p>\n\n\n\n Read our article on MIH-CPs impact on the homeless population<\/a> \u2013 this guide will give you more specifics.<\/p>\n\n\n\n The increase in 911 calls in your area is likely a compound of many issues. After you uncover the root of the uptick in calls, you’ll be in the best position to address it. <\/p>\n\n\n\n It could be chronic diseases, overdoses, or mental health struggles. All these issues can be efficiently addressed with community paramedicine and mobile integrated healthcare. For more information on initiating these systems, see our article on starting community paramedic programs. <\/a><\/p>\n\n\n\nUnderserved Populations: Homeless, Substance Abuse, Mental Health<\/h2>\n\n\n\n
\n
Final Words\u00a0on Reducing 911 Utilization Rate<\/h2>\n\n\n\n