An Interview with Tri-Med Ambulance

Tri-Med Ambulance serves the Puget Sound with highly trained emergency medical services personnel, specialized vehicles and sophisticated medical technology, providing quality basic life support, bariatric, critical care and wheelchair transportation. Its mission is to deliver dependable medical transportation services with safety and efficiency to residents of King County and the greater Seattle area. They were founded in 1995 to provide shorter response times and more compassionate care to ensure the well-being of the community.

Tri-Med Ambulance has always had a strong safety culture in place, so it is of no surprise that they jumped into action putting together procedures and policies to ensure they could continue to deliver outstanding service and do what they do best. To learn more about how COVID-19 affected their business, National Interstate’s Peter Walker sat down with Operations Manager, Matt Gau, to get the inside scoop on what it was like to work for an ambulance operation during a very uncertain time.

DESCRIBE THE EARLY DAYS OF COVID-19 AND HOW YOUR TEAM WAS IMPACTED.

In King County, where Tri-Med is based, the first death in the United States was reported on Saturday, February 29th, 2020. The planned topic of our morning meetings with the crew members was the transition to new software, but quickly changed to an all hands-on deck for our COVID-19 approach.

COVID-19 had been on our radar before this event. Still, as an agency, we were not prepared for the logistical and service delivery changes that needed to be made, and they needed to be made immediately. That morning, our team assembled and reached out to our public agency partners to formulate a consistent plan for keeping our crew members and the public safe. The plan included data sharing, PPE inventory counts, and training ideas and suggestions. By the evening of February 29th, mere hours after the first death was reported, our organization and region had a plan we could begin to work with, all the while knowing our plan would continue to evolve as new information became available.

This model of change continued to be aggressive until mid-May, with often daily changes communicated to our first responders. The phone calls with public health agencies were consistent. The operational changes coming from the hospitals as far as how they wanted patients delivered changed by the shift, and all the while, our first responders handled their response with bravery and professionalism.

DO YOU FEEL AS THOUGH YOU WERE PREPARED AS AN OPERATION TO HANDLE THE PANDEMIC?

We were prepared in the sense that we had a plan for transporting infectious disease, but we weren’t prepared for the volume. What would have typically been considered an adequate PPE supply became a pittance of stock in our new reality. From a crew safety and decontamination standpoint, the procedures were well in place before COVID-19, but we quickly ran into short supply on the things to protect our crews from exposure, which is what we needed most.

HOW DOES THE CURRENT PANDEMIC COMPARE TO WHAT YOU PREVIOUSLY EXPERIENCED WITH SARS, H1N1 OR EBOLA?

I don’t think they are even in the same arena as far as comparison goes. With the previous events, we were always mindful of protecting our crews and the public from exposure and have had the procedures in place to do just that; but with COVID-19, the sheer volume of patients was quite the contrast. The way that this current pandemic has changed our daily lives is profound, and I suspect things may never completely go back to the way they were before, whereas, with the previous diseases, our lives didn’t change nearly as much.

WHAT CHANGES HAVE YOU MADE IN YOUR OPERATION IN TERMS OF SAFETY, TRAINING, POLICIES, PROCEDURES, ETC., AS A RESULT?

All first responders and any other staff that have patient contact are now required to wear a protective N-95 or P-100 face mask for all patient encounters, and the cleaning of equipment and facilities has become much more rigorous. We have assigned health and safety officers to confirm that the cleaning is taking place when it should be, and all staff are temperature and symptom checked before entering any building.

WHAT ADVICE WOULD YOU GIVE TO OTHER COMPANIES REGARDING COVID-19?

Please stay the course, encourage all personnel to continue protecting themselves and others around them by reminding them that COVID-19 is still here and here to stay. Frequent communication with all personnel is critical as we continue to navigate a fluid situation.

HAVE YOU OBSERVED ANY CHANGES IN HOW YOU TRANSPORT PATIENTS AS A RESULT OF COVID-19?

For every patient contact we have, we now require all personnel to wear a higher level of protective equipment than they did prior to the COVID-19 pandemic, including a protective N-95 or P-100 face mask. This level of protection is required for every patient contact, whether or not COVID-19 is suspected.

Before the current pandemic, gloves and eye protection were required for each patient contact, but with the addition of the protective face mask, we are able to bring the safety of our first responders to a higher level. COVID-19 is often not suspected by way of known clinical indicators at the time of interaction with our first responders, so requiring the protective face mask as a precaution brings an added layer of confidence for all involved.

WHAT LONG-TERM EFFECTS DO YOU THINK COVID-19 HAS HAD ON YOUR OPERATION SPECIFICALLY?

I believe the way we deliver care to our patients will never be the same. Many years ago, it was not common practice for first responders to wear gloves as a standard for every patient contact, but this practice changed to where it is today because of data and lessons learned. I think the possibility of masking for every patient encounter from now on after this pandemic is very likely.

WHAT LONG-TERM EFFECTS DO YOU THINK COVID 19 HAS ON THE AMBULANCE INDUSTRY OVERALL?

The rapid introduction of mobile integrated health and telemedicine will change how we deliver service, most likely leading to a better overall experience for patients and healthcare providers. This will lead to more patient-centered and focused care, which will provide better outcomes.

WHAT ADDITIONAL SUPPORT OR GUIDANCE COULD AN INSURER LIKE NATIONAL INTERSTATE PROVIDE TO YOU DURING SUCH AN EVENT?

The MEDIC captive that we are in with National Interstate allows us to network with other providers in our industry, which has been incredibly valuable throughout this pandemic. Hearing stories about lessons learned from others enables us to be more proactive with our responses.

Industry lessons are always valuable as we have found that each of them, in one way or another, applies to our organization. Taking these lessons and data provided by National Interstate keeps us on the right track for success.