District rolls outs option for “minor” 911 calls

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Deputy Fire Chief Michael Donlon at ANC 5B discusses the Right Care, Right Now initiative which kicks off April 19, and will connect some low-acuity callers to 911 with a primary care provider. (Photo courtesy of D.C. FEMS)

Officials of the District’s Fire and EMS Department (FEMS) have been fanning out across the city in recent weeks to speak to community groups about a change to the 911 emergency call line.

At a Feb. 26 meeting of Advisory Neighborhood Commission 3/4G (Chevy Chase), Dr. Robert Holman, the medical director of FEMS, said the District has the highest per capita EMS use in the country, owing to calls to 911 for minor illnesses or injuries.

“People with headaches are taken in an ambulance to the emergency room,” Holman said. “That’s clearly the wrong thing to do. Headaches, a stubbed toe, toothaches, mosquito bites – you’d be surprised at the level of low-acuity calls to 911.”

Holman defined low-acuity as something that “is not or will not evolve into a limb-threatening or life-threatening illness.”

FEMS Chief Communications Officer Doug Buchanan said 911 is sometimes thought of as “you call, we haul” by residents.

“People call after eating chili at Wendy’s [asking for an ambulance],” Buchanan said. “This takes our resources for two hours while someone in cardiac arrest is waiting. People have used 911 as their primary care provider in some cases for generations.”

Beginning April 19, callers to 911 will have another option when suffering from such ailments as sore throats, the common cold or toothaches. Right Care Right Now is the name of the new program and was described as a nurse triage line by Buchanan at a March 7 meeting of ANC 1C (Adams Morgan).

“If a caller to 911 has symptoms that don’t appear to be life-threatening, the caller will be routed to [the Right Care Right Now line],” Buchanan said.  “This line will be staffed by a registered nurse.”

Deputy Fire Chief John Sollers has also been attending ANC meetings to help roll out the program. On March 15, he spoke to ANC 3E (Tenleytown, Friendship Heights).

“The 911 call-taker will walk through what the symptoms are with the caller. If they are non-life-threatening, the call will be transferred to [the Right Care Right Now line.]”

The program is intended to free up not only fire and emergency services, but also beds in hospital emergency rooms.

Sollers said the new system will help callers who have an illness that does not require hospitalization, but does need medical treatment. It will do so by arranging for callers to visit one of 18 clinics or medical care facilities.

“We will make a primary care introduction,” Buchanan said. “All 18 clinics are licensed and staffed with reputable doctors. This program puts patients on the path to healthcare. We’re hoping this process creates a link to a primary care physician. A hospital isn’t a primary care provider.”

Buchanan said callers enrolled in Medicaid or D.C. Healthcare Alliance will be provided with free transportation to and from a clinic, probably by Lyft drivers.

A flyer prepared by FEMS provided more information about Right Care Right Now.

“The Right Care Right Now line will be staffed from 7 a.m. to 11 p.m., seven days a week. The medical providers will be able to prescribe medications during a patient visit.

“Each clinic has walk-in appointments that will be available to Right Care, Right Now line patients. The nurse will notify the clinic that you are on the way, provide your estimated time of arrival and the reason you are seeking medical care. Upon arrival at the healthcare site, patients will be seen as soon as possible.”

“As soon as possible” will probably be quicker than if an ambulance takes 911 callers to an emergency room.

“People think if they call 911 they will get treated more quickly,” Sollers said. “That’s not true, if more serious cases arrive [in the emergency room].”

Officials say the District’s 911 line receives between 550 and 600 calls a day. Four hundred require an EMS response. Of those, 200 are low-acuity.

Buchanan said some of the low-acuity callers are young parents frightened when their children become ill.

“Young mothers call in the middle of the night who have sick kids with a fever. We can only put them in an ambulance and have them sit for a long time once they get to a hospital. It’s not good for families. And it ties up the emergency system for a long time.”

During the roll-out of Right Care Right Now, Buchanan said only 65 patients a day out of the 400 EMS daily 911 calls will be referred to the new line. The program will be evaluated and fine-tuned over a six-month period.

The flyer about Right Care Right Now says residents should not call 911 to schedule follow-up visits at the medical clinics that are part of the program.

“You should schedule all non-life-threatening medical appointments directly with the medical clinic in which you were seen, and where you are now a registered patient,” the flyer states.

Programs similar to Right Care Right Now already exist in Reno, Dallas and other cities.

Ted Guthrie, a member of the Adams Morgan ANC, took advantage of the presence of fire department officials at his commission’s March 7 meeting to lodge a complaint about noise.

“The sirens on D.C. fire trucks are louder than anyplace else in the world,” Guthrie said. “It seems really excessive. Coming through residential neighborhoods at top volume is not helpful in the long run.”

Sollers said the department is not buying special sirens, but that the fire apparatus in use has mechanical sirens that are louder than electrical sirens.

“The fire chief has directed us to use sirens on all emergency calls,” Sollers said.