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EMS report: offload times drop, nurse‑navigator pilot limited so far; RFP work constrained by state timelines
Summary
County EMS reported improved ambulance patient offload times and described a nurse navigator pilot with limited early use; staff outlined an EMS system assessment and a planned request for proposals but warned state approvals and missing statewide regulations could slow procurement.
Santa Clara County's Emergency Medical Services division updated the Health and Hospital Committee on several fronts: measured reductions in ambulance patient offload delays, early usage of a nurse navigator pilot, a PCR‑to‑EPIC data integration timeline, and progress toward an EMS system assessment and billing services request for proposals (RFP).
"A lot of compounding factors play a role but certainly Santa Clara Valley Healthcare's engagement and Regional Medical Center have played a significant role in supporting that reduction," EMS Director Nick Clay told the committee, describing declines in patient offload delays and improved throughput.
Key operational data: County and hospital staff cited sharp reductions in ambulance offload delays: committee materials noted Valley Medical Center's 90th‑percentile offload time in May was about 50 minutes lower than in January, and O'Connor Hospital's 90th‑percentile time was about 70 minutes lower over the same span. Presenters also said interfacility transfers rose roughly 50% as the system rebalanced capacity.
Nurse navigator pilot: The county's pilot — which allows select 911 callers or field providers to be offered a telephonic nurse navigator alternative to ambulance transport — has had about 100 uses from Nov. 13 through late May, staff said. "It's not necessarily that people are saying no; it's that we need to offer it to more patients," said a program lead. EMS staff plan to expand criteria and add a field‑referral protocol that paramedics can use to initiate navigation from the scene.
Data and procurement timelines: Staff described a PCR‑to‑EPIC project timeline that could take up to four months for TSS approval and a 120‑day window to implement. On the RFP for EMS assessment and billing, county staff said they are actively collecting data from partner agencies but warned that state EMS authority approval of any procurement could add many months — an external factor the committee cannot control. Staff also noted the absence of finalized state regulations in this area is a complicating factor.
Committee action: The committee voted to receive the EMS reports and asked staff to provide additional data requested by supervisors, including frequency and trends of supplemental ambulance callouts.
