In the new administrative offices of the Denver Health Paramedic Division at Sixth Avenue and Broadway, a bank of televisions hang above a U-shaped pod of desks.
One screen displays the calls ambulances are currently on; a second lists hospitals and the number of beds they have available. Josh Kennedy, a captain with the division and a 10-year veteran, gestures toward a third screen — one mapping traffic patterns throughout the city.
At midday, it shows mostly open routes. But in just a few hours, the streets on the map will turn red with backups. And that’s when the city’s paramedics will begin an increasingly complicated race: They will try to save lives while also navigating a gridlocked city.
“The frustration they see is more calls and more cars on the road,” Kennedy said later. “Some of their best routes are getting clogged.”
For Denver’s paramedics, congestion has emerged as one of their greatest enemies.
Traffic in Denver is bad — one recent study listed it as the 21st-worst for American cities — and it is projected to get worse as the city grows. Some of what officials have done to fight congestion has made the city more livable for residents, paramedics Chief Gary Bryskiewicz said. He mentioned Broadway south of downtown, where the city took one traffic lane and made it a protected bike lane, while taking another lane and devoting it full-time to buses.
But those changes also stuffed the cars on Broadway into three lanes instead of, potentially, five. And that has made the road more crowded for ambulances trying to race toward patients in need or race them back to the hospital.
“I think there’s some unintended consequences,” he said.
So, Bryskiewicz said, Denver’s paramedics have begun an ambitious rethink of how they distribute ambulances throughout the city and how they avoid gridlock to and from the hospital.
For one, there are more ambulances on the road. On a typical weekday this month, Kennedy said there were 23 ambulances scheduled for the day and 21 for the night, a few more for each shift than there would have been several years ago. There are also more lieutenants, helping to spot traffic as it builds up and suggest alternate routes to ambulance drivers.
Those extra ambulances are needed because call volume is rising. Denver Health paramedics are primarily based out of Denver Health Medical Center, the city’s near-downtown safety-net hospital. But they cover the entire city and also transport patients to other hospitals.
In 2016, Denver Health paramedics went on more than 112,000 calls, a 5 percent increase over the previous year. Bryskiewicz said he expects to see another 5 percent increase in calls this year. The total paramedic fleet is expected to travel as many as 1.2 million miles this year.
The extra wheels on the street also help account for the added time ambulances spend in traffic just driving to and from staging points around the city.
But those staging points have also changed, Bryskiewicz said. Think of the city like a bicycle wheel. Most of the hospitals are in the hub. As a result, paramedics have traditionally hung out near the center and responded out toward the rim as needed.
Bryskiewicz said, with increased traffic, that strategy potentially means two trips through central congestion in order to pick up a patient and bring them back. Now, Denver paramedics are staging more ambulances on the rim to get to patients quickly and spend as little time in traffic as possible.
The division is also getting creative in how it responds to calls in the center of the city. Its team of paramedics on bicycles is expanding. Marc Scherschel, the division’s deputy chief, said he has looked at the possibility of putting paramedics on motorcycles, so they can nimbly respond to calls that don’t require an ambulance transport. (A similar shift is at work at Denver International Airport, where rising numbers of travelers in the terminal and concourses mean many paramedics now respond to calls on Segway scooters instead of in larger golf carts.)
So far, Bryskiewicz said, the congestion hasn’t affected response times.
When ambulances are running with lights and sirens, which are about 70 percent of the calls, the division’s standards require a response within nine minutes. Denver’s ambulances were able to meet that standard on 90 percent of calls last year, a level putting them in compliance with city rules. The rate was almost identical in 2015, and Bryskiewicz said he expects the city’s paramedics to meet the standard again this year.
But the paramedic division is also planning for a future where gridlock could make those standards harder and harder to reach. That means thinking of ways around construction logjams, including the mother of all traffic headaches: the looming Interstate 70 renovation scheduled to begin next year.
“All that stuff has a major impact on our ability to get to 911 calls within our time frames,” Scherschel said.
To do this, the paramedics have a new tool — a software program called Optima — that is helping them analyze traffic patterns and map the fastest routes. Bryskiewicz said the program has so far confirmed that ambulance drivers are intuitively picking the fastest paths through the current congestion. But he and other leaders are also able to use the program to model what traffic might look like during I-70 construction, giving them insight into where to stage ambulances and how to avoid jams.
Thinking even longer term, Bryskiewicz said the best way to keep ambulances from being stuck in traffic is to keep them off the roads as much as possible. He’s thinking about public education campaigns on when it is necessary to call 911 and when it’s not. He’s thinking about public health initiatives that ultimately lower the demand for emergency medical treatment.
“We’re planning,” he said, “for not just how we handle responses but what we can do so that people are utilizing the system less.”
The Denver Post