Health Board detects operational issues with Tallinn ambulance service

Ambulance workers in Estonia
Ambulance workers in Estonia Source: Ida-Tallinna Keskhaigla

The Estonian Health Board (Terviseamet) discovered during the national monitoring that the Tallinn Ambulance service (Tallinna Kiirabi) exceeded the legal response times for ambulance brigades and that there were instances where incorrect departure times were manually entered by ambulance drivers. The Health Board issued an injunction against the ambulance service due to these inconsistencies, which the chief doctor of service, Raul Adlas, promised to contest.

The Health Board initiated a national monitoring procedure against Tallinn Ambulance on September 1 in response to a complaint alleging that an ambulance driver altered incorrect departure times on an ambulance card.

During the procedure, the northern regional office of the Health Board discovered that, out of 57 ambulance calls, 26 ambulance brigades exceeded the response time for ambulance brigade dispatch calls established in Annex 1 of the government regulation No. 119.

"The departure times on the ambulance cards, which were automatically retrieved from the emergency center, and the times manually entered by the ambulance brigade driver differed in six instances. The actual time of ambulance departure cannot be later than the time entered manually by the driver," Health Board spokesperson Kirsi Pruudel said.

Pruudel said that delaying timely assistance can endanger the life and health of the individual in need and that issuing such an injunction is the most effective way to achieve the goal of the national monitoring procedure.

The Health Board's injunction requires Tallinn Ambulance to ensure that the ambulance brigade departs immediately after receiving a call from the emergency center and no later than the legally specified time.

Moreover, the board expects the ambulance service to check the accuracy and correctness of the data entered on ambulance cards and to conform to information systems standards when filling out ambulance cards.

"Within thirty days of receiving a letter of official notice, the recipient may file a written appeal with the head of the Health Board. The act of filing a complaint, however, does not release the complainant of the obligation to comply with the injunction," Pruudel added.

In accordance with statutory guidelines, an ambulance service must be dispatched within one to 10 minutes of receiving a call, depending on the urgency of the case. The "delta call" of the highest priority, such as a heart failure, must be handled within one minute.

Tallinn Ambulance chief: Clearing protective equipment for Covid-19 slowed response time

Tallinn Ambulance service's chief doctor of service, Raul Adlas, told ERR that he intends to contest the Health Board's decision.

"This related to 26 calls made in 2021. And the health board's criticism is that the ambulance did not dispatch within one minute, as they say they should have. We were asked why we did not leave on time. It was primarily due to the fact that it was the peak of the pandemic and we were wearing protective gear, which simply cannot be cleaned in a few seconds. However, the health authority did not take this into consideration in its latest monitoring, this is why we have decided to contest this injunction," Adlas said.

Adlas emphasized that the ambulance's actions posed no threat to anyone's life or health.

"No, certainly not. Our main mission is to quickly reach those in need. When we consider it in the context of the 2021 epidemic, we soon realize that our employees worked nearly 27,000 hours of overtime in order to help individuals in need and manage the enormous workload. We now feel somewhat out of touch with the notion that ambulance staff have put anyone in danger through their work; quite the opposite is true. Our primary objective is to help people as quickly as possible and this is the essence of what we did," Adlas said.

ERR also asked Adlas why, in six cases, ambulance drivers manually entered inaccurate departure times on the ambulance card.

"In one case, we were able to determine that a staff member had forgotten to record his or her departure, and in the other five cases, so much time had passed that that staff were unable to identify the reason for correcting these entries a year ago," Adlas explained.

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Editor: Kristina Kersa

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