WYNE improves patient care

Sometimes it pays off to get a little WYNE.

The Wyoming-Nebraska (WYNE) state line committee has helped Emergency Medical Services (EMS) groups on both sides of the state line and improved patient care since its inception over two years ago, according to Kimball County Ambulance Director Carla Goranson.

The group formed at the urging of the Albin, Wyo., fire chief, in order to work through issues near the Nebraska-Wyoming border, Goranson said. The group has met monthly since it started, and its focus is how best to serve the patient – despite any differences in rules and regulations that are present due to the state border.

“We decided as a group that we were going to do what’s right for the patient,” Goranson said. “We’ve always kind of been doing that, but we came together to see if we could legally do that by getting the two states to work together.”

Goranson said there are many issues to work through, and the hope is that both states will eventually codify the agreements into state law to help emergency workers on both sides of the border.

For instance, one issue Goranson cited is an emergency call in Nebraska that could be a 25-mile trip for the Kimball County ambulance, but might just be three miles from Albin, Wyo. In that instance, it would be better for the patient to be served by the Albin ambulance because it is closer, even though it is across the state line. Goranson said current rules allow the ambulance service to have the Albin ambulance dispatched there, if they know that it is closer. However, she said it is not a decision the dispatcher is allowed to make own his own.

“For the 911 calls...we wanted to do it from a legal avenue and when we found out there wasn’t a legal way to do it, we’re going to start with a grassroots effort and develop an interlocal type agreement,” she said. “There are interlocal agreements for mass casualties and fire departments, but nothing for EMS. We want to come up with something that we can eventually get into law, and we know it’s going to take about five years to get this done. That will help all of the bordering communities in every state, Nebraska and Wyoming in this case.”

The state EMS directors for both Wyoming and Nebraska are on board with the grassroots effort to get something concrete into law, Goranson said. She said the WYNE committee recently met with them for about two hours in Cheyenne, Wyo.

“We made more progress in those two hours than we had in the two years of meeting once a month that we had been doing,” she said.

Another issue present is the different regulations in each state. For instance, a Wyoming ambulance can come into Nebraska and take a patient to a Nebraska hospital. However, the rules are different on the other side of the border.

”We cannot go to, say, Cheyenne, and pick up a Kimball patient who has maybe been there for surgery and needs a ride home for rehab. We can’t legally do that,” Goranson said.

Licensing is also an issue. There is a cost for a Wyoming EMS license, but there is not for a Nebraska EMS license. Goranson, who is in the process of applying for a Wyoming EMS license, said she has to duplicate things such a fingerprints and background checks that have already been done since she has a Nebraska license.

One issue that has been solved since the inception of the WYNE committee is the ability of the Kimball County Ambulance Service to once again contact the Cheyenne Regional Medical Center. Goranson said the ambulance service had been unable to contact the hospital over the radio for more than two years. She said they had talked with the hospital there and multiple agencies several times to resolve the issue, but had been unable to fix the problem. However, after talking with the emergency management director in Cheyenne, she was informed the problem was that Wyoming changed its entire radio system. The director gave the ambulance service in Kimball County two radios to be able to communicate with the hospital and other agencies across the border.

“It was very generous of the Wyoming emergency management to give those to us in Nebraska, and we’re very grateful for them because we have excellent communication with the hospital,” Goranson said.

The ambulance director said a similar group needs to be formed with Colorado, but that is on the back burner for now. She said the process there will be even more difficult because individual counties are allowed to set their own EMS policies, instead of having a statewide policy.

She said patients in Colorado who go to the doctor in Nebraska know to call the county instead of going through the 911 system to have a Kimball County ambulance dispatch to them. However, sometimes ambulances from both states are dispatched to the same scene, without the other one knowing. This is a problem because it pulls resources away from both counties and duplicates the effort.

“There is a lot more travel down there (on Hwy. 71 in Colorado) than one would think, and we do end up down there a few times a year for things – mainly accidents,” Goranson said.

Although the process has been slow at times, Goranson said it has been a joy working with agencies in both Nebraska and Wyoming to work through issues and improve patient care.

“It’s been a real pleasure working with the people and the departments in Wyoming,” she said. “You know that we’re all there for patient care, but it’s really nice to get the higher ups and the departments there and say, ‘We’re here for patient care. We don’t care if you come over here if you can get there quicker than we can.’ That’s been real nice, the working relationship that we have with everybody...It’s been a very positive experience.”