Demands of Aging Population Stressing Thurston County EMS, Hospitals


Thurston County's aging population needs more care and that's factoring into delays for emergency services, officials say.

Calls for emergency medical services (EMS) increased from 26,570 in 2013 to an expected 43,000 in 2023, said Ben Miller-Todd, director of Thurston County Emergency Services.

"We've had about a 62% overall growth over the course of 11 years in Thurston County's EMS infrastructure," Miller-Todd said. "That significantly outpaces the growth that we have in population. A lot of that is due to age."

Miller-Todd shared statistics about the county's emergency services with the Board of County Commissioners last week. He was joined by officials from Providence Swedish South Puget Sound and MultiCare.

The average age of people that EMS serves is 60 years old, Ben Miller-Todd said. An aging population, he added, has more needs than a younger one.

"It's not just that our population is growing, it's that our population is changing and so that change is something that we have to deal with," Miller-Todd said.

Thurston County's population surpassed 300,000 in June, according to the Washington State Office of Financial Management. Citing figures from the Thurston Regional Planning Council, Miller-Todd said the county population may reach 370,000 by 2040.

Miller-Todd said the county's median age increased from 29.8 in 1980 to about 37.3 in 2010. He also showed a population pyramid graph that showed how the the number of people in their 20s and 30s has declined.

Average EMS response times have increased along with growing call volumes. Miller-Todd said response times increased 12% from 414 seconds (about 7 minutes) in 2019 to 463 seconds (almost 8 minutes) in 2021.

At the same time, he said more people are waiting longer than 45 minutes at the hospital emergency departments.

Darin Goss, chief executive of Providence Swedish South Puget Sound, presented a graph that showed emergency department visits have actually decreased overall between 2018 and 2022. He attributed this to efforts to direct people to lower-cost settings such as an urgent care or a primary care physician's office.

But doing that leaves people with more serious needs at the hospital.

"What's not on this graph, though, is the acuity," Goss said. "So, as we move more of our lower acuity patients out of the emergency room, the higher acuity remains."

The average length of stay at Providence St. Peter Hospital has increased from over 5 days in 2019 to almost 7 days in 2022, according to a graph presented by Goss.

Staffing has been a concern, he said, not just at the hospital but at long-term care facilities. This had made it difficult to discharge patients sooner because sometimes they have nowhere to go, he added.

Bill Kriegsman, chief medical officer of MultiCare Capital Medical Center, said emergency department visits at his hospital have increased from 19,607 in 2018 to 25,068 in 2022.

Meanwhile, the average length of stay has increased from 3.16 days in 2018 to 3.84 days in 2022. He said his hospital has had similar difficulties discharging patients.

"We've seen consistent increases in pressure on the rest of the hospital and this results in longer lengths of stay because we have the same number of beds but more patients," Kriegsman said.

MultiCare broke ground on a new emergency department in Lacey in August, The Olympian previously reported. Kriegsman said that facility may open by the end of the year.

The new facility will provide 10 exam rooms, on-site radiology services including X-ray, ultrasound, and CT scans; an in-house laboratory; and a pediatric provider available seven days a week, according to a MultiCare news release.

With EMS, Miller-Todd said the county has implemented a countywide dashboard to informs EMS workers of turnaround times at local hospitals. They can use this information to give patients a choice of which hospital to go to.

Additionally, the county has worked with Providence to station two emergency medical technicians at the emergency department ambulance bay entryway. Miller-Todd said this effort returned 130 hours of ambulance availability to the system from Jan. 3 to Feb. 21.

"You take the staffing of one ambulance, and you get four back," Miller-Todd said. "That's incredible."

Providence also recently launched a new program that allows some emergency department patients to receive care at home instead of being kept at the hospital.

"We've had about 250 patients go through that," Goss said. "It's been wildly successful, and we'll continue to explore and mature in the space as we learn more about how to do this."