- The Washington Times - Tuesday, June 9, 2009

About a dozen D.C. paramedics were ordered into retraining and others have been required to take course work, but D.C. Fire Chief Dennis L. Rubin told a city council committee that a series of poor performances in medical-knowledge tests did not require punishment or a major shake-up in the department.

D.C. Council member Phil Mendelson, however, called the results “completely disturbing.”

The Washington Times reported in April that dozens of the District’s paramedics either failed to meet a minimum national standard on written exams that tested their medical knowledge or had mishandled basic lifesaving procedures during videotaped assessments.

During a hearing Monday at City Hall, Mr. Mendelson, chairman of the D.C. Council’s Committee on Public Safety and the Judiciary, took note of The Times’ report and questioned Chief Rubin closely about the District’s emergency medical services and the test results.

“Why shouldn’t people be alarmed?” Mr. Mendelson asked.

Chief Rubin stressed that the exams were evaluations that were meant to guide the department’s training program and to improve medical protocols.

He added that the department’s medical director, Dr. James J. Augustine, recognized that the tests showed a “generalized deficiency” in two areas, including one related to paramedics’ reading of the electrical activity of the heart. But he said the workers were not in need of discipline.

“We feel like we have turned the corner, but we’ll continue to provide education to bring them up to national standards, and we’ll do it in a way that’s not punitive,” Chief Rubin said.

Instead, he said, the paramedics were required to take a two-day, 16-hour course related to the heart activity issue, while 12 to 15 workers who still performed poorly were forced to undergo remedial training.

“I don’t see a need to provide any kind of discipline,” Chief Rubin said. “But we’ve made some significant improvements, and with a little bit of time I think you’re going to see a lot more.”

After the hearing, Mr. Mendelson called the test results “completely disturbing” in an interview with The Times, but he likened the exercise to rounds in a hospital where there can be “a discussion of shortcomings to improve skills.”

“You’ve got to be able to have a discussion of shortcomings to improve skills,” said Mr. Mendelson, an at-large Democrat. “So it can’t be a punitive process.”

The written tests - equivalent to the National Registry of Emergency Medical Technicians test for paramedics - were performed last year at the Maryland Fire and Rescue Institute (MFRI) and taken by about 175 of the city’s 250 advanced life-support providers. The same 175 paramedics were videotaped during a practical skills assessment in which they were required to deal with a cardiac arrest on a high-tech mannequin.

The Times obtained about 90 of the videotaped assessments and 95 of the written test scores. On the written tests, only three paramedics scored 70 percent or above; a passing grade for an entry-level paramedic on the national registry exam is 75.

More than 75 of the 10-minute videos were submitted by The Times to multiple local and nationally recognized paramedic instructors and quality-assurance specialists, who said they observed egregious health care violations.

Chief Rubin said 75 employees still must be tested. MFRI then will provide officials with a comprehensive analysis of the results.

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