scholarly journals Accessibility Assessment of Prehospital Emergency Medical Services considering Supply-Demand Differences

2021 ◽  
Vol 2021 ◽  
pp. 1-16
Author(s):  
Zhaoqing Shen ◽  
Ge Gao ◽  
Zhen Wang
Keyword(s):  
Emergency Medical Services ◽  
Catchment Area ◽  
Emergency Services ◽  
Supply And Demand ◽  
Assessment Method ◽  
Medical Services ◽  
Prehospital Emergency Care ◽  
Emergency Medical ◽  
Prehospital Emergency ◽  
The Difference

The reasonable accessibility assessment method is an important basis for the measurement of the level of prehospital emergency medical services. There is no general model for prehospital emergency care in traditional accessibility evaluation, and its supply-demand characteristics have also been ignored. Based on the three-step floating catchment area (3SFCA) model, the supply-demand three-step floating catchment area (SD3SFCA) model is proposed in this paper, which can express the difference between supply and demand of prehospital emergency medical services and accurately simulate unified dispatching of emergency centers. The unified dispatching behavior of emergency centers is simulated based on the potential service capacity of emergency stations with a supply-demand difference. The supply capacity of different emergency facilities is quantified from the perspective of infrastructure and technical quality. The needs of typical population densities are taken into account and adjusted by the weighting index. The validity of the model is verified, with the prehospital emergency medical service in the West Coast New District of Qingdao as an example. The results show that the model can effectively measure the accessibility level of prehospital emergency services and truly reflect the characteristics of supply and demand. Compared with previous models, the model has been significantly improved, which can provide an important reference for optimizing the allocation of prehospital emergency resources.

scholarly journals Collaboration for preliminary design of a mobile health solution for ambulance dispatch in Rwanda

2020 ◽  
Vol 3 (2) ◽  
pp. 1-5
Author(s):  
Ashley Rosenberg ◽  
◽  
Rob Rickard ◽  
Fraterne Zephyrin Uwinshuti ◽  
Gabin Mbanjumucyo ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Emergency Services ◽  
Prehospital Care ◽  
Capital City ◽  
Medical Services ◽  
Middle Income ◽  
Golden Hour ◽  
Middle Income Countries ◽  
Emergency Medical ◽  
Prehospital Emergency

The first 60 minutes after a trauma are described as “the golden hour.” For each minute of prehospital time, the risk of dying increases by 5% (Sampalis et al., 1999). Since 90% of the global burden of injuries occur in low- and middle-income countries and lead to 5.8 million deaths annually, addressing rapid access to emergency services is critical in these settings (Nielsen et al., 2012). In most low- and middle-income countries (LMICs), there are no formal trauma systems, and many lack organized prehospital care (Nielsen et al., 2012). Emergency medical dispatch and communication systems are a foundational component of emergency medical services (World Health Organization, 2005). Yet there are no established recommendations of creating these systems inLMICs.Rwanda, a country of over 12 million people, is a rapidly developing leader in East Africa. The Ministry of Health of Rwanda established the Service d’Aide Medicale Urgente (SAMU) in 2007, recognizing the need for public emergency medical services. SAMU’s national dispatch center receives roughly 3,000 calls per month through a national 912 hotline. It organizes regional transportation with 260 total ambulances located at hospitals throughout the country and provides prehospital emergency services in the capital city of Kigali with a fleet of 12 ambulances. In the city, each ambulance has a driver, nurse and anesthetist dispatched for every call. Emergency department nursing and anesthetist staff are dispatched from hospitals around the country to respond to regional emergencies. No formal prehospital cadre of the workforce exists although the SAMU staffhave extensive field experience in prehospital care. SAMU has several challenges to rapid prehospital emergency care including lack of addresses beyond the capital city, unclear location data in densely populated areas, complex communication processes with little information about health facility capacity, and no established electronic dispatch system. The average response time for SAMU ambulances was 59 minutes in 2018, but 39% of calls were not completed within the golden hour.

The Prehospital Emergency Care System in Mexico City: A System's Performance Evaluation

2006 ◽  
Vol 21 (2) ◽  
pp. 104-111 ◽  
Author(s):  
Luis Mauricio Pinet Peralta
Keyword(s):  
Emergency Medical Services ◽  
System Design ◽  
Mexico City ◽  
Emergency Care ◽  
Response Times ◽  
Medical Services ◽  
Prehospital Emergency Care ◽  
High Quality ◽  
Emergency Medical ◽  
Prehospital Emergency

AbstractIntroduction:Mexico City has one of the highest mortality rates in Mexico, with non-intentional injuries as a leading cause of death among persons 1–44 years of age. Emergency medical services (EMS) in Mexico can achieve high levels of efficiency by offering high quality medical care at a low cost through adequate system design.Objective:The objective of this study was to determine whether the prehospital EMS system in Mexico City meets the criteria standards established by the American Ambulance Association Guide for Contracting Emergency Medical Services (AAA Guide) for highly efficient EMS systems.Methods:This retrospective, descriptive study, evaluated the structure of Mexico City's EMS system and analyzed EMS response times, clinical capacity, economic efficiency, and customer satisfaction. These results were compared with the AAA guide, according to the social, economic, and political context in Mexico. This paper describes the healthcare system structure in Mexico, followed by a description of the basic structure of EMS in Mexico City, and of each tenet described in the AAA guide. The paper includes data obtained from official documents and databases of government agencies, and operative and administrative data from public and private EMS providers.Results:The quality of the data for response times (RT) were insufficient and widely varied among providers, with a minimum RT of 6.79 minutes (min) and a maximum RT of 61 min. Providers did not define RT clearly, and measured it with averages, which can hide potentially poor performance practices. Training institutions are not required to follow a standardized curriculum. Certifications are the responsibility of the individual training centers and have no government regulation. There was no evidence of active medical control involvement in direct patient care, and providers did not report that quality assurance programs were in place. There also are limited career advancement opportunities for EMS personnel. Small economies of scale may not allow providers to be economically efficient, unit hours are difficult to calculate, and few economic data are available.There is no evidence of customer satisfaction data.Conclusions:Emergency medical services in Mexico City did not meet the AAA requirements for high-quality, prehospital, emergency care. Coordination among EMS providers is difficult to achieve, due, in part, to the lack of: (1) an authoritative structure; (2) sound system design; and (3) appropriate legislation. The government, EMS providers, stakeholders, and community members should work together to build a high quality EMS system at the lowest possible cost.

Emergency Medical Services in India: The Present and Future

2014 ◽  
Vol 29 (3) ◽  
pp. 307-310 ◽  
Author(s):  
Mohit Sharma ◽  
Ethan S. Brandler
Keyword(s):  
Emergency Medical Services ◽  
Emergency Services ◽  
Prehospital Care ◽  
Emergency Medical Technician ◽  
Medical Services ◽  
Prehospital Emergency Care ◽  
Publication Type ◽  
Emergency Medical ◽  
Trauma Service ◽  
Care System

AbstractIndia is the second most populous country in the world. Currently, India does not have a centralized body which provides guidelines for training and operation of Emergency Medical Services (EMS). Emergency Medical Services are fragmented and not accessible throughout the country. Most people do not know the number to call in case of an emergency; services such as Dial 108/102/1298 Ambulances, Centralized Accident and Trauma Service (CATS), and private ambulance models exist with wide variability in their dispatch and transport capabilities. Variability also exists in EMS education standards with the recent establishment of courses like Emergency Medical Technician-Basic/Advanced, Paramedic, Prehospital Trauma Technician, Diploma Trauma Technician, and Postgraduate Diploma in EMS. This report highlights recommendations that have been put forth to help optimize the Indian prehospital emergency care system, including regionalization of EMS, better training opportunities, budgetary provisions, and improving awareness among the general community. The importance of public and private partnerships in implementing an organized prehospital care system in India discussed in the report may be a reasonable solution for improved EMS in other developing countries.SharmaM, BrandlerES. Emergency Medical Services in India: the present and future. Prehosp Disaster Med. 2014;29(3):1-4.

scholarly journals Remote monitoring in emergency medical services

2017 ◽  
Vol 3 (2) ◽  
pp. 479-481 ◽  
Author(s):  
Andreas Follmann ◽  
Rolf Rossaint ◽  
Jörg Christian Brokmann ◽  
Stefan K. Beckers ◽  
Michael Czaplik
Keyword(s):  
Emergency Medical Services ◽  
Emergency Service ◽  
Emergency Services ◽  
Modern Technology ◽  
Medical Services ◽  
Utilization Rate ◽  
Prehospital Emergency Medicine ◽  
Visual Contact ◽  
Emergency Medical ◽  
Prehospital Emergency

AbstractAn increasing number of missions in emergency medical services and a progressive utilization rate of emergency physicians also require the use of the benefits of telemedicine in prehospital emergency medicine. Through modern technology, such as the transmission of vital data in real time and a secure audio-visual contact, paramedics can be quickly connected to an experienced emergency physician from a distance and supported in diagnostics and therapy of a patient. This tele-emergency services physician is established in the Aachen emergency service since 2014 and has already had numerous successful missions.

scholarly journals Understanding quality systems in the South African prehospital emergency medical services: a multiple exploratory case study

2020 ◽  
Vol 9 (2) ◽  
pp. e000946
Author(s):  
Ian Howard ◽  
Peter Cameron ◽  
Lee Wallis ◽  
Maaret Castrén ◽  
Veronica Lindström
Keyword(s):  
Emergency Medical Services ◽  
Emergency Care ◽  
Medical Services ◽  
Prehospital Emergency Care ◽  
Quality Systems ◽  
Exploratory Case Study ◽  
Private Service ◽  
Emergency Medical ◽  
Prehospital Emergency

IntroductionIn South Africa (SA), prehospital emergency care is delivered by emergency medical services (EMS) across the country. Within these services, quality systems are in their infancy, and issues regarding transparency, reliability and contextual relevance have been cited as common concerns, exacerbated by poor communication, and ineffective leadership. As a result, we undertook a study to assess the current state of quality systems in EMS in SA, so as to determine priorities for initial focus regarding their development.MethodsA multiple exploratory case study design was used that employed the Institute for Healthcare Improvement’s 18-point Quality Program Assessment Tool as both a formative assessment and semistructured interview guide using four provincial government EMS and one national private service.ResultsServices generally scored higher for structure and planning. Measurement and improvement were found to be more dependent on utilisation and perceived mandate. There was a relatively strong focus on clinical quality assessment within the private service, whereas in the provincial systems, measures were exclusively restricted to call times with little focus on clinical care. Staff engagement and programme evaluation were generally among the lowest scores. A multitude of contextual factors were identified that affected the effectiveness of quality systems, centred around leadership, vision and mission, and quality system infrastructure and capacity, guided by the need for comprehensive yet pragmatic strategic policies and standards.ConclusionUnderstanding and accounting for these factors will be key to ensuring both successful implementation and ongoing utilisation of healthcare quality systems in emergency care. The result will not only provide a more efficient and effective service, but also positively impact patient safety and quality of care of the services delivered.

scholarly journals Satisfaction with the performance of emergency medical services: a case study in Tabriz

2019 ◽  
Vol 5 (2) ◽  
pp. 37-40
Author(s):  
Fereshteh Jamali ◽  
Haniyeh Ebrahimibakhtavar ◽  
Mahbubeh Zomordi Torkdari ◽  
Farzad Rahmani
Keyword(s):  
Emergency Medical Services ◽  
Medical Equipment ◽  
Emergency Services ◽  
Point Of View ◽  
Medical Services ◽  
Medical Sciences ◽  
Patients Satisfaction ◽  
Emergency Medical ◽  
Level Of Satisfaction ◽  
Prehospital Emergency

Objective: Assessing patients’ satisfaction with emergency medical services (EMSs) is an important managerial point of view. The present study aimed to assess the patients’ satisfaction with EMS in Tabriz, Iran. Methods: This is a descriptive-analytic study that was done in the prehospital emergency and disaster management center of Tabriz University of Medical Sciences. In this study, from May to December 2017, we included 659 patients who were transferred to hospitals with our prehospital emergency services. A valid and reliable questionnaire was used to evaluate the satisfaction of patients about the performance of prehospital EMSs. Results: Data of 659 patients were evaluated. Trauma was the most common cause of contact with 115 and help request (33.83%). The results indicated that patients’ level of satisfaction was good and very good. The highest level of satisfaction was related to the treatment of patients and use of medical equipment in the ambulance (n=578 patients, 87.7%) as well as the treatment practiced by the emergency medical technicians (EMTs) (n=575 patients, 87.24%). However, the lowest level of satisfaction was related to the absence of an active EMT in the rear cabin when transferring patients to the hospital (n=337 patients, 51.14%) and transfer of the patient from the accident scene to the ambulance (n=410 patients, 62.21%). Conclusion: Patients’ satisfaction with EMS was optimal. The minimum and maximum satisfaction rates were related to the absence of an active EMT in the rear cabin, treatment of the patient, and use of medical equipment.

scholarly journals Outcomes of people with severe hypoglycaemia requiring prehospital emergency medical services management: a prospective study

Diabetologia ◽  
2019 ◽  
Vol 62 (10) ◽  
pp. 1868-1879 ◽  
Author(s):  
Melanie Villani ◽  
Arul Earnest ◽  
Karen Smith ◽  
Dimitra Giannopoulos ◽  
Georgia Soldatos ◽  
...  
Keyword(s):  
Prospective Study ◽  
Emergency Medical Services ◽  
Severe Hypoglycaemia ◽  
Medical Services ◽  
Emergency Medical ◽  
Prehospital Emergency ◽  
A Prospective Study

scholarly journals IMPACT OF AGING POPULATIONS ON MUNICIPAL EMERGENCY MEDICAL SERVICES

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S956-S956
Author(s):  
Nidya Velasco Roldan ◽  
Caitlin E Coyle ◽  
Michael Ward ◽  
Jan Mutchler
Keyword(s):  
Emergency Medical Services ◽  
Assisted Living ◽  
Local Governments ◽  
Emergency Services ◽  
Medical Services ◽  
Assisted Living Facilities ◽  
Older Population ◽  
Emergency Medical ◽  
Age Related ◽  
Aging Populations

Abstract The services that residents require from their local governments vary depending on the demographics of their populations. While municipalities have long sought to consider how changes in the young population may impact their school system needs, few systematic considerations have been developed relating to how aging populations may impact municipal service provision. This study aims to address this issue by focusing on demands on emergency services at the municipal level. Using data from the Massachusetts Ambulance Trip Record Information System (MATRIS) we explore the association between emergency medical services (EMS) demand and population age-structure. The data shows an overrepresentation of older people among EMS users. People age 65 and older represent 16% of Massachusetts’ population but account for 31% of the transported emergent calls —e.g., 911 calls— and 60% of the scheduled transports. Results from the OLS regression analysis suggest that communities with larger shares of older residents have significantly higher numbers of EMS calls. The type of community and other age-related community features such as the percentage of older residents living alone and the percentage of older population dually eligible for Medicare and Medicaid are also significantly associated with the number of EMS calls. Contrary to our expectations, other resources available in the community such nursing homes or assisted living facilities were not significantly associated with number of EMS calls. Our research indicates that if growth in the older population occurs as projected, the demand placed on the EMS system by older populations will grow considerably in coming decades.

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