Reduction in unavailable-for-response episodes in a private emergency medical services agency

2016 ◽  
Vol 14 (1) ◽  
pp. 79 ◽  
Author(s):  
Brian L. Risavi, DO, MS, FACEP, FAAEM ◽  
Saad Mahmood, DO ◽  
Kevin Andryc, DO ◽  
John Libonati, EMT-P ◽  
Mark A. Terrell, EdD
Keyword(s):  
Emergency Medical Services ◽  
Critical Time ◽  
Internal Audit ◽  
Cost Benefit ◽  
Temporal Patterns ◽  
Cost Effective ◽  
Medical Services ◽  
Emergency Medical ◽  
Time Period ◽  
Time Periods

Objective: Increased demand for emergency medical services (EMS), financial constraints, emergency department overcrowding, EMS crews kept in hospital, all result in ambulance unavailability. This study seeks to identify daily temporal patterns for unavailable-for-response episodes, impact of increasing staffing during peak periods, and evaluating the extent of reduction in unavailable-for-response episodes due to temporally precise increases in staffing during critical time periods and the resulting cost/ benefit analysis.Design: The authors evaluated all EMS responses during a 7-month time period and recorded all unavailable-for-response episodes. This identified clusters of unavailable-for-response episodes for which incremental staffing changes were implemented. Internal audit of cost/revenues was recorded.Setting: Midsized private EMS agency in Northwest Pennsylvania.Subjects/participants: EMS Responders/Agency calls.Interventions: Temporally precise increases in staffing during critical time periods/unavailable-for-response episodes.Main outcome measure(s): Reduction in unavailable-for-response episodes, cost effectiveness.Results: Evaluating 23,833 EMS responses that occurred during the study period, staffing changes resulted in a 93 percent average reduction and 100 percent maximum reduction in unavailable-for-response episodes and were cost effective, based on evaluation of cost versus revenue, in this EMS agency.Conclusions: Identification of opportunities for system staffing improvement in a midsized EMS agency demonstrated feasibility and usability of mapping temporal patterns of unavailable-for-response episodes to substantially reduce the number of unavailable-for-response episodes and was cost effective.

scholarly journals Emergency medical services evaluations for chest pain during first COVID-19 lockdown in Hollands-Midden, the Netherlands

2021 ◽  
Vol 29 (4) ◽  
pp. 224-229 ◽  
Author(s):  
E. R. de Koning ◽  
M. J. Boogers ◽  
J. Bosch ◽  
M. de Visser ◽  
M. J. Schalij ◽  
...  
Keyword(s):  
Chest Pain ◽  
Emergency Medical Services ◽  
Medical Services ◽  
Cardiac Symptoms ◽  
Emergency Medical ◽  
Time Period ◽  
Number Of Patients ◽  
St Elevation ◽  
Pain Patients ◽  
Hospital Cardiac Arrest

Abstract Objective To assess whether the COVID-19 lockdown in 2020 had negative indirect health effects, as people seem to have been reluctant to seek medical care. Methods All emergency medical services (EMS) transports for chest pain or out-of-hospital cardiac arrest (OHCA) in the Dutch region Hollands-Midden (population served > 800,000) were evaluated during the initial 6 weeks of the COVID-19 lockdown and during the same time period in 2019. The primary endpoint was the number of evaluated chest pain patients in both cohorts. In addition, the number of EMS evaluations of ST-elevation myocardial infarction (STEMI) and OHCA were assessed. Results During the COVID-19 lockdown period, the EMS evaluated 927 chest pain patients (49% male, age 62 ± 17 years) compared with 1041 patients (51% male, 63 ± 17 years) in the same period in 2019, which corresponded with a significant relative risk (RR) reduction of 0.88 (95% confidence interval (CI) 0.81–0.96). Similarly, there was a significant reduction in the number of STEMI patients (RR 0.52, 95% CI 0.32–0.85), the incidence of OHCA remained unchanged (RR 1.23, 95% CI 0.83–1.83). Conclusion During the first COVID-19 lockdown, there was a significant reduction in the number of patients with chest pain or STEMI evaluated by the EMS, while the incidence of OHCA remained similar. Although the reason for the decrease in chest pain and STEMI consultations is not entirely clear, more attention should be paid to the importance of contacting the EMS in case of suspected cardiac symptoms in possible future lockdowns.

scholarly journals Introduction and contemporary condition of helicopter emergency medical services in Korea

2020 ◽  
Vol 63 (4) ◽  
pp. 193-198
Author(s):  
Jin-Seong Cho ◽  
Hyuk Jun Yang
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Emergency Medical Services ◽  
Local Governments ◽  
Cost Effective ◽  
Severe Trauma ◽  
Economic Research ◽  
Medical Services ◽  
Air Ambulances ◽  
Emergency Medical

As most medical facilities in Korea have been concentrated in large cities, the need to improve emergency medical services in islands and mountainous areas has emerged. Consequently, the Ministry of Health and Welfare and local governments have introduced emergency medical helicopters (known as helicopter ambulances or air ambulances) with doctors in medically vulnerable areas. Having been introduced in two regions in 2011, air ambulances are operational in seven regions as of the end of 2019. The flight time is from sunrise to sunset, except in Gyeonggi province, which is open all day. Although the criteria for transport vary depending on whether an ambulance is available for operation, it is basically intended for emergency critical diseases, such as severe trauma, stroke, and acute myocardial infarction. From September 23, 2011 to December 31, 2018, a total of 10,367 transfer requests were received, which included 534 (5.2%) interruptions, 2,657 (25.6%) rejects, and 7,176 (69.2%) transfers. A total of 7,209 patients were transferred during this period, which included 1,693 (23.5%) patients of severe trauma, 1,149 (15.9%) patients of stroke, 802 (11.1%) patients of acute myocardial infarction, and 3,565 (49.5%) patients suffering from other emergency diseases. Some economic research on air ambulances in Korea has been reported to be cost-effective, but additional research should be performed. In the future, it is necessary to widen the area of operation of air ambulances and find alternative means of transporting patients during unfavorable conditions such as night or bad weather.

The Utilization of Bicycles in the Delivery of Emergency Medical Services: A Preliminary Report

1997 ◽  
Vol 12 (2) ◽  
pp. 102-108 ◽  
Author(s):  
John F. Gorham ◽  
Todd S. Kramer
Keyword(s):  
Emergency Medical Services ◽  
Response Times ◽  
Cost Effective ◽  
Mean Value ◽  
Medical Services ◽  
Special Events ◽  
Emergency Medical ◽  
Service Areas ◽  
Minor Injuries ◽  
The Impact

AbstractIntroduction:Bicycles may be useful in the delivery of out-of-hospital emergency medical services. The use of bicycles in providing emergency medical services was investigated by surveying currently existing bicycle-medic systems.Methods:Two questionnaires were developed to gain information on service areas, injuries, gear used, missions, and specific data from bicycle-medic response.Results:Of 210 surveys mailed to bicyclemedics, 21 (10%) were completed and returned by the pre-established deadline. Of 11 surveys mailed to bicycle-medic supervisors, four (36%) were returned. Preliminary results showed that 76% of respondents are career providers and the remainder serve as volunteers. Mean age for respondents was 33±7.4 years, with 96% being males. Most teams have been in existence for three to four years. Job satisfaction was greater when participating on the bicycle crews than when not performing on the bicycle crew, t = 4.15, p = 0.0002. The teams varied in size (6–100 persons) with a mean value of 31. On the average, team size represented 10% of total number of personnel for the respective organizations.The majority of bicycle teams operate all year in all conditions. Most bicycle-medic teams were initiated for special events. Nineteen percent reported injuries while on duty or in training. Ninety percent of units that responded use existing agency protocols and have no special protocols related to the bicycle team. Eighty percent of the units are dispatched through the normal agency procedures. Eighty-five percent of respondents coordinate for transport units via dispatch. Reported response times were under two minutes for special event responses. These were within established agency response times. In approximately 25% of the responses, the patients refused transport, and another 65% of the responses were for relatively minor injuries or complaints that did not require transport to a hospital.Conclusion:This survey begins to characterize the utilization of bicycles as a tool to gain patient access in specialized situations. The use of bicycle-medics may be cost-effective, may help to improve employee morale, and possibly reduce employee health-care costs. Further study is needed to determine the impact of bicycle-medics on patient outcomes and response times.

scholarly journals Lessons learned from an analysis of the Emergency Medical Services’ COVID-19 drive-through testing facilities in Israel

2021 ◽  
pp. 1-18
Author(s):  
Itay Zmora ◽  
Evan Avraham Alpert ◽  
Uri Shacham ◽  
Nisim Mishraki ◽  
Eli Jaffe
Keyword(s):  
Emergency Medical Services ◽  
Cost Effective ◽  
Lessons Learned ◽  
Medical Services ◽  
Improvement Program ◽  
Emergency Medical ◽  
Home Testing ◽  
Operational Improvement ◽  
October 17 ◽  
National Emergency

Abstract One strategy for the containment of a pandemic is mass testing. Magen David Adom (MDA), the Israeli National Emergency Medical Services (EMS) Organization undertook this mission by operating a nationwide series of drive-through testing complexes. The objective of this study is to learn lessons from an analysis of these centers. Data from 198 stationary and mobile drive-through complexes from March 20, 2020, through October 17, 2020, were analyzed for temporal and geographic factors, and cost. Also, an operational improvement program was implemented and analyzed. A total of 931,074 patients were sampled in the MDA drive-through system: 46.9% in stationary complexes, and 53.1% in mobile complexes. The optimized cost per patient of home testing was estimated at 74.5 USD compared to 6.55 USD in the drive-through centers. An operational improvement program lowered the total sampling time from 128 seconds per patient to 98 seconds and decreased the total cost per patient from 6.55 USD to 6.27 USD. The EMS led drive-through complexes were cost-effective and efficient in performing large numbers of viral tests, especially when compared to home testing. Established concepts in clinical operations should be implemented to increase the number of persons that can be tested and decrease cost.

scholarly journals GIS Mapping Evaluation of Stroke Service Areas in Bangkok Using Emergency Medical Services

2021 ◽  
Vol 10 (10) ◽  
pp. 651
Author(s):  
Kiatirat Sreemongkol ◽  
Manoj Lohatepanont ◽  
Pannee Cheewinsiriwat ◽  
Tanyaluk O. Bunlikitkul ◽  
Jirapong Supasaovapak
Keyword(s):  
Emergency Medical Services ◽  
Medical Services ◽  
Gis Mapping ◽  
Conditioning Factors ◽  
Stroke Service ◽  
Emergency Medical ◽  
Time Period ◽  
Service Areas ◽  
Travelling Time ◽  
Delivery Models

Stroke is a major cause of death in Thailand. It requires a specific time period of 4.5 h from onset to treatment to increase recovery rates, and therefore, it can be categorized as a time-sensitive disease. The objective of this research is to identify whether the service areas of the main existing Emergency Medical Services (EMS) prehospital stroke practices cover all areas in Bangkok. This is determined by using GIS mapping. After verifying the current EMS delivery models, comparisons are drawn to find the travelling time of each model. The conditioning factors for GIS mapping were collected and verified, including the traffic speed and duration spent in each mode of the prehospital stroke process. After inputting all of the data into GIS, the service areas were visualized to show the area serviced in each delivery model. The results also show the different hospital groups, including the service areas for (1) non-network hospitals and (2) hospitals with stroke networks. Suggestions for re-networking and adding more hospitals to the existing networks were also identified using GIS. Regularly updating the service area with up-to-date data in GIS is key to improving stroke service areas.

Service Location Optimization Model for Improving Rural Emergency Medical Services

2018 ◽  
Vol 2672 (32) ◽  
pp. 83-93 ◽  
Author(s):  
Zhaoxiang He ◽  
Xiao Qin ◽  
Yuanchang Xie ◽  
Jianhua Guo
Keyword(s):  
Emergency Medical Services ◽  
Rural Areas ◽  
Optimization Model ◽  
Resource Constraints ◽  
Prehospital Care ◽  
Cost Effective ◽  
Medical Services ◽  
Location Optimization ◽  
Emergency Medical ◽  
Multiple Challenges

Approximately 35,000 fatalities are attributed to accidents on U.S. highways each year and more than half of them occurred in rural areas. With such a high percentage of fatalities, rural areas are in critical need of timely and reliable Emergency Medical Services (EMS). EMS provide important prehospital care to victims before they are transferred to a hospital. After an accident occurs, the time it takes for victims to receive care from EMS is crucial to their survival. Compared with urban EMS, rural EMS face multiple challenges. One of them is how to properly site EMS stations to provide cost-effective services in rural areas. The goals of this paper include analyzing the spatial patterns of EMS station and incident locations, and optimizing rural EMS station locations. The data were collected from South Dakota, a rural state. This dataset was used to perform spatial analysis and to develop and evaluate an EMS location optimization model. The location optimization model aims to maximize the rural EMS coverage while taking service equity into consideration. The model was solved by a genetic algorithm toolbox in R. The proposed model provides an important and practical tool for rural EMS officials to select new EMS stations or relocate existing stations to improve service performance under budget and resource constraints.

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