Emergency ambulance service systems

Response time is currently considered to be an important performance indicator in Emergency Medical Services (EMS) systems. A number of factors may affect response times, including the location of emergency vehicles and the type of response system design used. This study aimed to assess the effects of emergency vehicle location and response system design on response time performance in a model of a large South African urban EMS system, using discrete-event simulation. Results indicated that both the emergency vehicle location and response system design factors had a significant effect on response time performance, with more decentralised vehicle location having a greater effect.

Prehospital Emergency Care, 2019

Faced with increasing demand for their services, Emergency Medical Services (EMS) agencies must find more efficient ways to use their limited resources. This includes moving beyond the traditional response and transport model. Alternative Response Units (ARUs) are one way to meet the prehospital medical needs of some members of the public while reducing ambulance transports. They are non-transport vehicles tasked with very specific medical missions. These can include acute management of low-acuity complaints, ongoing home care for chronic medical conditions, preventive medicine, and post-hospital discharge follow-up visits. Their focus can be tailored to the individual needs of the agency. The Philadelphia Fire Department (PFD) operates one of the busiest EMS systems in the country. It has added additional staff and ambulances in recent years yet continues to face an increasing call volume. In an effort to reduce ambulance transports, the PFD recently introduced two ARUs. The first unit, AR-1, is deployed on a university campus and responds to students with low acuity medical complaints or mild alcohol intoxication. It provides many of these a courtesy ride to one of two university emergency departments for further evaluation, eliminating the need for ambulance transport. The second unit, AR-2, works in an area heavily impacted by the opioid crisis. It responds to individuals who have overdosed, been revived with naloxone, and refuse ambulance transport but are interested in long-term treatment for their opioid use disorder. The staff of AR-2 has successfully placed some of these individuals in treatment programs the same day. The AR-1 program is financially supported by the university while AR-2 is funded by the PFD and a federal grant. Both have the potential to decrease ambulance transports or reduce 9-1-1 calls. Whether these or other ARU programs can be financially sustained long-term is unclear. It is 3 also unknown if ARUs represent a better investment than using the money to purchase additional transport vehicles. However, as health care evolves, EMS must innovate and adapt so it can continue to meet the prehospital needs of the public in a timely and cost-effective manner.

European Journal of Operational Research, 2019

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World population keeps growing up and injuries related death statistics is increasing. Optimizing healthcare logistic processes became then a vital need to lead patient cares to higher performances. Moreover, Worldwide healthcare systems are facing the challenge of the sophistical facilities rising costs as well as patients' requirement of high-quality care at lower cost. In the other hand, undetected behaviors of citizens and environmental constraints are influencing the quality of deployment which amplifying the response time threshold. In the present paper, we regulate vehicles capacities to optimize patients picking for each incident nature. We proposed also a dynamic vehicle relocation and routing using a decision making processes. We are considering for each decision to take, the aspect of the variable emergency constraints influence to satisfy different scenarios of daily life.

1979

This volwne reports on the status of a cooperative effort by staff members of departments of the City of Austin and students and faculty at The University of Texas at Austin • to develop a plan for deployment of emergency medical service (EMS) vehicles in Austin, Texas. This work was carried out •during the 1978-79 school year in a Policy Research Project (PRP) at the Lyndon B. Johnson School of Public Affairs with the financial support of The University of Texas at Austin, the City of Austin, and the Ford Foundation. This swnmary briefly describes the four volumes of materials developed by the PRP members. EMS SERVICES IN AUSTIN Although ambulanees have operated in Austin for many. • years, a City-managed emergency medical service is of recent origin. The City of Austin created a Department of Erner, gency Medical Services as a separate administrative unit ' through aii ordinance passed by the City Council on January 16, 1975. The purpose of the new department is:. .. to provide on a twenty-four hour a day basis necessary emergency medical personnel, facilities, and equipment to effectively respond to individual needs in the Cit}' of Austin for inimediate medical. ... (l) The ordinance also created an Emergency Medical Services Quality Assurance Team to serve as an advisory body to the City Countil. The team periodically advises ... the City Manager, the Director of the Department of Emergency Medical Services, and the City Council concerning ng planning, reviewing, and evaluating the operations, performance, and procedures of the Department of Emergency Medical Services and is privileged to recommend professional performance standards for the Department. (2) On July 31, 1975, the Austin City Council reaffinned its commitment through a motion supporting a separate EMS Department. The Council authorized the City Manager to implement the motion as quickly as possible. After a brieftiansitio'n period from private Austin ambulance services, the Department of Emergency Medical Services began full ,city-wide operation on January 1, 1976. EMS, Volume I Key *This data is different from the coded call data described in reference (2).

1979

This volwne reports on the status of a cooperative effort by staff members of departments of the City of Austin and students and faculty at The University of Texas at Austin • to develop a plan for deployment of emergency medical service (EMS) vehicles in Austin, Texas. This work was carried out •during the 1978-79 school year in a Policy Research Project (PRP) at the Lyndon B. Johnson School of Public Affairs with the financial support of The University of Texas at Austin, the City of Austin, and the Ford Foundation. This swnmary briefly describes the four volumes of materials developed by the PRP members. EMS SERVICES IN AUSTIN Although ambulanees have operated in Austin for many. • years, a City-managed emergency medical service is of recent origin. The City of Austin created a Department of Erner, gency Medical Services as a separate administrative unit ' through aii ordinance passed by the City Council on January 16, 1975. The purpose of the new department is:. .. to provide on a twenty-four hour a day basis necessary emergency medical personnel, facilities, and equipment to effectively respond to individual needs in the Cit}' of Austin for inimediate medical. ... (l) The ordinance also created an Emergency Medical Services Quality Assurance Team to serve as an advisory body to the City Countil. The team periodically advises ... the City Manager, the Director of the Department of Emergency Medical Services, and the City Council concerning ng planning, reviewing, and evaluating the operations, performance, and procedures of the Department of Emergency Medical Services and is privileged to recommend professional performance standards for the Department. (2) On July 31, 1975, the Austin City Council reaffinned its commitment through a motion supporting a separate EMS Department. The Council authorized the City Manager to implement the motion as quickly as possible. After a brieftiansitio'n period from private Austin ambulance services, the Department of Emergency Medical Services began full ,city-wide operation on January 1, 1976. EMS, Volume I Key *This data is different from the coded call data described in reference (2).

Knowledge Based Systems, 2014

The main objective of emergency medical assistance (EMA) services is to attend patients with sudden diseases at any possible location within an area of influence. This usually consists in providing "in situ" assistance and, if necessary, the transport of the patient to a medical centre. The potential of such systems to reduce mortality is directly related to the travel times of ambulances to emergency patients. An efficient coordination of the ambulance fleet of an EMA service is crucial for reducing the average travel times. In this paper we propose mechanisms that dynamically improve the allocation of ambulances to patients as well as the redeployment of available ambulances in the region under consideration. We test these mechanisms in different experiments using historical data from the EMA service of the Autonomous Region of Madrid in Spain: SUMMA112. The results empirically confirm that our proposal reduces the average response times of EMA services significantly.

Socio-Economic Planning Sciences

Providers of Emergency Medical Services (EMS) are typically concerned with keeping response times short. A powerful means to ensure this, is to dynamically redistribute the ambulances over the region, depending on the current state of the system. In this paper, we provide new insight in how to optimally (re)distribute ambulances. We study the impact of (1) the frequency of redeployment decision moments, (2) the inclusion of busy ambulances in the state description of the system, and (3) the performance criterion on the quality of the distribution strategy. In addition, we consider the influence of the EMS crew workload, such as (4) chain relocations and (5) time bounds, on the execution of an ambulance relocation. To this end, we use trace-driven simulations based on a real-life dataset of ambulance providers in the Netherlands. In doing so, we differentiate between rural and urban regions, which typically face different challenges when it comes to EMS. Our results show that: (1) taking the classical 0-1 performance criterion for assessing the fraction late arrivals only differs slightly from taking expert-opinion based S-curve for evaluating *

International Journal of Innovation in Engineering (IJIE), 2021

In this study, two mathematical models have been developed for assigning emergency vehicles, namely ambulances, to geographical areas. The first model, which is based on the assignment problem, the ambulance transfer (moving ambulances) between locations has not been considered. As ambulance transfer can improve system efficiency by decreasing the response time as well as operational cost, we consider this in the second model, which is based on the transportation problem. Both models assume that the demand of all geographical locations must be met. The major contributions of this study are: ambulance transfer between locations, day split into several time slots, and demand distribution of the geographical zone. To the best of our knowledge the first two have not been studied before. These extensions allow us to have a more realistic model of the real-world operation. Although, in previous studies, maximizing coverage has been the main objective of the goal, here, minimizing operating costs is a function of the main objective, because we have assumed that the demand of all geographical areas must be met.

Hukum perdata adalah salah satu macam dari dua jenis hukum yang ada di Indonesia. Salah satu cara bagaimana masyarakat luas bisa mengetahui hukum-hukum di Indonesia adalah dengan kita membuat sebuah tulisan yang berhubungan dengan hukum. Ada beberapa jenis hukum di Indonesia. Pengertian hukum sendiri adalah sebuah peraturan-peraturan atau kaedah yang tertulis maupun secara lisan. Namun di Indonesia hukum yang diterapkan adalah hukum secara terlulis. Hukum di Indonesia sangat berpengaruh terhadap masalah-masalah di negara Indonesia sendiri, tanpa adanya hukum di Indonesia, negara Indonesia bisa menjadi negara yang sangat tidak ada aturannya. Oleh karena itu, hukum di Indonesia di buat peraturan-peraturan untuk menciptakan suatu kedamaian dan untuk mencegah adanya perselisihan yang biasa disebut dengan hukum.