Why the Closest Ambulance Cannot be Dispatched in an Urban Emergency Medical Services System
Why the Closest Ambulance Cannot be Dispatched in an Urban Emergency Medical Services System
复制标题
城市紧急医疗服务系统为何无法派出就近的救护车
DOI：
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发表时间：
2008
影响因子：
2.2
通讯作者：
S. Dean
中科院分区：
文献类型：
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作者：
S. Dean
摘要简介：响应时间的性能是一个相对较小的一组危重患者的生存率增加。由于成本效益和安全性的原因，有效地利用现有资源是所有紧急医疗服务（EMS）系统的挑战。问题：本研究的目的是确定在城市EMS系统中使用固定部署提高救护车响应时间性能的机会。研究方法：这是一个定性和定量的案例研究，其中包括结构化的采访，决策者，管理人员和工人在消防部门EMS部门，以及分析调度数据和观察调度操作。结果如下：目前的计算机辅助调度（CAD）系统不能识别离紧急情况最近的救护车，因此，当救护车不在其站点或“第一次到达”区域内时，调度员必须猜测哪个救护车更接近。没有办法跟踪调度员正确猜测的频率，或者最近的救护车实际上被派往紧急情况的频率。确定了时间和地理模式。还查明了通过使用动态部署和高峰负荷工作人员配置来改善响应时间绩效的机会。结论：结果表明，有机会改善救护车的响应时间，实施战略，如高峰负荷的人员配置和动态部署。然而，最重要的改进将是执行一项政策，派遣最近的救护车前往紧急情况。需要更多的研究，以确定如何普遍未能发送最近的救护车内EMS系统，使用fixeddeployment响应策略和计算机辅助调度系统，无法跟踪单位的位置以外的站。
Abstract Introduction: Response time performance is related to increased survival for a relatively small group of patients with critical emergencies. Effectively utilizing current resources is a challenge for all emergency medical services (EMS) systems for reasons of cost-effectiveness and safety. Problem: The objective of this study was to identify opportunities for improving ambulance response-time performance in an urban EMS system using fixed deployment. Methods: This was a qualitative and quantitative case study which consisted of structured interviews with policy makers, managers, and workers in a fire department EMS division, as well as analysis of dispatch data and observation of dispatch operations. Results: The current computer-aided dispatch (CAD) system does not identify the closest ambulance to the emergency, and therefore, dispatchers must guess which unit is closer when units are not within their stations or “first due” areas. There is no means to track how often dispatchers guess correctly or how often the closest ambulance actually is dispatched to the emergency. Temporal and geographic patterns were identified. Opportunities also were identified to improve response time performance through the use of dynamic deployment and peak-load staffing. Conclusions: The results suggest that there were opportunities for improving ambulance response times by implementing strategies such as peak-load staffing and dynamic deployment. However, the most important improvement would be the implementation of a policy to send the closest ambulance to the emergency. More research is needed to identify how prevalent the failure to send the closest ambulance is within EMS systems that use fixeddeployment response strategies and computer-aided dispatch systems that are incapable of tracking unit locations outside of their stations.