Category Archives: Uncategorized

The Role of Response Time in EMS Performance

Several months ago, Rob Lawrence of the Richmond Ambulance Authority started a thread on the High Performance EMS Group of LinkedIn by asking “So what does the phrase ‘High Performance EMS’ mean to you?? This innocent sounding question sparked immediate debate even within the small group at that time. Benjamin Podsiadlo of AMR quickly tied the quality of EMS performance to “experience? and “outcomes? stating further that “response time is not an evidence based factor in ALS performance.? He later backed up his assertion by writing that “the catch 22 of pushing the workforce to be responsible and accountable drivers while simultaneously achieving narrow response time goals to the vast majority incidents that have no medical need for such high speed driving is also a bizarre and irresponsible contradiction.? This is a point that even Lawrence admits could foster the “mentality of ‘arrive on time and the patient dies – good outcome, arrive late and the patient lives – bad outcome’? that has already been affecting common sense both in the UK and increasingly in the US since NFPA 1710 set response time standards several years ago.

While there were other good comments, I would like to focus on the specific assertion that measuring response time (a well established practice today such as at Huron Valley Ambulance’s public web Performance Dashboard) is not an “evidence-based? practice. There are many specific accounts of individual lives saved that I have heard mentioned by different agencies, but I will concede that the plural of “anecdote? is not “data?. However, one of the best stories of response time saving lives was made on February 9 when Richard Sposa of Jersey City Medical Center EMS discussed an interesting finding in a recent webcast. The chart reproduced here shows a correlation between

Return of Spontaneous Circulation vs. Response Time

response time and the Return of Spontaneous Circulation (ROSC). This unexpected finding clearly traced an upward trend of ROSC with the decline in Average Response Time for Priority 1 Calls graphed quarterly from the beginning of 2005 to the end of 2007. This is a verified statistical trend (Mount Sinai Hospital reviewed these findings) and I suggest you click to view the graph in full detail. This shows not just living anecdotes, but a statistical increase patients with restored heartbeats.

Many things about our business can and should be questioned, but this is exactly the sort of evidence I would like to see investigated at other services. Can what Jersey City Medical Center is experiencing be reproduced elsewhere? And probably more importantly, does fast response necessarily mean “high speed driving??

The point of System Status Management (SSM) is that ambulances can be effectively pre-positioned through scientific statistical forecasting in order to reduce the time of a response even without driving faster to the call.  Zoll Software Solutions, as an example, considers the elimination of inefficiencies to be a core component for closing the loop on your dispatch process and is even offering free medical equipment to customers who use this technology to improve their system. One customer who has done this already with Zoll technology is Grand Rapids who was also featured in the following FOX News video on Predicting Where your Next Emergency will Happen.

If you believe that knowing where your next calls are likely to come from in time to allow you to safely prepare for that response, the science is available today. You just need to be able to integrate that knowledge into your process.

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Filed under Dispatch & Communications, EMS Dispatch, EMS Topics, Opinion, Rescues, Technology & Communications, Uncategorized, Vehicle Operation & Ambulances

A New Look

Whether you have been one of our followers this past year or just found us recently, we appreciate your interest in High Performance EMS and our revised blog site. We are excited to now be a part of the FireEMS Blogs network and look forward to the possibility of reaching a larger audience and hearing from additional voices. Please bookmark the URL at http://HighPerformanceEMS.com in place of any previous addresses and visit back here often. You can expect to find conference reviews, technology updates, topical opinions, and profiles of High Performance EMS agencies along with links to key topics and constantly updated news feeds and tweets.

As an additional resource, we have a Solutions tab that links you to providers that enhance the capabilities of your EMS agency to become more efficient and effective in delivering prehospital care. This is not a paid advertisement listing, but an “invitation-only? section where vendors earn their inclusion by proving their value in successful implementations that show a positive return on investment. The Guest Blog tab provides information on how you can submit a posting to be considered for inclusion in this blog. There are some rules and we reserve the right to accept or reject content based on its perceived value to our community. If you want to learn more about why this blog was created and what we hope to accomplish, check out the About tab. If you have comments or suggestions, we love to hear those too. So feel free to post a comment anytime.

@hp_ems

There are also other ways to keep in touch with High Performance EMS topics and the discussion around them through various social media options. We are on Twitter and Facebook and would love to have you “follow? or “like? us to keep in touch.

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A New Look (and Updated URL)

Whether you have been one of our followers this past year or just found us recently, we appreciate your interest in High Performance EMS and our revised blog site. We are excited to now be a part of the FireEMS Blogs network and look forward to the possibility of reaching a larger audience and hearing from additional voices. Please be sure to click and bookmark the URL at http://HighPerformanceEMS.com in place of any previous addresses and visit back here often. You can expect to find conference reviews, technology updates, topical opinions, and profiles of High Performance EMS agencies along with links to key topics and constantly updated news feeds and tweets.

As an additional resource, we have a Solutions tab that links you to providers that enhance the capabilities of your EMS agency to become more efficient and effective in delivering prehospital care. This is not a paid advertisement listing, but an “invitation-only” section where vendors earn their inclusion by proving their value in successful implementations that show a positive return on investment. The Guest Blog tab provides information on how you can submit a posting to be considered for inclusion in this blog. There are some rules and we reserve the right to accept or reject content based on its perceived value to our community. If you want to learn more about why this blog was created and what we hope to accomplish, check out the About tab. If you have comments or suggestions, we love to hear those too. So feel free to post a comment anytime.

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Preparedness Reminder

I know that today is the last day of National Preparedness Month, but preparedness is not seasonal and these videos are great reminders of what we can do to be prepared for ourselves, our families, and our communities.  I hope you never need to know anything they teach, but ask that you look through them and take action anyway.  You never know when or where some sort of disaster or emergency can strike – Be Prepared!

Being prepared while traveling.

Being prepared at the office.

Preparing your family includes your pets.

FEMA Chief Craig Fugate Issues a Challenge

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Celebrate EMS Week

The dates for National EMS Week 2011 are May 15 thru May 21.  Thank a Paramedic or EMT today, but also consider going a step or two further with the following suggestions:

  • Become a “Fan” on the “National EMS Week” Facebook page at: http://www.facebook.com/National.EMS.Week.
  • “Like” our own Facebook presence for High Performance EMS where we are looking to help communicate news regularly about advanced pre-hospital care with a special focus on high economic efficiency to that community.
  • You can also follow @hp_ems on Twitter to keep up with news at no more than 140 characters at time throughout the year as well.
  • Consider adding to the conversation on this page by leaving comments to articles of interest encouraging others seeking to improve the EMS profession through EMS2.0 and NG911.

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