Keywords
communication technology
rural
urban
How to Cite
Abstract
Introduction: Ambulance response times are affected by several factors and play a critical role in the outcome of patients requiring urgent treatment. This article aims to highlight the response time differences within and outside Doha (Capital city of Qatar), identify causal trends in slower response times observed, and explore related technological advances.
Methods: High-priority response times were collected for a two-day period in three-hour time slots and categorised as urban or rural. The average response time within each time slot was analysed to determine trends and identify the worst peaks so communication logs between dispatchers and ambulance crews could be played back to determine the cause of the “delayed” response.
Results: Over the period analysed, 394 high-priority calls were received with an overall median average response time of five minutes 32 seconds. The average urban and rural setting response times were respectively five minutes 15 seconds (n = 311) and six minutes 22 seconds (n = 83). Radio communications of the highest median response time peaks for urban and rural response calls were analysed (n = 11): three with dispatchers giving directions, one crew reporting a physical obstruction preventing them from approaching the scene, and seven others containing no indication for the delayed response time.
Discussion: Over the period analysed, high-priority response time targets were met 100%. As expected, rural setting response times were usually longer than in the urban setting. The average response times appear longer on the second day (Tuesday) particularly in the afternoon in the urban setting, but there is otherwise no apparent trend between the two days over the different time slots. Ambulance crew familiarity with their environment and clear information by the caller play an important role in an ambulance reaching the scene quickly but new navigation and information sharing technology is expected to alleviate challenges faced at the time of the pilot study.
References
Sillitoe P. Sustainable Development: An Appraisal from the Gulf Region: Berghahn Books; 2014.
MDPS. Monthly figures on total population in Qatar 2016. Doha: Ministry of development planning and statistics; 2016. http://www.mdps.gov.qa/portal/ page/portal/gsdp_en/statistics_en/monthly_preliminary_figures_on_population_en. (last access 5/05/2016)
Gotting F. Healing hands of Qatar. 2nd ed. Doha, Qatar: F. Gotting, Dar Al Sharq Press, Qatar; 2006.
Hamad Medical Corporation Ambulance Service. HMCAS Homepage: HMC; 2017 http://as.hamad.qa/en/index.aspx (last access 4/02/2017).
Hamad Medical Corporation Ambulance Service. Standard Operating Procedures. Doha, Qatar: HMC, 2014.
Blackwell TH, Kaufman JS. Response time effectiveness: comparison of response time and survival in an urban emergency medical services system. Acad Emerg Med 2002; 9:288-95.
Gunst M, Ghaemmaghami V, Gruszecki A, Urban J, Frankel H, Shafi S. Changing epidemiology of trauma deaths leads to a bimodal distribution. Proceedings 2010; 23:349-54.
Kleber C, Giesecke MT, Tsokos M, Haas NP, Schaser KD, Stefan P, et al. Overall distribution of trauma-related deaths in Berlin 2010: advancement or stagnation of German trauma management? World J Surg 2012; 36:2125-30.
World Health Organization. Prehospital trauma care systems 2005 http://www.who.int/violence_injury_prevention/publications/services/39162_oms_new. pdf (last access 8/06/2015).
Wankhade P. Performance measurement and the UK emergency ambulance service: Unintended consequences of the ambulance response time targets. International J Public Sector Management 2011; 24:384-402.
NHS. Emergency and Urgent Care Services NHS UK Website 2015 http://www.nhs.uk/nhsengland/aboutnhsservices/emergencyandurgentcareservices/ pages/ambulanceservices.aspx (last access 7/06/2015).
Turner J, O’Keeffe C, Dixon S, Warren K, Nicholl J. The Costs and Benefits of Changing Ambulance Service Response Time Performance Standards Sheffield: University of Sheffield; 2006 http://www.shef.ac.uk/polopoly_fs/1.43652!/file/Cost-and-effectiveness-of-the-implementation-of-new-ambulance- response-time-standards.pdf (last access 7/06/2015).
OSHA. Emergency Services Review: Good Practice Guide for Ambulance Services and their Commissioners. Office of the Strategic Health Authorities, London , UK 2009 http://www.nhsimas.nhs.uk/fileadmin/Files/IST/ESR_Good_practice_guide_for_Ambulance_Services_and_their_commissioners.pdf (last access 5/05/2016).
O’Meara P, Boyle M. From roadside to hospital: A pilot study to investigate the factors influencing the time taken to deliver trauma patients to a regional hospital. Australasian J Paramed 2012; 6:5.
Gunnarsson B, Svavarsdóttir H, Dúason S, Sim A, Munro A, McInnes C, et al. Ambulance Transport and Services in the Rural Areas of Iceland, Scotland and Sweden. Australasian J Paramed 2012; 5:3.
Peleg K, Pliskin JS. A geographic information system simulation model of EMS: reducing ambulance response time. Am J Emerg Med 2004; 22:164-70.
Gunnarsson B, Svavarsdóttir H, Dúason S, Sim A, Munro A, McInnes C, et al. Ambulance Transport and Services in the Rural Areas of Iceland, Scotland and Sweden. J Emerge Primary Health Care 2007; 5:1-12.
Peyravi M, Ortenwal P, Djalali A, Khorram-Manesh A. An overview of shiraz emergency medical services, dispatch to treatment. Iran Red Crescent Med J 2013; 15:823-8.
Hutton D, Alinier G. Ambulance service operational improvement. Intl Paramedic Practice. 2013; 3:61-3.
Barnes TJ. Geography’s underworld: the military-industrial complex, mathematical modelling and the quantitative revolution. Geoforum 2008; 39:3-16.
Peters J, Hall GB. Assessment of ambulance response performance using a geographic information system. Soc Sci Med 1999; 49:1551-66.