Supporting decision making to improve the performance of an Italian Emergency Medical Service

Abstract

An Emergency Medical Service (EMS) plays a fundamental role in providing good quality health care services to citizens, as it provides the first answer in distressing situations. Early response, one of the key factors in a successful treatment of an injury, is strongly influenced by the performance of ambulances, which are sent to rescue the patient. Here we report the research carried on by the authors on the ambulance location and man- agement in the Milano area (Italy), as a part of a wider research project in collaboration with the EMS of Milano and funded by Regione Lombardia. The questions posed by the EMS managers were clear and, at the same time, tricky: could decision making tools be applied, based on the currently available data, to provide suggestions for decision makers? To an- swer such a question, three different studies have been carried on: first the evaluation of the current EMS system performance through statistical analysis; then the study of operational policies which can improve the system performance through a simulation model; and finally the definition of an alternative set of posts through an optimization model. This paper describes the methodologies underlying such studies and reports on how their main findings were crucial to help the EMS in changing its organization model

Understanding the concept of ‘demand’ in policing: a scoping review and resulting implications for demand management

“…As such, studies from other fields may be useful in bridging this gap in the literature, as resource modelling is further advanced for other emergency services (see e.g. Mendonça and Morabito 2001, de Souza et al 2015, Zeinali et al 2015, Aringhieri et al 2016.…”

Response time in the emergency services. Systematic review

“…The World Health Organization has defined provision of basic life support to all risk situations involving people and goods as a main objective of Emergency Medical Services (EMS) 5 . EMS is included in this discussion as they are responsible for the provision of acute prehospital care for patients with illnesses and injuries and have a key role to providing quality services to people, minimizing the degree of lesions and even the death toll 6 . The response time of EMS is a fundamental factor for prehospital care to be successful and, therefore, must be controlled in order to increase the chances of survival 7 .…”

“…Response time is the main indicator of this service. It is defined as the time between notification of an occurrence and respectively [6][7][8] . Throughout the time, there was a tendency of growth of the publications that addressed in its scope the time of response of EMS.…”

Policy analysis and policy analytics

“…Healthcare and medical services are also important areas for policy analytics, with several papers in this volume. The first one is by Aringhieri et al (2015) who study the problem of organizing emergency medical services in Milan. They develop a simulation model for ambulance dispatch and a more strategic model to calculate the size of the ambulance fleet needed to serve given demand and discuss how these problems can be designed.…”