Wynand Van Der Net, Craig Vincent-Lambert, Kevin Govender

Emergency Medical Service response and mission times in an African metropolitan setting

Introduction

Emergency medical service response and mission times in an african metropolitan setting . Explore EMS response & mission times in a South African metropolitan setting. Discover how lengthy delays impact patient care and crucial ambulance availability.

Abstract

Background: Emergency Medical Services (EMS) aim to respond to emergencies, treat and transport patients efficiently thus ensuring the ambulance call or “mission” is completed with ambulances available to service the next call as soon as possible. A typical mission may be divided into activities, each linked to a set time interval. The response time interval starts from the time a call is received by the call centre until the ambulance arrives on scene. The patient care interval includes the time taken to treat and transport the patient to hospital. The total mission time can be viewed as the time from when a call is first received by the call centre until the ambulance dispatched to that incident is again available to service the next call. The aim of this study was to describe response interval, patient care interval and total mission times routinely associated with servicing emergency incidents within a metropolitan public sector EMS in South Africa. Methods: A quantitative, prospective, descriptive design was followed wherein time intervals associated with 784 missions were analysed to document and describe response time interval, patient care interval and total mission times. Results: On average crews took 0h 23:16 to respond to incidents before spending an additional 0h 43:20 treating and transporting their patients. Lengthy delays were noted between arrival at hospital andcrews booking available for the next call. This led to total mission times averaging 2h 11:00. Conclusion: Average response and patient care time intervals noted in our study were longer than national and international norms and standards. Delays between arrival at hospital and crews booking available to service the next call led to average mission times of over 2 hours. This negatively impacts on availability of ambulances. Further studies are recommended to explore factors that may be contributing to the lengthy response and mission times reported in this study.

Review

This paper, "Emergency Medical Service response and mission times in an African metropolitan setting," offers a pertinent and valuable examination of operational efficiency within a public sector EMS in South Africa. The authors clearly outline their objective to describe response, patient care, and total mission times, which are essential metrics for evaluating and improving emergency healthcare delivery. The study's findings reveal significant operational challenges, specifically that average response and patient care intervals surpass national and international standards. Crucially, the research identifies substantial delays between ambulance arrival at the hospital and crews becoming available for the next call, leading to total mission times averaging over two hours. This work contributes meaningfully to the sparse literature on EMS performance in African urban environments, providing a critical data point for understanding system bottlenecks. The methodological approach, a quantitative, prospective, descriptive design analyzing 784 missions, is appropriate for the study's aim of documenting and describing these time intervals. This substantial sample size lends credibility to the reported averages for response (0h 23:16), patient care (0h 43:20), and total mission times (2h 11:00). The clear articulation of these distinct time intervals allows for a precise understanding of where inefficiencies occur. While the abstract clearly highlights *that* these "lengthy delays were noted between arrival at hospital and crews booking available," a more detailed breakdown within the main paper of the *specific components* of these delays (e.g., patient handover, documentation, cleaning, crew rest) would greatly enhance the utility of these findings for targeted interventions. Without this detail, the exact points for improvement remain somewhat obscured despite the strong statistical evidence. The implications of these extended mission times are profound, directly impacting ambulance availability, resource allocation, and potentially patient outcomes in this metropolitan setting. The conclusion that these times negatively affect ambulance availability is well-supported by the data. The recommendation for further studies to explore factors contributing to these lengthy times is highly pertinent. Future research should delve into the root causes of the post-hospital arrival delays, investigating aspects such as hospital offload delays, inadequate staffing, administrative processes, or inter-agency communication issues. This foundational study provides a robust empirical basis for advocating for policy changes and operational improvements aimed at enhancing EMS efficiency and ensuring better resource utilization in comparable contexts.

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