Alternative metrics to measure EMS system performance

abstract

In the development of strategy for the response to emergent incidents, emergency medical services (EMS) organizations must properly manage their resources while also adhering to response time mandates established by contractual agreements. Performance of an EMS system is typically measured by focusing on the response time of its first responders. However, given that some incidents require the response of multiple emergency vehicles, investigating only the initial response to incidents is inadequate. In this research, we propose two new metrics, in addition to the first response metric, to evaluate the performance of EMS operations: total response time and last responder response time. We develop three mixed integer programming formulations, each one focused on minimizing one of the three metrics, to model the assignment of emergency vehicles to incidents. We also propose a fourth model that combines the metrics via a weighted objective function. This model allows for the simultaneous consideration of the response metrics when evaluating the effectiveness of an emergency response dispatch policy. Experimental results, from comparisons of the models against a greedy dispatch policy, suggest the consideration of multiple response metrics leads to a more robust and effective dispatch policy. Finally, analysis using the models has potential to shape improved strategic and operational policies of EMS organizations. Journal of the Operational Research Society advance online publication, 29 June 2016; doi:10.1057/jors.2016.39

Keywords:

• OR in health services
• Integer programming
• Incident response

Dr Keskin’s research is supported through TUBITAK’s 2221 program.

Dr Keskin’s research is supported through TUBITAK’s 2221 program.

Acknowledgements

The authors wish to express their sincere thanks to the area editor and the two anonymous reviewers for constructive comments that improved the exposition of the paper.