Pre-hospital care is provided by emergency medical services (EMS) staff, the initial health care providers at the scene of disaster. This study aimed to describe the characteristics of EMS callers and space-time distribution of emergency requests in a large urban area. Descriptive thematic maps of EMS requests were created using an empirical Bayesian smoothing approach. Spatial, temporal and spatio-temporal clustering techniques were applied to EMS data based on Kulldorff scan statistics technique. Almost 225,000 calls were registered in the EMS dispatch centre during the study period. Approximately two-thirds of these calls were associated with an altered level of patient consciousness, and the median response time for rural and urban EMS dispatches was 12.2 and 10.1 minutes, respectively. Spatio-temporal clusters of EMS requests were mostly located in central parts of the city, particularly near the downtown area. However, high-response time clustered areas had a low overlap with these general, spatial clusters. This low convergence shows that some unknown factors, other than EMS requests, influence the high-response times. The findings of this study can help policymakers to better allocate EMS resources and implement tailored interventions to enhance EMS system in urban areas.
Background: This study was aimed to improve the information adequacy of clinical Morning Reports by developing a structured reporting model. Methods: This study was a qualitative research conducted in three phases at the Obstetrics and Gynecology Department of three educational hospitals in northeastern Iran. After investigating the current status of MR sessions, the content of 120 reports were included extracted. The items were assigned subject groups for primary structuring while their validation getting confirmation using a two-round Delphi technique involving 10 specialists. Then, the structured model of clinical MRs was developed in two formats: structured paper-based form (SPF) and structured electronic format (SEF). The final evaluation was conducted comparing three practices of SPF, SEF, and conventional formats.Results: All studied MR samples were found unstructured in content. From 120 collected samples, 58 items were extracted and categorized into four categories. During the first Delphi round, all existing information were preserved with varying weights. but the participating experts also suggested six additional items to be included. In the second round, 11 items with the lowest scores were removed. Results of the comparative evaluation showed that the SPF format scored highest on the preference of use, ease of archiving and retrieval, application in future research, and ease of reporting. The SEF format scored highest on the clear understanding of patient status and readability.Conclusion: Using a standardized structured morning report based on the preference of local experts improves the quality of morning reports in various matters including efficiency, adequacy, and ease.
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