Determining response time factors of emergency medical services during the COVID-19 pandemic

Abstract

PurposeThe lack of studies about the response time of emergency medical service during the coronavirus disease 2019 (COVID-19) pandemic in a dense city of a developing country has triggered this study to explore the factors contributing to a high response time of ambulance service to reach patients in need. An evaluation of contributing factors to the response time is necessary to guide decision-makers in keeping a high service level of emergency medical service.Design/methodology/approachThis research employed an agent-based modeling approach with input parameters from interviews with emergency medical service staff in Bandung city, Indonesia. The agent-based model is established to evaluate the relevant contribution of the factors to response time reduction using several scenarios.FindingsAccording to agent-based simulation, four factors contribute to the response time: the process of preparing crew and ambulance during the pandemic, coverage area, traffic density and crew responsiveness. Among these factors, the preparation process during the pandemic and coverage area significantly contributed to the response time, while the traffic density and crew responsiveness were less significant. The preparation process is closely related to the safety procedure in handling patients during the COVID-19 pandemic and normal time. The recommended coverage area for maintaining a low response time is 5 km, equivalent to six local subdistricts.Research limitations/implicationsThis study has explored the factors contributing to emergency medical response time. The insignificant contribution of the traffic density showed that citizens, in general, have high awareness and compliance to traffic priority regulation, so crew responsiveness in handling ambulances is an irrelevant factor. This study might have different contributing factors for less dense population areas and focuses on public emergency medical services provided by the local government.Practical implicationsThe local government must provide additional funding to cover additional investment for ambulance, crew and administration for the new emergency service deployment point. Exercising an efficient process in ambulance and crew preparation is mandatory for each emergency deployment point.Originality/valueThis study evaluates the contributing factors of emergency medical response time in the pandemic and normal situation by qualitative analysis and agent-based simulation. The performance comparison in terms of medical response time before and after COVID-19 through agent-based simulation is valuable for decision-makers to reduce the impact of COVID-19.

Emergency medical service interventions and experiences during pandemics: A scoping review

“…In addition, four studies were mixed-methods [ 10 – 13 ] that involved both a quantitative and qualitative design. One of these studies [ 11 ] used interviews only to describe the model for the deployment process of EMS procedures and, as such, only the quantitative arm of this study will be included in this review. In addition, only the qualitative arm of the study by Petrie and colleagues [ 12 ] will be included in this review, as their quantitative arm did not meet our inclusion criteria.…”

“…Call volumes , ambulance response times and triage (logistics of service delivery) . Twenty five studies (34.2%) [ 11 , 24 , 54 – 76 ] looked at the impact of the COVID-19 pandemic on EMS utilisation and how implementing a variety of COVID-19-related interventions (such as changing coding calls and protocols for assessment or care; developing coronavirus EMS support tracks or web-based self-triage systems, etc.) affected EMS utilisation.…”

“…Other studies, however, found less positive results related to a sustained increase of EMS calls [ 58 , 69 , 70 , 73 ], queue times (though the significant increase in the total EMS call volume was mitigated by the implementation of a coronavirus EMS support track) [ 60 ], EMS dispatches [ 69 , 73 ], EMS processing times [ 62 ], prehospital times (except for the scene time of cardiac arrest patients) [ 68 ], and response times/interval [ 70 , 72 ]. Mulyono and colleagues [ 11 ], employing an agent-based simulation model, found that the main factors contributing to increased response times were the process of preparing crew and ambulance during the pandemic (relating to the safety procedure in handling patients), service coverage area, traffic density and crew responsiveness. The recommended coverage area for maintaining a low response time was 5 km.…”

Effect of the pandemic on prehospital management of patients with mental and behavioral disorders: a retrospective cohort study

“…Additionally, EMS teams as well as ED physicians have assumed new and varied healthcare roles during the pandemic, owing to the overall increased healthcare needs. Provision of vaccinations, managing COVID-19 admissions, and caring for post-COVID-19 sequelae belong to the new spectrum of conditions being managed by most specialties, especially internists, pneumologists, and intensive care unit personnel, all specialties commonly involved in the emergency rooms ( 38 , 39 ). It is essential to note that the COVID-19 pandemic has had a significant impact on the mental health of EMTs, resulting in elevated levels of stress and anxiety ( 40 ), which have led to decreased self-efficacy and sleep quality ( 41 ).…”