Actual vs perceived EMS response time

Perception and Satisfaction of Patients’ Relatives Regarding Emergency Medical Service Response Times: A Cross-Sectional Study

Purpose

Delays in emergency medical service (EMS) directly affect life-threatening emergencies. Delays also indirectly affect the perception and satisfaction of patients and their relatives, which are important qualitative EMS indicators.

Patients and Methods

For this cross-sectional study, data was collected from May 1 to July 31, 2021, through questionnaires developed by the authors. The study sample consisted of relatives of EMS patients. The primary objective was the perceived EMS response time, which was compared to the actual EMS response time. The secondary objective was the relatives’ perceptions and feelings regarding the waiting time.

Results

During study period, the sample was 165 relatives of patients managed by EMS. The mean perceived EMS response time of 18.28 ± 8.10 min was significantly longer than the mean actual response time of 14.44 ± 4.86 min (p < 0.001). The positive correlation between the perceived and actual times was low but statistically significant (p < 0.001) with a correlation coefficient of 0.315 (95% CI 0.170–0.446). The overall satisfaction level was high (\documentclass[12pt]{minimal} \usepackage{wasysym} \usepackage[substack]{amsmath} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage[mathscr]{eucal} \usepackage{mathrsfs} \DeclareFontFamily{T1}{linotext}{} \DeclareFontShape{T1}{linotext}{m}{n} {linotext }{} \DeclareSymbolFont{linotext}{T1}{linotext}{m}{n} \DeclareSymbolFontAlphabet{\mathLINOTEXT}{linotext} \begin{document} $$\overline {\rm{x}} \,{\rm{ = }}\,{\rm{4}}{\rm{.47}}$$ \end{document}, standard deviation 0.63). The mean perceived EMS response time compares with the high-to-highest satisfaction levels of relatives was significantly lower than the mean perceived EMS response time compares with the lowest-to-middle satisfaction levels of relatives (17.83 ± 8.05 and 22.50 ± 7.47 min, respectively; p = 0.028).

Conclusion

The perceived EMS response time was longer than the actual response time, with a low correlation. However, the relatives’ overall satisfaction level was high.

Postal survey methodology to assess patient satisfaction in a suburban emergency medical services system: an observational study

BACKGROUND

Patient satisfaction is of growing importance to providers of emergency medical services (EMS). Prior reports of patient satisfaction have frequently used resource-intensive telephone follow-up to assess satisfaction. We determine the feasibility of using a single mailing, anonymous postal survey methodology for collecting patient satisfaction data from a suburban EMS system.

METHODS

Patients transported between January 2001 and December 2004 were mailed a brief satisfaction questionnaire. The questionnaire was printed on a pre-addressed, postage paid postcard and consisted of five questions that used a five-point Likert scale to assess satisfaction with EMS personnel and services provided. Three open-ended questions assessed concerns, the most important service provided, and methods for improving service. Survey response rate was the primary outcome of interest. The Chi-square test was used to compare rates between years.

RESULTS

The survey required about 6 man hours and cost about $70 per month. Overall response rate was 32.0% (857/2764; 95CI 30.3% - 33.9%). During the first year, response rate was 42.6% (95CI 38.5% - 46.8%), but was significantly lower in subsequent years (29.0% in year 2, 30.8% in year 3, and 27.6% in year 4, p < 0.05). There were 847/851 respondents (99.5%) who were satisfied or very satisfied with their EMS experience. Three patients felt the service was adequate and one was very unsatisfied. Open-ended questions suggested that interpersonal communications were the single most important contributor to patient satisfaction. Patients also reported that response times and technical aspects of care were important to them.

CONCLUSION

Postal surveys for assessing patient satisfaction following EMS transport can achieve comparable response rates to similar surveys in other health care settings. Response rates did not decline after the second year of patient surveys, suggesting some stability after the initial year. Interpersonal communication was determined to be the single most important contributor to patient satisfaction.

Customer satisfaction in a large urban fire department emergency medical services system

OBJECTIVES

The purpose of this study was to determine if emergency medical services (EMS) customer satisfaction could be assessed using telephone-survey methods. The process by which customer satisfaction with the EMS service in a large, fire department-based EMS system is reported, and five month results are presented.

METHODS

Ten percent of all patients transported during the period of October 15, 2001, through March 15, 2002, were selected for study. In addition, during the same period, all EMS incidents in which a patient was not transported were identified for contact. Customer-service representatives contacted patients via telephone and surveyed them from prepared scripts.

RESULTS

A total of 88,528 EMS incidents occurred during the study period. Of these, 53,649 resulted in patient transports and 34,879 did not. Ten percent of patients transported (5,098) were selected for study participation, of which 2,498 were successfully contacted; of these, 2,368 (94.8%) reported overall satisfaction with the service provided. Of the 34,879 incidents without transport, only 5,859 involved patients who were seen but not transported. All of these patients were selected for study. Of these, 2,975 were successfully contacted, with 2,865 (96.3%) reporting overall satisfaction. The most common reason given for nonsatisfaction in both groups was the perception of a long response time.

CONCLUSIONS

It is possible to conduct a survey of EMS customer satisfaction using telephone-survey methods. Although difficulties exist in contacting patients, useful information is made available with this method. Such surveys should be an integral part of any EMS system's quality-improvement efforts. In this survey, the overwhelming majority of patients, both transported and not transported, were satisfied with their encounter with EMS.

Outcomes research and emergency medical services for children: domains, challenges, and opportunities

Outcomes research focuses on the end results of medical care. This paper describes the specific domains of outcomes research, namely, clinical effectiveness, quality of care, quality of life, patient satisfaction, cost-effectiveness, and organization of care, which are the primary domains of outcomes research. Specific examples of pediatric emergency medicine applications are provided for each domain. Outcomes research in the clinical specialties of pediatrics, emergency medicine, and emergency medical services is in an early stage of development relative to that of adult medicine. Thus, the intersection of these clinical specialties, pediatric emergency medicine, presents many challenges and opportunities.

Delays in the EMS response to and the evacuation of patients in high-rise buildings in Singapore

BACKGROUND

Singapore is a highly urbanized and cosmopolitan city situated at the crossroads of Southeast Asia. High-rise buildings and "vertical living" are common, and the city serves as a major business, financial, and industrial hub in the region. More than 80% of the population live in high-rise apartments. This poses unique problems and challenges for emergency ambulance services personnel in the access to and evacuation of patients.

OBJECTIVE

To estimate the arrival-to-patient contact delay when accessing patients in high-rise buildings and evacuating them to the hospital, compared with accessing patients in ground-level premises.

METHODS

This was a prospective study carried out from February 2 to March 1, 1998, for emergency calls from two of the busiest fire stations. The first 150 consecutive cases were enrolled into each of the two groups. Cases of road traffic accidents were excluded because these did not require the crew to get into a building. The times were clocked by one of the paramedics, using a stopwatch. A high-rise building was defined as one where the crew had to ascend at least one flight of stairs. A ground-level building did not involve any stair climbing. We set forth to determine whether the interval between the following was statistically significant when comparing high-rise vs ground-level premises: 1) time when the ambulance arrives at the scene (taken as the time when the driver turns the engine off) and time of arrival at the patient's side; 2) time of leaving the dwelling with the patient and time when the ambulance starts its journey to the hospital (taken as the time when the driver starts the engine). Data analysis was done with the use of SPSS, and the one-tailed unpaired Student's t-test was used for significance testing, with the alpha error rate set at 0.05. Results. One hundred fifty runs were analyzed for each group. The mean delay from arrival to patient contact was 2.49 +/- 0.98 minutes for the high-rise group compared with 1.02 +/- 1.41 minutes for the ground-level group (difference was statistically significant with 95% CI: 1.20, 1.74 minutes; p = 0.0106). The mean delays from the time of leaving the building with the patient to the time when the ambulance turned its engine on to start its journey to the hospital were 3.24 +/- 1.58 minutes and 1.27 +/- 0.71 minutes for the two groups, respectively (difference was statistically significant with 95% CI: 1.68, 2.04 minutes; p = 0.0098).

CONCLUSION

There were significant delays present when accessing patients in high-rise buildings and evacuating them to the hospital. Modification to buildings and increasing public awareness and education have been suggested to help minimize these delays.