JMIR Publications

ABSTRACT

Background:

For nearly half a century, ambulance response times have been considered paramount for evaluating quality of service delivery. Advances in paramedic scope and changing perspectives about the risks associated with excessive use of speed are shifting historical norms and challenging traditional views about response times.

Objective:

We propose that geo-spatial specific response time benchmarks (defined as the estimated travel time from a point of origin, the paramedic station, to the destination, a pre-determined geographic location) may provide a novel approach that considers health equity in evaluating service quality. Our aim is to evaluate the feasibility of this approach through a series of inter-related comparisons.

Methods:

The following protocol describes a four-part series of observational studies to investigate new approaches to measuring ambulance response times. Part one acknowledges that a given response time is the function of a distance traveled at a rate of speed, using this function to generate a priori response time benchmarks. Part two compares different criteria used in the establishment of response time benchmarks. Part three uses response time benchmarks to evaluate system performance. Finally, part four makes comparison over time to evaluate the utility of benchmarks for detecting changes in service delivery.

Results:

We have identified publicly available data that will inform our analysis for 11 predominantly rural paramedic services. We anticipate that the multi-part analysis will generate multiple manuscripts to detail the respective findings from our work.

Conclusions:

Collectively, our investigations will challenge traditional assumptions about response time benchmarks and generate new insights about evaluating paramedic service delivery. We expect that our findings will provide a foundation to further explore alignment between service delivery and population changes and contribute to emergency planning and preparedness. While we are focusing our preliminary analysis on predominantly rural settings, future work may consider mixed urban-rural or predominantly urban settings. In bringing an equity lens to spatial analysis that explicitly captures the inherent differences between different communities, we will provide a useful context to what the populations of these different communities can expect when accessing paramedic services.