References
Organisational structural predictors of ambulance crashes: an analysis
Abstract
Objective: This study investigated the association between three organisational structural factors—organisational type, organisation status (staffing model), and level of service—and ambulance crash rates. The null hypothesis was that there would be no difference in ambulance crash rates during response or transport between any of the three factors. Methods: A cross-sectional design with a sample drawn from the 2019 National Emergency Medical Services Information System dataset was used to examine the relationship between these systems-level factors and ambulance crashes. After applying inclusion criteria, a sample of 2207 cases was drawn and analysed using the χ2 test of association and multiple logistic regression. Results: There was a statistically significant but small association between level of service and ambulance crashes during transport, using the χ2 test of association (
Emergency medical services (EMS) is a healthcare specialty concerned with delivering prehospital emergency medical care and transporting patients to the hospital for further care (Office of EMS, 2021). In the United States, EMS workers include emergency medical technicians (EMTs), paramedics and others who work in fire departments, hospitals, non-fire-based governmental agencies, private companies and tribal departments. The EMS workforce of any of these organisations may be paid, volunteer or a mix of the two.
When responding to a scene of injury or illness and when transporting patients to the hospital, EMS workers often use lights and sirens (L&S) to signal traffic to yield to them to expedite their transit. Industry practice prioritises the rapid transport of patients to the hospital, based on the golden hour concept, attributed to R Adams Cowley, the founder of Baltimore's Shock Trauma Institute (Rogers et al, 2015). Cowley asserted that a trauma patient has the best chance of survival if they receive definitive care within 60 minutes of injury. This concept has led to an emphasis on rapid response and transport of trauma patients by EMS agencies, despite a lack of evidence supporting this (Newgard et al, 2010).
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