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RURALSIM: the design and implementation of a rural EMS simulator
L J Shuman1, H Wolfe, M J Gunter
1University of Pittsburgh, PA.
Journal of the Society for Health Systems
|January 1, 1992
Summary
Simulation technology for Emergency Medical Services (EMS) planning faced significant barriers due to political factors and limited regional commitment. These challenges, including localism and resistance to standards, hindered the successful implementation of complex simulation models like RURALSIM.
Area of Science:
- Health Services Research
- Public Policy Analysis
- Simulation Modeling
Background:
- Emergency Medical Services (EMS) planning in the early 1980s faced challenges in adopting advanced technologies.
- Limited regional commitment and political factors created significant barriers to implementing simulation tools.
Purpose of the Study:
- To analyze the reasons for the unsuccessful application of simulation technology in EMS planning.
- To identify political and systemic barriers hindering the development of regional EMS systems.
Main Methods:
- Evaluation of four field tests using the RURALSIM simulation model.
- Analysis of political factors, local government attitudes, and inter-agency cooperation.
- Assessment of the complexity and usability of the RURALSIM simulator.
Main Results:
- Parochialism, volunteer-based planning, and limited regional commitment were key barriers.
- Political factors such as funding concerns, opposition to regulation, and jurisdictional disputes significantly impeded progress.
- The RURALSIM model's complexity required extensive tailoring and expert support, limiting its independent use.
Conclusions:
- Successful regional EMS system development was hindered by local opposition and a lack of authority among planners.
- Political and structural issues, rather than the simulation technology itself, were the primary reasons for implementation failures.
- Improved simulation languages and increased face-to-face interaction could potentially mitigate some implementation challenges in future EMS planning efforts.