A Time-Motion Study of the Emergency Medical Services Turnaround Interval

Area of Science:

• Emergency Medicine
• Health Services Research
• Operations Research

Background:

• Ambulance availability is critical for overall emergency medical services (EMS) system response.
• The EMS turnaround interval, from hospital arrival to returning in service, directly impacts resource availability.
• Understanding and optimizing this interval is key to enhancing EMS system efficiency.

Purpose of the Study:

• To prospectively study the EMS turnaround interval in a large urban EMS system.
• To analyze the duration and variability of subintervals within the turnaround process.
• To assess the accuracy of radio-reported availability compared to observed times.

Main Methods:

• A prospective time-motion study was conducted using an on-site observer at a university hospital emergency department.
• EMS radio traffic was monitored to record ambulance delivery and recovery activities.
• Data on patient delivery, emergency department (ED) entry, patient placement, verbal reports, and call report documentation were collected and analyzed.

Main Results:

• The mean time for ambulance call report documentation was 17 minutes and 12 seconds, representing the longest subinterval.
• Significant discrepancies were observed between radio-reported and actual times for both ambulance arrival and departure.
• The overall turnaround interval and its subintervals exhibited wide variability, with a mean time off radio of 29 minutes and 51 seconds.

Conclusions:

• Ambulance call report documentation is the primary determinant of the EMS turnaround interval.
• The wide variability and poor correlation of radio-reported times with observed events challenge efforts to actively manage and improve system response.
• Reliance on inaccurate radio-reported availability may impede effective management of EMS resources.