Simulation of single start station for Edmonton EMS
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Simulation of single start station for Edmonton EMS A Ingolfsson*, E Erkut and S Budge University of Alberta, Edmonton, Canada The City of Edmonton’s Emergency Medical Services (EMS) department proposed to move to a ‘single start station system’ (SS system) in which all ambulances would begin and end their shifts at the same location. We developed a discrete event simulation model to estimate the impact of this change and subsequently used this model to explore other changes to Edmonton EMS operations, including the addition of stations, the addition of ambulances, different shifts, and a different redeployment system. We found that a SS system increased average unit availability and the fraction of calls reached within the department’s response time standard, particularly during the current shift changeover periods. The paper describes the development and validation of the simulation model and summarizes the results of its application. Journal of the Operational Research Society (2003) 54, 736–746. doi:10.1057/palgrave.jors.2601574 Keywords: simulation; emergency medical system; ambulance deployment; health service; single start station
Introduction A review1,2 of the City of Edmonton’s Emergency Medical Services (EMS) made several recommendations for operational changes, including a move to a single start station system (SS system) in which all ambulances begin and end their shift at the same location. This recommendation attracted our attention and we contacted the city to suggest further analysis. This led to the project described in this paper. Edmonton is a city in Western Canada with a population of 650 000 within the city limits. An additional 250 000 people live in neighbouring communities and many of them commute to the city each day, resulting in an average daytime population of 850 000.1 Currently, there are 10 EMS stations throughout the city where on-duty ambulances are located between calls, with paramedics beginning and ending their shifts at six of those stations. Depending on the time of day, between 14 and 20 ambulances operate concurrently. We will refer to the current multiple-start system as the ‘MS system’ or as the ‘status quo.’ We initially expected that a SS system might increase ambulance travel, which in turn could reduce service levels, compared to the current MS system with six different shift start locations. The review report1,2 and discussions with EMS staff indicated that the anticipated benefits of a SS system include the pooling of ‘spare’ ambulances in one location and the ability to use dedicated employees to clean, check, and restock ambulances. This would result in reduced *Correspondence: Ingolfsson, School of Business, University of Alberta, Edmonton, Canada AB T6G 2R6. E-mail: [email protected]
downtime at the beginning and end of a shift, since paramedics would no longer need to perform these tasks and because an ambulance would (almost) always be a
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