To properly serve the township, ambulance units must be located in a manner that best services all the residents. The location of ambulances is based on the concept of fractal, rather than average response times. Measuring the response time of all sectors of the district derives the fractal response time. Our goal is to have the first unit on-scene in less than eight minutes and an Advanced Life Support (ALS) transport unit on-scene in less than eight minutes on 90% of all calls. To ensure quality care to all sections of the response districts, each unit is located where it can respond predominantly within its defined territory and can arrive at an emergency within the time frames established by the system based on an area's need for emergency service. All areas of our response district have the same response time goals.
In an effort to minimize the response time to citizen's emergency calls, we implemented a "Squad" program in 2005. A Squad consists of two paramedics that respond to an incident to administer advanced care. If they are not needed to assist the transport with patient care, the Squad can return to service ready to provide additional care to citizens.
When the response time for an ambulance unit is extended, or when a probable critical situation exists, the Squad and a nearby engine, ladder or rescue truck are dispatched simultaneously to initiate ALS as needed or to provide ALS support for the ambulance crew. The First Responder may be dispatched to certain emergency types where there is a low probability that a patient transport will occur. Under these circumstances the First Responder is dispatched to a call in lieu of an ambulance unit, saving the ambulance for another, possibly more emergent call. Due to the new expanded patient care role, it has become even more important that engine, ladder and rescue companies be consistently staffed with a minimum of three fire fighters, one of whom is a paramedic. Currently, the department operates five front-line vehicles capable of supporting the ambulance crews.
Emergency medical dispatchers from the City of Dublin, Division of Police, interview callers to determine location, nature, and priority of the medical emergency. The dispatchers use a computer-assisted medical priority dispatch system to identify and dispatch the closest available appropriate EMS response units. Dispatchers are also trained to provide pre-arrival instructions during critical life support incidents over the telephone until EMS units arrive on scene.
To help track the quality and effectiveness of the emergency medical service system, the Fire Department monitors numerous indicators. While response times are tracked, they are only a crude measure of the system. Clinical outcomes such as cardiac arrest survival rates are a more accurate indicator of performance.
Washington Township EMS is developing a continuous comprehensive evaluation program, which will assess all aspects of the EMS system. This program will include evaluation of structural, process and outcome measures. In addition to survival, other outcomes such as disease, disability, discomfort and dissatisfaction may be used for evaluation.