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The purpose of this study/paper is to identify the importance of the partnership between the public and private health-care institutions to improve interhospital patient transfers. Scientific research and statistical data show the increased number of interhospital transportation services; therefore, timely and qualified patient transportation between different health-care institutions must be considered, the activity that directly and significantly impacts the patient’s health status and overall quality of the health-care services. The successful patient transportation from the smaller hospitals to the health-care institutions with advanced intensive care or urgent care units can be enhanced through the partnership between private and public health-care institutions.

The methodology included quantitative method, statistical data analysis and theoretical data generalization. Both primary and secondary data were collected and analyzed during the research. Expert quantification was performed using the survey research method. The survey was conducted in Lithuania. The respondents were selected to be the general managers of the health-care and urgent care institutions, the chief doctors of the reanimation and intensive care department also the chief doctors of the emergency department.

Because of the centralization and regionalization of health-care services, the number of patients transferred between hospitals by the emergency medical services (EMS) and personal health-care institutions has increased. University hospitals are not sufficiently prepared to accept an increasing flow of patients in accordance with the Ministry of Health orders. Not all regional or district hospitals have the right to provide such assistance, which increases transportation time and costs as well as requires additional human resources. The five EMS categories could be used to improve the patient transfer between different levels of health-care institutions. To increase partnership between private and public health-care organizations, incentives should be provided for the development of private health-care organizations, as well as encouraging actions should be taken to increase the demand for private health-care services by Lithuanian patients.

Five EMS categories identified in this paper could be used to ensure a smooth mechanism for the patient transfer between different levels of the personal health-care institutions. The proposed categories should also be used in the pre-stationary emergency phase (for reducing the interhospital patient transportation amount).

Properly organized secondary and tertiary interhospital patient transfers influence the availability and quality of the EMS and reduce inequalities in the provided services and social exclusion.

This paper presents the classification of the interhospital transfer issues, determines the main reasons for the patient interhospital transfer, creates the model for the EMS patient process flows and defines five EMS categories for the assessment of patient conditions. Therefore, the research conducted and the results obtained have both theoretical and social-practical value.

The purpose of this paper is to investigate the way technology affects the provision of prehospital emergency care, upgrading the quality of services offered and significantly reducing the risk of premature termination of the patients.

The paper presents the development of the eEKAB, a pilot emergency medical information system that simulates the main services offered by the Greek National Instant Aid Centre (EKAB). The eEKAB was developed on an agile system methodology. From a technical perspective, the features and the technology were mainly chosen to provide reliable and user-friendly interfaces that will attract many users. eEKAB is based on three important pillars for offering health care to the patients: the “On-time Incident Reporting”, the “On-time Arrival at the Incident” and “Transfer to the Health Center”. According to the literature review, the emergency medical services (EMS) systems that combine all the features are very few.

It reduces the total time of the EMS procedures and it allows for an easier management of EMS, by providing a better allocation of human resources and a better geographical distribution of ambulances. The evaluation displayed that it is a very helpful application for the ambulance drivers as it reduces the ambulance response time to arrive in the patient's location and contributes significantly to the general performance of the prehospital medical care system. Also, the survey verified the importance of implementing eEKAB on a larger scale beyond the pilot usage. It is worth mentioning that the younger ambulance drivers had a more positive view for the purpose of the application.

The paper clearly identifies implications for further research. Regarding interoperability, the mobile app cooperates with the Operational Center of EKAB, while further collaboration could be achieved with other operational ambulance handling center, mainly, of the private sector. The system can evolve to include better communications among the EKAB departments. Particularly, the ambulance crew as well as the doctors should be informed with more incident features such as the emergency signal so that they know whether to open the siren, the patient's name, etc. The authors are currently working on implementing some features to provide effective medical health services to the patient in the ambulance.

eEKAB will have very significant implications in case of its enforcement, such as the reduction of the total time of EMS procedures with a corresponding reduction of the operating costs of an accident management system and an ambulance fleet handling system while in parallel informing in time the doctors/clinics. It will provide better distribution of ambulances as well as of total human resources. It will greatly assist ambulance drivers, while reducing ambulance response time to reach the patient's location. In other words, the authors will have a better performance of the whole prehospital care system.

Providing emergency care before the hospital is of great importance for upgrading the quality of health services provided at the accident site, thus significantly reducing the risk of premature death of patients. This in itself has a significant social implication.

The paper demonstrates a solid understanding in the field of the EMS systems and the corresponding medical services offered. It proposes the development of an effective, feasible and innovative EMS information system that will improve the existing emergency health care system in Greece (EKAB). An in depth literature review and presentation of the adopted new technologies and the respective architecture take place. An evaluation and statistical validation were conducted for proving the high applicability of eEKAB in case of real-life running.

The lack of studies about the response time of emergency medical service during the coronavirus disease 2019 (COVID-19) pandemic in a dense city of a developing country has triggered this study to explore the factors contributing to a high response time of ambulance service to reach patients in need. An evaluation of contributing factors to the response time is necessary to guide decision-makers in keeping a high service level of emergency medical service.

This research employed an agent-based modeling approach with input parameters from interviews with emergency medical service staff in Bandung city, Indonesia. The agent-based model is established to evaluate the relevant contribution of the factors to response time reduction using several scenarios.

According to agent-based simulation, four factors contribute to the response time: the process of preparing crew and ambulance during the pandemic, coverage area, traffic density and crew responsiveness. Among these factors, the preparation process during the pandemic and coverage area significantly contributed to the response time, while the traffic density and crew responsiveness were less significant. The preparation process is closely related to the safety procedure in handling patients during the COVID-19 pandemic and normal time. The recommended coverage area for maintaining a low response time is 5 km, equivalent to six local subdistricts.

This study has explored the factors contributing to emergency medical response time. The insignificant contribution of the traffic density showed that citizens, in general, have high awareness and compliance to traffic priority regulation, so crew responsiveness in handling ambulances is an irrelevant factor. This study might have different contributing factors for less dense population areas and focuses on public emergency medical services provided by the local government.

The local government must provide additional funding to cover additional investment for ambulance, crew and administration for the new emergency service deployment point. Exercising an efficient process in ambulance and crew preparation is mandatory for each emergency deployment point.

This study evaluates the contributing factors of emergency medical response time in the pandemic and normal situation by qualitative analysis and agent-based simulation. The performance comparison in terms of medical response time before and after COVID-19 through agent-based simulation is valuable for decision-makers to reduce the impact of COVID-19.

Although adverse events are less studied in the prehospital setting, the evidence is beginning to paint an alarming picture. Consequently, improvements in Emergency Medical Services (EMS) demand a paradigm shift regarding the way care is conceptualized. The chapter aims to (1) support the dialogue on near-misses and adverse events as a learning opportunity and (2) to provide insights on applications of multiteam systems (MTSs).

To offer discussion on near-misses and adverse events and knowledge on how MTSs are applicable to emergency medical care, we review and dissect a complex patient case.

Throughout this case discussion, we uncover seven pertinent issues specific to this particular MTS: (1) misunderstanding with number of patients and their locations, (2a) lack of context to build a mental model, (2b) no time or resources to think, (3) expertise-facilitated diagnosis, (4) lack of communication contributing to a medication error, (5) treatment plan selection, (6) extended time on scene, and (7) organizational culture impacting treatment plan decisions.

By dissecting a patient case within the prehospital setting, we can highlight the value in engaging in dialogue regarding near-misses and adverse events. Further, we can demonstrate the need to expand the focus from simply teams to MTSs.

The purpose of this paper is to benchmark and measure the comparative efficiency of emergency medical services (EMS) in major US cities (populations greater than 100,000). In so doing, this paper aims to develop a benchmark that can be emulated by cities lagging in EMS efficiency. Also, it seeks to develop a profile of cities that are successful in providing highly efficient EMS as benchmarks.

Data envelopment analysis is used to measure the EMS efficiency of 127 selected large cities in the USA under the premise of a constant‐return to scales method of service delivery. In addition, to identify factors influencing the US cities' EMS efficiency and then to predict their efficiency scores, a Tobit regression analysis is employed, which tended to result in a smaller standard error, a smaller bias, and a smaller mean squared error than ordinary least squares.

This paper examines whether more densely settled and populated areas have greater efficiency in delivering EMS. After controlling variables such as weather and climate, income, population growth, the age of a residential home, and geographic size of a city in land area, It is found that more densely settled, geographically large, and high income cities show more efficient provision of EMS.

This paper is the first to develop in a comprehensive way EMS benchmark performance standards for municipal governments and elaborate on a host of factors which are associated with the success of EMS deliveries. By setting such standards and identifying factors affecting EMS efficiency, this paper helps municipal governments to continuously improve their EMS and develop more efficient public policy.

This paper's aim is to study a neglected relationship: testing the impact of emotional labor on the work exhaustion for samples of emergency medical service (EMS) professionals.

Three distinct samples of EMS professionals, i.e. emergency medical technician (EMT) – basic, EMT – intermediate, and paramedic, were surveyed to test the impact of three variable sets, personal (e.g. gender, age, health), work‐related (e.g. years of service, job satisfaction), and emotional labor (i.e. surface acting, deep acting) on work exhaustion.

Results across the three samples consistently showed that surface acting had a significantly stronger positive impact than deep acting on work exhaustion. In addition it was found that surface acting had a significantly stronger negative relationship to job satisfaction than deep acting. Surface acting also had a significant negative relationship to perceived health. Years of service were positively related to work exhaustion across all samples, while job satisfaction was negatively related.

Work exhaustion is an occupational risk for EMS professionals. Individuals considering EMS as a career must have realistic expectations and information about the rewards as well as challenges facing them. To help buffer the impact of emotional labor on work exhaustion and related outcomes, EMS stakeholders should consider facilitating mentor and/or peer support group programs to enhance the development of stronger camaraderie in different EMS‐based organizations (e.g. hospitals, fire services).

Prior research has not tested for the impact of emotional labor on work exhaustion for EMS professionals. Even after controlling for personal and work‐related variables, surface acting maintained a stronger positive impact than deep acting on work exhaustion. Key demographics for each of the three samples (type of work, community size, gender) indicate representativeness to previous cohort samples of nationally certified EMS professionals.

The purpose of this paper is to examine emergency medical service (EMS) personnel’s perceptions and experiences of managing underground mining injury incidents.

In total, 13 EMS personnel were interviewed according to a semi-structured interview guide. The interviews were transcribed verbatim and analyzed using qualitative content analysis.

An underground mining environment was described as unfamiliar and unsafe and, with no guidelines for operational actions in an extreme environment, such as underground mines, the EMS personnel were uncertain of their role. They therefore became passive and relied on the rescue service and mining company during a major incident. However, the medical care was not considered to be different from any other prehospital care, although a mining environment would make the situation more difficult and it would take longer for the mine workers to be placed under definitive care.

This study complements earlier studies by examining the EMS personnel’s perceptions and experiences of major incidents.

The purpose of this paper is to present observations on the National Human Rights Commission report on the emergency medical services (EMS) with special reference to Uttaranchal, India.

The paper presents observations of road accidents in Uttaranchal between 2002 and 2003.

Some of the major causes of medical emergencies are road accidents, fall, burns, poisoning, drowning, suicides and attempted suicides and violence of various types. Along with this, natural disasters are a major medical emergency care. According to an estimate there is one accident in every two minutes in India. For every trauma related death, there are many injured and disabled persons. The male age group of 15‐40 years is the most affected by trauma. The cost of trauma is terms of direct costs and loss in terms of productive life is astronomical. The sudden increase in the length, breadth and kinds of roads and an exponential growth in the number and quality of transports and commuters is going to need an extremely well co‐ordinated response system. This by the very complexity of the task involved will have to be a multidisciplinary agency under a unified command. As Uttaranchal enters the fifth year of its existence the various components which would tend to aggravate the existing situation are only too apparent. Connectivity of habitats through road construction, already a top priority activity, is going to be intensified further. Exponential growth in several services sector, all leading to tremendous pressure on the existing roads and infrastructure, resulting in accidents.

The paper presents a road map for the establishment of EMS.

In North America, delegated practice “medical direction” models are often used as a proxy for clinical quality and safety in paramedic services. Other developed countries favor a combination of professional regulatory boards and clinical governance frameworks that feature paramedics taking lead clinician roles. The purpose of this paper is to bring together the evidence for medical direction and clinical governance in paramedic services through the prism of paramedic self-regulation.

This narrative synthesis critically examines the long-established North American Emergency Medical Services medical direction model and makes some comparisons with the UK inspired clinical governance approaches that are used to monitor and manage the quality and safety in several other Anglo-American paramedic services. The databases searched were CINAHL and Medline, with Google Scholar used to capture further publications.

Synthesis of the peer-reviewed literature found little high quality evidence supporting the effectiveness of medical direction. The literature on clinical governance within paramedic services described a systems approach with shared responsibility for quality and safety. Contemporary paramedic clinical leadership papers in developed countries focus on paramedic professionalization and the self-regulation of paramedics.

The lack of strong evidence supporting medical direction of the paramedic profession in developed countries challenges the North American model of paramedics practicing as a companion profession to medicine under delegated practice model. This model is inconsistent with the international vision of paramedicine as an autonomous, self-regulated health profession.

The purpose of this paper is to analyse how the police, the rescue services and the emergency medical services perceive the threat of terrorism and preparedness for a terrorist-induced crisis. It also aims to unravel differences among the emergency organizations and to discuss their potential implications for emergency preparedness.

Data were collected using a questionnaire distributed to operational personnel from the emergency services in eight Swedish counties; 864 responses were received and analysed.

There were significant differences between the police, rescue and ambulance services regarding perceptions of event likelihood, willingness to respond, estimated management capability and level of confidence with tasks to be performed on-scene. Perceived likelihood of events appeared affected by institutional logic; events within their respective domain of responsibility were perceived as more likely. The police stood out in many aspects, with more personnel with experience of violence on duty and a high grading of the probability of terrorist attacks compared to the other organizations. Fewer police had high estimates of their organizations’ management capability and knowledge of tasks on-scene.

Differences in perspectives of terrorism preparedness and response among the emergency services were shown, highlighting the importance of enabling inter-organizational insights on safety culture, with risk awareness and management strategies, as well as knowledge of the other organizations’ institutional logics and main tasks, so as to achieve an effective, collaborative response to terrorism-induced crises.

Little research has been conducted comparatively with regard to the emergency services and their perceptions of terrorism-specific threats and preparedness, particularly in the Swedish context.