Department of Industrial Economics and Technology Management, Norwegian University of Science and Technology, Trondheim, Norway.
Department of Science and Technology, Linköping University, Norrköping, Sweden.
Int J Med Inform. 2020 Jan;133:103975. doi: 10.1016/j.ijmedinf.2019.103975. Epub 2019 Oct 9.
To achieve high performing emergency medical services (EMS), planning is of vital importance. EMS planners face several challenges when managing ambulance stations and the fleet of ambulances. In this paper, three strategic cases for EMS planners are presented together with potential solutions. In the first case, the effects of closing down a local emergency room (ER) are analyzed together with how adding an ambulance station and an ambulance to the area affected by the closing of the ER can be used to mitigate the negative consequences from the closing. The second case investigates a change in the organization of EMS. Currently, many non-urgent transport assignments are performed by ambulances which make them unavailable for more urgent calls. The potential for a more effective utilization of the ambulances is explored through transferring these assignments to designated transport vehicles. The third case is more technical and challenges the common practice regarding how time dependent demand is handled. Looking at the busiest hour or the average daily demand, is compared with taking time varying demand into account. The cases and solutions are studied using a recently developed strategic ambulance station location and ambulance allocation model for the Maximum Expected Performance Location Problem with Heterogeneous Regions (MEPLP-HR). The model has been extended to also include multiple time periods. This article demonstrates an innovative use of the model and how it can be applied to find and evaluate solutions to real cases within the field of strategic planning of EMS. The model is found to be a useful decision support tool when analyzing the cases and the expected performance of potential solutions.
为了实现高效的紧急医疗服务（EMS），规划至关重要。EMS 规划人员在管理救护站和救护车车队时面临着几个挑战。本文提出了三个 EMS 规划人员的战略案例，并提出了潜在的解决方案。在第一个案例中，分析了关闭当地急诊室（ER）的影响，并探讨了在受 ER 关闭影响的地区增设救护站和救护车，以减轻关闭带来的负面影响。第二个案例研究了 EMS 组织的变化。目前，许多非紧急转运任务由救护车执行，导致这些救护车无法应对更紧急的呼叫。通过将这些任务转移到指定的运输车辆上，探讨了更有效地利用救护车的潜力。第三个案例更具技术性，挑战了处理时间相关需求的常见做法。比较了考虑时间变化的需求与关注最繁忙的小时或平均每日需求的做法。使用最近开发的用于具有异质区域的最大期望性能位置问题的战略救护站位置和救护车分配模型（MEPLP-HR）研究了这些案例和解决方案。该模型已经扩展到包括多个时间段。本文展示了该模型的创新应用，以及如何将其应用于寻找和评估 EMS 战略规划领域的实际案例中的解决方案。该模型在分析案例和潜在解决方案的预期性能时被证明是一个有用的决策支持工具。
