JackStout.com is Now Live!

We are pleased to announce our participation and support of a newly deployed website www.JackStout.com. Developed in cooperation with various individuals and agencies, this site is designed to provide users with access to Jack's history, writings, publications and thoughts on System Status Management, High Performance EMS and Advanced EMS System Design.  Click on the link to check it out!

EMSA Decreases Emergency Accident Rate by 50% by "Howling" While Responding

In November 2009, EMSA released a press release regarding their new Howler sirens from Whelen Engineering.  This technology emits a low-frequency tone that causes objects to reverberate, and when combined as a supplement to their existing audible warning devices, reduced their EMVA accidents by 50% over a year’s period of time.

I personally got to “experience” one of these devices on an ambulance at a different EMS agency and let me tell you, it does what it advertises.  While I have never experienced that mystical “urban legend” sound that causes people to go involuntarily “code brown”, this is about as close as it gets….it resembles feeling those cars drive by with over amped music and bass blaring that could deafen the deaf….an effective means to get attention in my opinion.

Read more about EMSA’s successes below.  While more research is needed to truly determine if this device is the causation behind a reduction in EMVA’s, it’s certainly worth looking more into for your organization’s next ambulance spec.

EMSA’s Press Release

Predicting Hospital Diversion for Ambulances...Now a Mathematical Reality

Back in 2003, I was honored to be asked by Dr. Abey Kuruvilla, from the Department of Industrial Engineering at the University of Louisville, KY, to participate in a  study he was doing for his PhD dissertation in Systems Engineering on Ambulance Diversion.  His hypothesis was that using historical ambulance call volume patterns coupled with historical hospital diversion data, that a predictive mathematical model could be created to provide an early warning system for both EMS Agencies and Hospitals alike, thus providing time to try and avert the impending situation.

Hospital diversion effects everyone in the pre-hospital continuum.  Hospitals lose revenue, EMS systems prolong transport and task times thus impacting response capabilities and public safety, patients don’t get served as desired and insurance companies pay for larger out of network bills and longer ambulance mileage reimbursement claims.  Given these issues, any tool to help hospitals and EMS systems cope with the problem before it starts is useful.  While I truly believe that hospital diversion is a direct function of poor systems and process engineering within our healthcare systems, until such concepts are realized and systems engineering is adopted by hospitals to help solve their internal design flaws, diversions will continue and more then likely will get worse as our boomer population ages. 

In a collaborative project between Dr. Kuruvilla, his colleagues, MAST Ambulance, the regional Kansas City hospitals and FirstWatch (of which I am proudly a co-founder and partner) embarked on finding a solution.  Dr, Kuruvilla was successful in finding such a solution and while only tested in the Kansas City region, I believe has the potential to help EMS systems with this ever growing problem.  

Click on the links below to download Dr. Kuruvilla’s presentation and paper on the subject.  I believe that Dr. Kuruvilla is still looking for trial cities and if you find his work interesting, please let me know and I will put you in contact with him.

• Presentation on Predicting Hospital Diversion
• Predicting Hospital Diversion Poster Presentation

NAEMSP Discussion on Relevance of Response Times and Patient Care Outcomes

Interesting Google Group discussion getting ready to happen on the importance of response times in patient care outcomes:
http://groups.google.com/group/naemsp-dialog/web/ems-response-intervals-dec-2009

UCLA Research on Predictive Mathematical Models Used for EMS Temporal Demand Analysis

Washko & Associates was fortunate enough to be asked to participate in a research project to help determine the accuracy and validity of the mathematical models used by EMS agencies to perform Temporal Demand Analysis.  This project was funded by the Coalition of Advanced Emergency Medical Systems (CAEMS) and many different EMS agencies from around the U.S. participated.

The results from this study were not surprising.  The accuracy of the various predictive models used to help determine EMS Unit Hour supply was found to be consistent with industry expectations, norms and experiences.  To read more about the research project read the Prehospital Emergency Care Journal Article:  Are EMS Call Volume Predictions Based on Demand Pattern Analysis Accurate