Journal articles on the topic 'Ambulance service Dispatching Information technology'
To see the other types of publications on this topic, follow the link: Ambulance service Dispatching Information technology.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Ambulance service Dispatching Information technology.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
V.K., Sreekanth, and Ram Babu Roy. "Equity-constrained dispatching models for emergency medical services." Team Performance Management: An International Journal 23, no. 1/2 (March 14, 2017): 28–45. http://dx.doi.org/10.1108/tpm-10-2015-0051.
Full textAbstract:
Purpose The purpose of this paper is to apply agent-based modeling and simulation concepts in evaluating different approaches to solve ambulance-dispatching decision problems under bounded rationality. The paper investigates the effect of over-responding, i.e. dispatching ambulances even for doubtful high-risk patients, on the performance of equity constrained emergency medical services. Design/methodology/approach Agent-based modeling and simulation was used to evaluate two different dispatching policies: first, a policy based on maximum reward, and second, a policy based on the Markov decision process formulation. Four equity constraints were used: two from the patients’ side and two from the providers’ side. Findings The Markov decision process formulation, solved using value iteration method, performed better than the maximum reward method in terms of number of patients served. As the equity constraints conflict with each other, at most three equity constraints could be enforced at a time. The study revealed that it is safe to over-respond if there is uncertainty in the risk level of the patients. Research limitations/implications Further research is required to understand the implications of under-responding, where doubtful high-risk patients are denied an ambulance service. Practical implications The need for good triage system is apparent as over-responding badly affects the operational budget. The model can be used for evaluating various dispatching policy decisions. Social implications Emergency medical services have to ensure efficient and equitable provision of services, from the perception of both patients and service providers. Originality/value The paper applies agent-based modeling to equity constrained emergency medical services and highlights findings that are not reported in the existing literature.
2
Li, Jian-Wei, Chia-Chi Chang, Yi-Chun Chang, and Yung-Fa Huang. "Ambulance Dispatching System with Integrated Information and Communication Technologies on Cloud Environment." International Journal of Grid and High Performance Computing 6, no. 4 (October 2014): 72–87. http://dx.doi.org/10.4018/ijghpc.2014100105.
Full textAbstract:
The quality of emergency medical services (EMS) prior to a patient's arrival at a hospital is directly affected by the efficiency to dispatch an ambulance for first aid. In this paper, we created an ambulance dispatching system for first aid, which is integrated with Information and Communication Technology (ICT) and performed on a cloud platform. In virtue of ICT, the system can readily monitor the movements of ambulance with Geographic Information System (GIS) and determine any ambulance dispatching task and saves more time spent in transporting an accident victim to a hospital. Furthermore, the system running on a cloud platform is characteristic of integrated medical resources and terminal equipment with or without powerful hardware that is flexibly added into or removed from the system for supporting dispatch.
3
Popov, V. P., L. P. Rogozhina, E. V. Medvedeva, and L. R. Kashevarova. "Practical Experience of the Unified Center for Dispatching, Monitoring and Medical Evacuation Functioning as a Part of the Sverdlovsk Regional Center for Disaster Medicine." Disaster Medicine, no. 4 (December 2022): 17–20. http://dx.doi.org/10.33266/2070-1004-2022-4-17-20.
Full textAbstract:
Summary. The goal of the study is to show, on the basis of analysis of the experience of the unified center of dispatching, monitoring and medical evacuation in the structure of the Territorial Center for Disaster Medicine of Sverdlovsk region, the efficiency of unified dispatching service, operating on the functional basis in the same information field as the regional emergency medical service. Materials and research methods. Sources of information and materials on the research theme: normative and methodological documents regulating order and organization of the Disaster Medicine Service and emergency medical aid; publications in “Disaster medicine”, “Emergency Medical Aid” journals; reports of heads of joint centers and independent territorial disaster medicine centers. Research methods: analytical, statistical, method of direct observation, method of logical and informational modeling. Research results and their analysis. The work of three departments of unified center of dispatching, monitoring and medical evacuation was analyzed: operative-dispatching department, department of consultation and monitoring of intensive care patients, department of monitoring of ambulance calls. It is concluded that this model of a single dispatch service is financially inexpensive, efficient and can be recommended to the regions of Urals, Siberia and the Far East, where there are strong territorial disaster medicine centers and specialized resuscitation and consultative centers.
4
Kulikova, Inna B., and Svetlana S. Moskvina. "Transformation of the ambulance service during the COVID-19 pandemic: correlation and thematic analysis." Medical Journal of the Russian Federation 28, no. 3 (August 29, 2022): 193–99. http://dx.doi.org/10.17816/medjrf108938.
Full textAbstract:
BACKGROUND: Ensuring the availability and quality of an ambulance service, including specialized ambulance, medical care, and specialized medical care in emergency and emergency form for fatal diseases, accidents, injuries, poisoning, and other conditions that require urgent medical intervention is an integral part of the national security system and one of the most important areas of health development in the Russian Federation. During the COVID-19 pandemic, such tasks appeared in the organization of emergency and emergency medical care for patients as a prompt distribution to inpatient departments, considering the severity of the patients condition, their covid status, and the availability of free places in medical organizations in a specific region, compliance with the waiting time prescribed for emergency medical care, and cutting off the non-core calls.
AIM: To determine the optimal organizational structure of the ambulance service in the subject of the Russian Federation.
MATERIALS AND METHODS: Collection and statistical processing of information regarding the work of ambulance services in a specific region were carried out. Correlation-thematic analysis using the Pearsons coefficient was performed.
RESULTS: During the under covid period from 2016 to 2019, the overall mortality rate showed a clear downward trend. However, during the pandemic, even without taking into account the excess mortality, there was an increase, while, in 2020, when compared with 2019, the increase was 12%. Moreover, despite the increase in excess mortality in 2021 relative to that in 2020 by almost four times, the total mortality (excluding COVID) remained almost at the same level. In addition, it should be noted that, in regions where the ambulance service was represented by a single legal entity during the epidemic, excess mortality was lower in comparison with that in the regions where ambulance service was represented by departments within the Central District hospitals.
CONCLUSION: The period of the coronavirus epidemic has largely transformed the healthcare system. The presence of a Unified Dispatching Service or a unified ambulance service in a region has a positive effect on the quality indicators of its healthcare system. In addition, the formation of new units in the structure of the ambulance service, such as a department for remote counseling, allows not only to ensure more accessibility to patients but also to effectively use the financial resources of an institution.
5
Wen, Zhi Ming. "SOA-Based Integration Research of Integrated Management to the Municipal County Dispatch System." Advanced Materials Research 403-408 (November 2011): 558–62. http://dx.doi.org/10.4028/www.scientific.net/amr.403-408.558.
Full textAbstract:
The intelligent dispatch is important link in the intelligent electrical network construction, By the service architecture and the WEB technology, this article solves the municipal county intelligence scheduling problem. On the one hand, it has solved the dispatching and data-sharing issues of the inter-county, realized the inspection which moved to the county, the information uploaded which moved to the super rank; on the other hand, it has released the dispatching personnel from the traditional paper, the form and the man-dispatch to attain the more standardized dispatching system and raise the work quality and efficiency; and finally, to promote the management standard of the municipal county dispatch completely.
6
Yuan, Rong Chang, Zian Wang, Li Xin Li, Fang Chun Di, Zhi Xiang Ji, and Jiao Dai. "Distributed Modeling Technology for Large Power Grid Modeling Based on Cloud Computing." Applied Mechanics and Materials 448-453 (October 2013): 2721–29. http://dx.doi.org/10.4028/www.scientific.net/amm.448-453.2721.
Full textAbstract:
As the original grid model cant meet the needs of smart grid development, a distributed grid modeling and integrated management technologies based on cloud computing are proposed in this paper. In this scheme, a multi-level integrated "model cloud" is developed with horizontal collaboration and vertical cut-through using cloud storage, cloud services, cloud computing and other related technologies. The grid models of levels of dispatching institutions are gathered, stored and managed with unified model service. The scheme can dress the issues of device naming, information sharing, model exchanging and model unifying, reduce the maintenance workload, improve the quality of the model and the degree of coordinated automation and enhance the level of dispatching and analysis of the whole power grid.
7
Wu, Jun Xing, Pan Zhang, and Jian Cheng Yu. "IEC 61968 Standard-Based Distribution Systems Integration Solutions and Application Research." Advanced Materials Research 614-615 (December 2012): 785–91. http://dx.doi.org/10.4028/www.scientific.net/amr.614-615.785.
Full textAbstract:
Based on the Service Oriented Architecture (SOA) and Enterprise Service Bus (ESB) technology, following the IEC 61968 standards, This paper presents a program of building Distribution System of Information Exchange Bus (IEB); Study on the integration strategy of the Tianjin Eco Park Distribution Automation System (DAS), Dispatching Automation System, Production Management system and Geographic Information System (GIS) etc.; The information exchange between various systems and the specific processes on outage management application rely on the IEB bus was also presented.
8
Bowron, J. Shelby, and Knox H. Todd. "Job Stressors and Job Satisfaction in a Major Metropolitan Public EMS Service." Prehospital and Disaster Medicine 14, no. 4 (December 1999): 32–35. http://dx.doi.org/10.1017/s1049023x00027692.
Full textAbstract:
AbstractIntroduction:Behavioral and social science research suggests that job satisfaction and job performance are positively correlated. It is important that Emergency Medical Services managers identify predictors of job satisfaction in order to maximize job performance among prehospital personnel.Purpose:Identify job stressors that predict the level of job satisfaction among prehospital personnel.Methods:The study was conducted with in a large, urban Emergency Medical Services (Emergency Medical Services) service performing approximately 60,000 Advanced Life Support (Advanced Life Support) responses annually. Using focus groups and informal interviews, potential predictors of global job satisfaction were identified. These factors included: interactions with hospital nurses and physicians; on-line communications; dispatching; training provided by the ambulance service; relationship with supervisors and; standing orders as presently employed by the ambulance service. These factors were incorporated into a 21 item questionnaire including one item measuring global job satisfaction, 14 items measuring potential predictors of satisfaction, and seven questions exploring demographic information such as age, gender, race, years of experience, and years with the company. The survey was administered to all paramedics and Emergency Medical Technicians (Emergency Medical Technicians s) Results of the survey were analyzed using univariate and multivariate techniques to identify predictors of global job satisfaction.Results:Ninety paramedics and Emergency Medical Technicians participated in the study, a response rate of 57.3%. Job satisfaction was cited as extremely satisfying by 11%, very satisfying by 29%, satisfying by 45%, and not satisfying by 15% of respondents. On univariate analysis, only the quality of training, quality of physician interaction, and career choice were associated with global job satisfaction. On multivariate analysis, only career choice (p = 0.005) and quality of physician interaction (p = 0.05) were predictive of global job satisfactionConclusion:Quality of career choice and interactions with physicians are predictive of global job satisfaction within this urban emergency medical service (Emergency Medical Technicians). Future studies should examine specific characteristics of the physician-paramedic interface that influence job satisfaction and attempt to generalize these results to other settings.
9
Mcgrath, K. "The Golden Circle: a way of arguing and acting about technology in the London Ambulance Service." European Journal of Information Systems 11, no. 4 (September 2002): 251–66. http://dx.doi.org/10.1057/palgrave.ejis.3000436.
Full text
10
Tu, Dan, Liang Yun, Lan Chen, Yue Yang, Qiaoqiong Zeng, and Lin Chen. "Modeling of Mobility as a Service (MaaS) Collaborative Dispatching System of Railway Passenger Transport Hub Based on Neural Network Algorithm." Wireless Communications and Mobile Computing 2022 (October 5, 2022): 1–10. http://dx.doi.org/10.1155/2022/1288624.
Full textAbstract:
In order to solve the modeling problem of travel as a service (MaaS) collaborative dispatching system of railway passenger transport hub based on neural network algorithm, meet people’s needs, make up for the lack of high traffic travel pressure, and improve people’s living standards, through 30 random questionnaires, it is found that 28 people think that travel convenience improves their quality of life, and 2 people think that owning a car has little effect on travel convenience. Travel has always been people’s basic living needs. In recent years, with the improvement of people’s living standards, there are more and more urban vehicles. At the same time, the increase of vehicles also directly leads to the increasing pressure of urban traffic travel, and the problems of vehicle emission pollution and traffic congestion are becoming more and more obvious. With the national low-carbon environmental protection policies, green transportation has become the theme of the times. With the continuous development of shared transportation mode and intelligent information technology, the new transportation concept of “Mobility as a Service” based on this technical mode will highly integrate the existing transportation modes and travel services. With the support of MaaS system, people’s travel modes will change greatly. Starting with the MaaS cooperative dispatching system of railway passenger transport hub, a multiparameter fuzzy neural network control system dispatching algorithm is proposed to better help the modeling of MaaS cooperative dispatching system of railway passenger transport hub.
11
Li, Li Xin, Zian Wang, Rong Chang Yuan, Fang Chun Di, Da Peng Li, and Jiao Dai. "Multi-Dimensional Model Version Management System Based on Model Cloud Technology." Applied Mechanics and Materials 448-453 (October 2013): 2730–39. http://dx.doi.org/10.4028/www.scientific.net/amm.448-453.2730.
Full textAbstract:
Due to the poor openness between grid models at different levels in existing dispatching centers, theres lack of unified device naming conventions, data exchange standards and interface specifications, making it difficult to easily implement the exchange and sharing of network model parameters and data. In this article, a multi-dimensional grid model version management system is promoted based on model cloud technology with centralized and integrated deployment. Taking advantage of model cloud storage and service technology, unified maintenance and management technology, model subscribing and extracting technology as well as its releasing methods and standardized access technology, the system can construct a cloud service unified in the whole grid, covering all dispatch services with the integration of the grid model information, therefore realizing the unified management, maintenance, generation, release and subscriptions.
12
Jha, R. K., Manojit Chattopadhyay, and Yuvraj Gajpal. "Reducing Response Time of Ambulance Service by Utilizing the Knowledge of Service Location of Ambulance Drivers using Self-Organizing Map." International Journal of Operations and Quantitative Management 27, no. 3 (December 18, 2021): 219. http://dx.doi.org/10.46970/2021.27.3.2.
Full text
13
Fisher, Joanne D., Karoline Freeman, Aileen Clarke, Peter Spurgeon, Mike Smyth, Gavin D. Perkins, Mark-Alexander Sujan, and Matthew W. Cooke. "Patient safety in ambulance services: a scoping review." Health Services and Delivery Research 3, no. 21 (May 2015): 1–250. http://dx.doi.org/10.3310/hsdr03210.
Full textAbstract:
BackgroundThe role of ambulance services has changed dramatically over the last few decades with the introduction of paramedics able to provide life-saving interventions, thanks to sophisticated equipment and treatments available. The number of 999 calls continues to increase, with adverse events theoretically possible with each one. Most patient safety research is based on hospital data, but little is known concerning patient safety when using ambulance services, when things can be very different. There is an urgent need to characterise the evidence base for patient safety in NHS ambulance services.ObjectiveTo identify and map available evidence relating to patient safety when using ambulance services.DesignMixed-methods design including systematic review and review of ambulance service documentation, with areas for future research prioritised using a Delphi process.Setting and participantsAmbulance services, their staff and service users in UK.Data sourcesA wide range of data sources were explored. Multiple databases, reference lists from key papers and citations, Google and the NHS Confederation website were searched, and experts contacted to ensure that new data were included in the review. The databases MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Science Direct, Emerald, Education Resources Information Center (ERIC), Applied Social Sciences Index and Abstracts, Social Services Abstracts, Sociological Abstracts, International Bibliography of the Social Sciences (IBSS), PsycINFO, PsycARTICLES, Health Management Information Consortium (HMIC), NHS Evidence, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), NHS Economic Evaluation Database (NHS EED),Health Technology Assessment, the FADE library, Current Awareness Service for Health (CASH), OpenDOAR (Directory of Open Access Repositories) and Open System for Information on Grey Literature in Europe (OpenSIGLE) and Zetoc (The British Library's Electronic Table of Contents) were searched from 1 January 1980 to 12 October 2011. Publicly available documents and issues identified by National Patient Safety Agency (NPSA), NHS Litigation Authority (NHSLA) and coroners’ reports were considered. Opinions and perceptions of senior managers, ambulance staff and service users were solicited.Review methodsData were extracted from annual reports using two-stage thematic analysis, data from quality accounts were collated with safety priorities tabulated and considered using thematic analysis, NPSA incident report data were collated and displayed comparatively using descriptive statistics, claims reported to NHSLA were analysed to identify number and cost of claims from mistakes and/or poor service, and summaries of coroners’ reports were assessed using thematic analysis to identify underlying safety issues. The depth of analysis is limited by the remit of a scoping exercise and availability of data.ResultsWe identified studies exploring different aspects of safety, which were of variable quality and with little evidence to support activities currently undertaken by ambulance services. Adequately powered studies are required to address issues of patient safety in this service, and it appeared that national priorities were what determined safety activities, rather than patient need. There was inconsistency of information on attitudes and approaches to patient safety, exacerbated by a lack of common terminology.ConclusionPatient safety needs to become a more prominent consideration for ambulance services, rather than operational pressures, including targets and driving the service. Development of new models of working must include adequate training and monitoring of clinical risks. Providers and commissioners need a full understanding of the safety implications of introducing new models of care, particularly to a mobile workforce often isolated from colleagues, which requires a body of supportive evidence and an inherent critical evaluation culture. It is difficult to extrapolate findings of clinical studies undertaken in secondary care to ambulance service practice and current national guidelines often rely on consensus opinion regarding applicability to the pre-hospital environment. Areas requiring further work include the safety surrounding discharging patients, patient accidents, equipment and treatment, delays in transfer/admission to hospital, and treatment and diagnosis, with a clear need for increased reliability and training for improving handover to hospital.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
14
Hill, Arthur V. "An Experimental Comparison of Dispatching Rules for Field Service Support." Decision Sciences 23, no. 1 (January 1992): 235–49. http://dx.doi.org/10.1111/j.1540-5915.1992.tb00386.x.
Full text
15
Diaz, Roderick B., and Donald C. Schneck. "Bus Rapid Transit Technologies in the Americas: An Overview." Transportation Research Record: Journal of the Transportation Research Board 1731, no. 1 (January 2000): 3–9. http://dx.doi.org/10.3141/1731-01.
Full textAbstract:
Results from a survey of international bus rapid transit (BRT) systems reveal a wide range of technology options for implementing a BRT system. Eight BRT systems (seven existing and one under development) in North and South America demonstrate innovative applications of five bus technology components—vehicles, guideways and stations, control systems (dispatching and signaling), fare systems, and passenger information systems. These innovative applications, combined with fundamental changes in operating plans and the customer interface, provide a mode distinct from conventional bus transit. This preliminary phase of the survey found that guideway improvements are the most common strategy to move from conventional to rapid transit service. Innovations in vehicle design, control system technology, and fare system technology are also commonly used. All the surveyed systems demonstrate isolated innovation in passenger information systems technology. These technology applications were primarily directed toward improving the speed, reliability, and user-friendliness of service.
16
Barrett, Jack William, Pete Eaton-Williams, Craig ED Mortimer, Victoria FP Land, and Julia Williams. "A survey of ambulance clinicians’ perceptions of recording and communicating patient information electronically." British Paramedic Journal 6, no. 1 (May 1, 2021): 1–7. http://dx.doi.org/10.29045/14784726.2021.6.6.1.1.
Full textAbstract:
Objective: Ambulance services are evolving from use of paper-based recording of patient information to electronic platforms and the impact of this change has yet to be fully explored. The aim of this study is to explore how the introduction of a system permitting electronic information capture and its subsequent sharing were perceived by the ambulance clinicians using it.Methods: An online questionnaire was designed based upon the technology acceptance model and distributed throughout one ambulance service in the south east of England. Closed-ended questions with Likert scales were used to collect data from patient-facing staff who use an online community falls and diabetic referral platform or an electronic messaging system to update GPs following a patient encounter.Results: There were 273 responses from ambulance clinicians. Most participants agreed that they used tablet computers and smartphones to make their life easier (85% and 86%, respectively). Most participants felt that referring patients to a community falls or diabetic team electronically was an efficient use of their time (81% and 81%, respectively) and many believed that these systems improved the communication of confidential patient information. GP summaries were perceived as increasing time spent on scene but most participants (89%) believed they enabled collaborative working. Overall, collecting and sharing patient information electronically was perceived by most participants as beneficial to their practice.Conclusion: In this study, the ability to electronically refer patients to community services and share patient encounters with the GP was predominantly perceived as both safe for patients and an effective use of the participants’ clinical time. However, there is often still a need to communicate to GPs in real time, demonstrating that technology could complement, rather than replace, how clinicians communicate.
17
Li, Zongcheng. "Conception of a global dispatching system for metauniverse in internet of everything sky-earth computing (i) beyond cloud computing." ITM Web of Conferences 45 (2022): 01065. http://dx.doi.org/10.1051/itmconf/20224501065.
Full textAbstract:
In order to overcome the serious defects of information mechanism and promote the rationalization of resource allocation, this series of research proposes a hyper-cyber world computing mode which combines the traditional computing mode in various professional application fields with the modern computing mode in the field of information network technology (represented by distributed computing, grid computing, cloud computing and cluster computing), It can be called the Sky-Earth Computing (SEC). Here, “Sky (or Heaven)” metaphors the information world in the field of digital network technology, and “Earth” metaphors the real world in various professional application fields. Facing the ecosphere of metauniverse in Internet of everything, we propose to provide a customized global service dispatcher (GSD) and its enhanced version of the world-wise brain (WWB) with the user as the center. The global service dispatcher to be developed should have at least three functions: unified standard measurement system, supply-demand intelligent docking system, and integrated dispatching center system. Through the development and implementation of super metauniverse system engineering technology, let every user become the center of their own all-interconnected ecosphere (AIE)!
18
Nan, Dang. "The Design of Power Security Defense System Based on Resource Pool Cloud Computing Technology." International Journal of Information System Modeling and Design 11, no. 1 (January 2020): 1–11. http://dx.doi.org/10.4018/ijismd.2020010101.
Full textAbstract:
In order to realize the power system defense security, this article puts forward the idea and method of constructing power dispatching automation systems with a cloud computing architecture and realizes the unified management of distributed resources with server virtualization technology. Real-time online migration of each module of the scheduling system is realized by using the in-memory data transfer technology. The multi-node network heartbeat detection technology is used to realize the complete monitoring of the server cluster. In the form of an independent disk array, the fault node is removed, and the service is restored automatically. The whole disaster reserve of the system is realized by means of remote resource mapping. System analysis results show that compared with traditional architecture, the service interruption probability of the new scheduling automation system is effectively reduced. Fault redundancy capacity in the station is increased from a key module 2 node to multi-node protection of all modules.
19
Stueland, Dean, Mary Jean Patzner, Robert Rauch, and Marvin L. Birnbaum. "A Self-Assessment of Wisconsin Prehospital Provider Needs." Prehospital and Disaster Medicine 12, no. 4 (December 1997): 31–35. http://dx.doi.org/10.1017/s1049023x00037778.
Full textAbstract:
AbstractIntroduction:The pressures facing emergency medical services (EMS) in Wisconsin and their effects on the delivery of prehospital emergency medical care were not known by the Wisconsin EMS Board. In an effort to assess these pressures and the needs of the emergency medical services in the State as perceived by the services, the Board undertook a survey of the EMS providers in Wisconsin.Methods:A survey instrument was developed and approved by the EMS Board and distributed to all of the licensed emergency medical services in Wisconsin.Results:Of the 453 survey instruments distributed, 323 (71.3%) were completed and returned. Intermediate- and paramedic-level services were more likely to respond than were the basic services, but 235 (72.8%) of the respondents identified their service levels as basic. In addition to providing information about the service characteristics, each responding service also rated the importance of their perceived needs. Lack of medical direction was perceived as the greatest need by all levels of service. However, the second greatest area of need for basic and intermediate services related to difficulty in recruiting new staff. For paramedic services, the second greastest need was associated with dispatching. When comparing services by rural versus urban, difficulty in recruiting new staff and collecting ambulance fees were seen as second and third to lack of a medical director by rural services, whereas urban services noted local training to be in the top three. In the assessment of educational needs, patient-care issues dominated. A review of written comments also demonstrated a difference between rural and urban services, but both noted Medicare and Medicaid reimbursement issues more commonly than any other problem.Conclusion:In the restructuring of health care, it will be important to consider the various needs of prehospital providers and recognize that such needs may be unique to the providers' location and level of service.
20
Valente, Jacob T., and Miguel A. Perez. "Emergency Response to Vehicle Collisions: Feedback from Emergency Medical Service Providers." Safety 6, no. 4 (October 20, 2020): 48. http://dx.doi.org/10.3390/safety6040048.
Full textAbstract:
(1) Background: The purpose of this study is to identify emergency medical technicians’ perceptions of the most pressing issues that they experience when responding to motor vehicle collisions and record their opinions about what information is needed to improve the efficiency and effectiveness of the care they provide. (2) Methods: Emergency medical technicians participated in one-on-one structured interviews about their experiences responding to motor vehicle collisions. Their feedback on dispatching procedures and protocols, travel to and from the scene, and the response process was collected. (3) Results: Participants reported experiencing difficulties related to lack of or inaccuracies in information, interactions with traffic, incompatibility in communication technology, scene safety, resource management, and obtaining timely notifications of motor vehicle collisions. Regarding the type of information most needed to improve emergency medical response, respondents indicated a desire for additional data related to the vehicle and its occupants. (4) Conclusions: The early and widespread availability of this information is expected to aid emergency responders in coordinating necessary resources faster and more optimally, help service optimization in situations with multiple motor vehicle collisions in close temporal proximity, and improve on-scene safety for first responders and other necessary personnel.
21
Minnullin, I. P., V. G. Sorokin, A. I. Khodakov, M. Yu Kolodin, D. S. Parkhomchuk, R. I. Minnullin, N. V. Razumnyj, and V. M. Teplov. "INNOVATIVE SYSTEM OF DIAGNOSTICS AND DEVELOPMENT OF APPLIED PROFESSIONAL COMPETENCES OF EXPERTS OF EMERGENCY MEDICAL SERVICE. Message 2." EMERGENCY MEDICAL CARE 19, no. 1 (November 20, 2018): 4–9. http://dx.doi.org/10.24884/2072-6716-2018-0-1-4-9.
Full textAbstract:
In the message 2 presents the results of testing in real conditions the region described earlier [1] Internetsystem for testing, vocational information and counselling specialists visiting emergency medical assistance. In the message 1 [1] general principles were presented modern approaches to increase the level of training for ambulance services using computer technology. Describes the Organization of distance learning cycle for doctors and paramedics, the technique of stimulating self-learning address their personal health advice on pressing practical issues. Examines the effectiveness of the proposed system, provides evidence of significant improvement in the level of training participants in the experimental group for a two-month training cycle.
22
Snooks, Helen A., Rebecca Anthony, Robin Chatters, Jeremy Dale, Rachael Fothergill, Sarah Gaze, Mary Halter, et al. "Support and Assessment for Fall Emergency Referrals (SAFER) 2: a cluster randomised trial and systematic review of clinical effectiveness and cost-effectiveness of new protocols for emergency ambulance paramedics to assess older people following a fall with referral to community-based care when appropriate." Health Technology Assessment 21, no. 13 (March 2017): 1–218. http://dx.doi.org/10.3310/hta21130.
Full textAbstract:
BackgroundEmergency calls are frequently made to ambulance services for older people who have fallen, but ambulance crews often leave patients at the scene without any ongoing care. We evaluated a new clinical protocol which allowed paramedics to assess older people who had fallen and, if appropriate, refer them to community-based falls services.ObjectivesTo compare outcomes, processes and costs of care between intervention and control groups; and to understand factors which facilitate or hinder use.DesignCluster randomised controlled trial.ParticipantsParticipating paramedics at three ambulance services in England and Wales were based at stations randomised to intervention or control arms. Participants were aged 65 years and over, attended by a study paramedic for a fall-related emergency service call, and resident in the trial catchment areas.InterventionsIntervention paramedics received a clinical protocol with referral pathway, training and support to change practice. Control paramedics continued practice as normal.OutcomesThe primary outcome comprised subsequent emergency health-care contacts (emergency admissions, emergency department attendances, emergency service calls) or death at 1 month and 6 months. Secondary outcomes included pathway of care, ambulance service operational indicators, self-reported outcomes and costs of care. Those assessing outcomes remained blinded to group allocation.ResultsAcross sites, 3073 eligible patients attended by 105 paramedics from 14 ambulance stations were randomly allocated to the intervention group, and 2841 eligible patients attended by 110 paramedics from 11 stations were randomly allocated to the control group. After excluding dissenting and unmatched patients, 2391 intervention group patients and 2264 control group patients were included in primary outcome analyses. We did not find an effect on our overall primary outcome at 1 month or 6 months. However, further emergency service calls were reduced at both 1 month and 6 months; a smaller proportion of patients had made further emergency service calls at 1 month (18.5% vs. 21.8%) and the rate per patient-day at risk at 6 months was lower in the intervention group (0.013 vs. 0.017). Rate of conveyance to emergency department at index incident was similar between groups. Eight per cent of trial eligible patients in the intervention arm were referred to falls services by attending paramedics, compared with 1% in the control arm. The proportion of patients left at scene without further care was lower in the intervention group than in the control group (22.6% vs. 30.3%). We found no differences in duration of episode of care or job cycle. No adverse events were reported. Mean cost of the intervention was £17.30 per patient. There were no significant differences in mean resource utilisation, utilities at 1 month or 6 months or quality-adjusted life-years. In total, 58 patients, 25 paramedics and 31 stakeholders participated in focus groups or interviews. Patients were very satisfied with assessments carried out by paramedics. Paramedics reported that the intervention had increased their confidence to leave patients at home, but barriers to referral included patients’ social situations and autonomy.ConclusionsFindings indicate that this new pathway may be introduced by ambulance services at modest cost, without risk of harm and with some reductions in further emergency calls. However, we did not find evidence of improved health outcomes or reductions in overall NHS emergency workload. Further research is necessary to understand issues in implementation, the costs and benefits of e-trials and the performance of the modified Falls Efficacy Scale.Trial registrationCurrent Controlled Trials ISRCTN60481756 and PROSPERO CRD42013006418.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 13. See the NIHR Journals Library website for further project information.
23
Porter, Alison, Anisha Badshah, Sarah Black, David Fitzpatrick, Robert Harris-Mayes, Saiful Islam, Matthew Jones, et al. "Electronic health records in ambulances: the ERA multiple-methods study." Health Services and Delivery Research 8, no. 10 (February 2020): 1–140. http://dx.doi.org/10.3310/hsdr08100.
Full textAbstract:
Background Ambulance services have a vital role in the shift towards the delivery of health care outside hospitals, when this is better for patients, by offering alternatives to transfer to the emergency department. The introduction of information technology in ambulance services to electronically capture, interpret, store and transfer patient data can support out-of-hospital care. Objective We aimed to understand how electronic health records can be most effectively implemented in a pre-hospital context in order to support a safe and effective shift from acute to community-based care, and how their potential benefits can be maximised. Design and setting We carried out a study using multiple methods and with four work packages: (1) a rapid literature review; (2) a telephone survey of all 13 freestanding UK ambulance services; (3) detailed case studies examining electronic health record use through qualitative methods and analysis of routine data in four selected sites consisting of UK ambulance services and their associated health economies; and (4) a knowledge-sharing workshop. Results We found limited literature on electronic health records. Only half of the UK ambulance services had electronic health records in use at the time of data collection, with considerable variation in hardware and software and some reversion to use of paper records as services transitioned between systems. The case studies found that the ambulance services’ electronic health records were in a state of change. Not all patient contacts resulted in the generation of electronic health records. Ambulance clinicians were dealing with partial or unclear information, which may not fit comfortably with the electronic health records. Ambulance clinicians continued to use indirect data input approaches (such as first writing on a glove) even when using electronic health records. The primary function of electronic health records in all services seemed to be as a store for patient data. There was, as yet, limited evidence of electronic health records’ full potential being realised to transfer information, support decision-making or change patient care. Limitations Limitations included the difficulty of obtaining sets of matching routine data for analysis, difficulties of attributing any change in practice to electronic health records within a complex system and the rapidly changing environment, which means that some of our observations may no longer reflect reality. Conclusions Realising all the benefits of electronic health records requires engagement with other parts of the local health economy and dealing with variations between providers and the challenges of interoperability. Clinicians and data managers, and those working in different parts of the health economy, are likely to want very different things from a data set and need to be presented with only the information that they need. Future work There is scope for future work analysing ambulance service routine data sets, qualitative work to examine transfer of information at the emergency department and patients’ perspectives on record-keeping, and to develop and evaluate feedback to clinicians based on patient records. Study registration This study is registered as Health and Care Research Wales Clinical Research Portfolio 34166. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 10. See the NIHR Journals Library website for further project information.
24
Porter, Alison, Sarah Black, Jeremy Dale, David Fitzpatrick, Robert Harris-Mayes, Robin Lawrenson, Ronan Lyons, et al. "VP205 Implementing Electronic Records In Ambulances." International Journal of Technology Assessment in Health Care 33, S1 (2017): 246. http://dx.doi.org/10.1017/s0266462317004305.
Full textAbstract:
INTRODUCTION:Increasingly, ambulance services offer alternatives to transfer to the emergency department (ED), when this is better for patients. The introduction of electronic health records (EHR) in ambulance services is encouraged by national policy across the United Kingdom (UK) but roll-out has been variable and complex.Electronic Records in Ambulances (ERA) is a two-year study which aims to investigate and describe the opportunities and challenges of implementing EHR and associated technology in ambulances to support a safe and effective shift to out of hospital care, including the implications for workforce in terms of training, role and clinical decision-making skills.METHODS:Our study includes a scoping review of relevant issues and a baseline assessment of progress in all UK ambulance services in implementing EHR. These will inform four in-depth case studies of services at different stages of implementation, assessing current usage, and examining context.RESULTS:The scoping review identified themes including: there are many perceived potential benefits of EHR, such as improved safety and remote diagnostics, but as yet little evidence of them; technical challenges to implementation may inhibit uptake and lead to increased workload in the short term; staff implementing EHR may do so selectively or devise workarounds; and EHR may be perceived as a tool of staff surveillance.CONCLUSIONS:Our scoping review identified some complex issues around the implementation of EHR and the relevant challenges, opportunities and workforce implications. These will help to inform our fieldwork and subsequent data analysis in the case study sites, to begin early in 2017. Lessons learned from the experience of implementing EHR so far should inform future development of information technology in ambulance services, and help service providers to understand how best to maximize the opportunities offered by EHR to redesign care.
25
Williams, Victoria, Yvette LaFlamme-Williams, Katie McNee, Heather Morgan, Zoe Morrison, Henry WW Potts, Debbie Shaw, et al. "PP18 Implementation of electronic patient clinical records in ambulances in the UK: a national survey." Emergency Medicine Journal 36, no. 1 (January 2019): e7.3-e8. http://dx.doi.org/10.1136/emermed-2019-999.18.
Full textAbstract:
BackgroundThe roll-out of electronic Patient Clinical Records (ePCR) across UK ambulance services has been an important aspect of modernisation. Electronic Records in Ambulances (ERA) is a two-year study which aims to describe the opportunities and challenges of implementing ePCR and associated technology in emergency ambulances.Our study includes a baseline survey of progress implementing ePCR in all UK ambulance services providing a snapshot of current usage.MethodsWe carried out semi-structured telephone interviews with information managers in each ambulance service in the UK. We asked them about the systems in use, the process and current stage of implementation and explored the perceived value of using ePCR. If services did not use ePCR we asked about plans for future introduction.The interviews were transcribed and thematically analysed, by three members of the research team.ResultsWe completed interviews with 22 managers from 13 services. Implementation varied across the UK. Seven services were using electronic records. Four services had adopted electronic records but, at the time of interview, had reverted to paper with the intention of implementing a new ePCR. Two services still used paper but hoped to move to ePCR in the future. Those who had fully implemented ePCR reported mixed success in terms of staff compliance, and in realising the potential benefits offered by ePCR to link with primary and secondary care.Reported benefits of ePCR were largely associated with improved data management for audit and record keeping. Potential improvements to patient care were discussed, but tended to be associated with future planned developments.ImplicationsImplementation of ePCR has proved challenging with wide variation in use between ambulance services. Progress has been erratic, rather than linear, demonstrated by difficulties that services experienced putting ePCR into practice. There is potential for ambulance services in the earlier stages of implementation to learn from the experiences of others.
26
Wankhade, Paresh, Peter Stokes, Shlomo Tarba, and Peter Rodgers. "Work intensification and ambidexterity - the notions of extreme and ‘everyday’ experiences in emergency contexts: surfacing dynamics in the ambulance service." Public Management Review 22, no. 1 (August 23, 2019): 48–74. http://dx.doi.org/10.1080/14719037.2019.1642377.
Full text
27
Heffernan, Eithne, Dylan Keegan, Bridget Clarke, Conor Deasy, Cathal O'Donnell, Philip Crowley, Angela Hughes, Andrew W. Murphy, and Siobhán Masterson. "Quality improvement in a crisis: a qualitative study of experiences and lessons learned from the Irish National Ambulance Service response to the COVID-19 pandemic." BMJ Open 12, no. 1 (January 2022): e057162. http://dx.doi.org/10.1136/bmjopen-2021-057162.
Full textAbstract:
ObjectivesThe COVID-19 pandemic has produced radical changes in international health services. In Ireland, the National Ambulance Service established a novel home and community testing service that was central to the national COVID-19 screening programme. This service was overseen by a multidisciplinary response room. This research examined the response room service, particularly areas that performed well and areas requiring improvement, using a quality improvement (QI) framework.DesignThis was a qualitative study comprising semi-structured, individual interviews. Maximum variation sampling was used. The data were analysed using an established thematic analysis procedure. The analysis was guided by the framework, which comprised six QI drivers.SettingResponse room employees, including clinicians, dispatchers and administrators, were interviewed via telephone.ResultsLeadership for quality: participants valued person-oriented leadership, including regular, open communication and consultation with staff. Person/family engagement: participants endeavoured to provide patient-centred care. Formal patient feedback mechanisms and shared decision-making could be beneficial in the future. Staff engagement: working in a response room could affect well-being, though it also provided networking and learning opportunities. Staff require support and teambuilding. Use of improvement methods: improvements were made in a relatively informal, ad hoc manner. The use of robust methods based on improvement science was not reported. Measurement for quality: data were collected to improve efficiency and accuracy. More rigorous measurement would be beneficial, especially formally collecting stakeholder feedback. Governance for quality: close alignment with collaborators and clear communication with staff are essential. Information and communications technology for quality: this seventh driver was added because the importance of information technology specially designed for pandemics was frequently highlighted.ConclusionsThe study provides insights on what worked well and what required improvement in a pandemic response room. It can inform health services, particularly emergency services, in their preparation for additional COVID-19 waves, as well as future crises.
28
Feng, Fei, Xin Du, Qiang Si, and Hao Cai. "Hybrid Game Optimization of Microgrid Cluster (MC) Based on Service Provider (SP) and Tiered Carbon Price." Energies 15, no. 14 (July 21, 2022): 5291. http://dx.doi.org/10.3390/en15145291.
Full textAbstract:
Carbon trading is a market-based mechanism towards low-carbon electric power systems. A hybrid game optimization model is established for deriving the optimal trading price between microgrids (MGs) as well as providing the optimal pricing scheme for trading between the microgrid cluster(MC) and the upper-layer service provider (SP). At first, we propose a robust optimization model of microgrid clusters from the perspective of risk aversion, in which the uncertainty of wind and photovoltaic (PV) output is modeled with resort to the information gap decision theory (IGDT). Finally, based on the Nash bargaining theory, the electric power transaction payment model between MGs is established, and the alternating direction multiplier method (ADMM) is used to solve it, thus effectively protecting the privacy of each subject. It shows that the proposed strategy is able to quantify the uncertainty of wind and PV factors on dispatching operations. At the same time, carbon emission could be effectively reduced by following the tiered carbon price scheme.
29
Qureshi, Haneya Naeem, Marvin Manalastas, Aneeqa Ijaz, Ali Imran, Yongkang Liu, and Mohamad Omar Al Kalaa. "Communication Requirements in 5G-Enabled Healthcare Applications: Review and Considerations." Healthcare 10, no. 2 (February 2, 2022): 293. http://dx.doi.org/10.3390/healthcare10020293.
Full textAbstract:
Fifth generation (5G) mobile communication technology can enable novel healthcare applications and augment existing ones. However, 5G-enabled healthcare applications demand diverse technical requirements for radio communication. Knowledge of these requirements is important for developers, network providers, and regulatory authorities in the healthcare sector to facilitate safe and effective healthcare. In this paper, we review, identify, describe, and compare the requirements for communication key performance indicators in relevant healthcare use cases, including remote robotic-assisted surgery, connected ambulance, wearable and implantable devices, and service robotics for assisted living, with a focus on quantitative requirements. We also compare 5G-healthcare requirements with the current state of 5G capabilities. Finally, we identify gaps in the existing literature and highlight considerations for this space.
30
Gates, Simon, Ranjit Lall, Tom Quinn, Charles D. Deakin, Matthew W. Cooke, Jessica Horton, Sarah E. Lamb, et al. "Prehospital randomised assessment of a mechanical compression device in out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised trial and economic evaluation." Health Technology Assessment 21, no. 11 (March 2017): 1–176. http://dx.doi.org/10.3310/hta21110.
Full textAbstract:
BackgroundMechanical chest compression devices may help to maintain high-quality cardiopulmonary resuscitation (CPR), but little evidence exists for their effectiveness. We evaluated whether or not the introduction of Lund University Cardiopulmonary Assistance System-2 (LUCAS-2; Jolife AB, Lund, Sweden) mechanical CPR into front-line emergency response vehicles would improve survival from out-of-hospital cardiac arrest (OHCA).ObjectiveEvaluation of the LUCAS-2 device as a routine ambulance service treatment for OHCA.DesignPragmatic, cluster randomised trial including adults with non-traumatic OHCA. Ambulance dispatch staff and those collecting the primary outcome were blind to treatment allocation. Blinding of the ambulance staff who delivered the interventions and reported initial response to treatment was not possible. We also conducted a health economic evaluation and a systematic review of all trials of out-of-hospital mechanical chest compression.SettingFour UK ambulance services (West Midlands, North East England, Wales and South Central), comprising 91 urban and semiurban ambulance stations. Clusters were ambulance service vehicles, which were randomly assigned (approximately 1 : 2) to the LUCAS-2 device or manual CPR.ParticipantsPatients were included if they were in cardiac arrest in the out-of-hospital environment. Exclusions were patients with cardiac arrest as a result of trauma, with known or clinically apparent pregnancy, or aged < 18 years.InterventionsPatients received LUCAS-2 mechanical chest compression or manual chest compressions according to the first trial vehicle to arrive on scene.Main outcome measuresSurvival at 30 days following cardiac arrest; survival without significant neurological impairment [Cerebral Performance Category (CPC) score of 1 or 2].ResultsWe enrolled 4471 eligible patients (1652 assigned to the LUCAS-2 device and 2819 assigned to control) between 15 April 2010 and 10 June 2013. A total of 985 (60%) patients in the LUCAS-2 group received mechanical chest compression and 11 (< 1%) patients in the control group received LUCAS-2. In the intention-to-treat analysis, 30-day survival was similar in the LUCAS-2 (104/1652, 6.3%) and manual CPR groups [193/2819, 6.8%; adjusted odds ratio (OR) 0.86, 95% confidence interval (CI) 0.64 to 1.15]. Survival with a CPC score of 1 or 2 may have been worse in the LUCAS-2 group (adjusted OR 0.72, 95% CI 0.52 to 0.99). No serious adverse events were noted. The systematic review found no evidence of a survival advantage if mechanical chest compression was used. The health economic analysis showed that LUCAS-2 was dominated by manual chest compression.LimitationsThere was substantial non-compliance in the LUCAS-2 arm. For 272 out of 1652 patients (16.5%), mechanical chest compression was not used for reasons that would not occur in clinical practice. We addressed this issue by using complier average causal effect analyses. We attempted to measure CPR quality during the resuscitation attempts of trial participants, but were unable to do so.ConclusionsThere was no evidence of improvement in 30-day survival with LUCAS-2 compared with manual compressions. Our systematic review of recent randomised trials did not suggest that survival or survival without significant disability may be improved by the use of mechanical chest compression.Future workThe use of mechanical chest compression for in-hospital cardiac arrest, and in specific circumstances (e.g. transport), has not yet been evaluated.TriaI registrationCurrent Controlled Trials ISRCTN08233942.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 11. See the NIHR Journals Library website for further project information.
31
Spicher, Nicolai, Ramon Barakat, Ju Wang, Mostafa Haghi, Justin Jagieniak, Gamze Söylev Öktem, Siegfried Hackel, and Thomas Martin Deserno. "Proposing an International Standard Accident Number for Interconnecting Information and Communication Technology Systems of the Rescue Chain." Methods of Information in Medicine 60, S 01 (May 12, 2021): e20-e31. http://dx.doi.org/10.1055/s-0041-1728676.
Full textAbstract:
Abstract Background The rapid dissemination of smart devices within the internet of things (IoT) is developing toward automatic emergency alerts which are transmitted from machine to machine without human interaction. However, apart from individual projects concentrating on single types of accidents, there is no general methodology of connecting the standalone information and communication technology (ICT) systems involved in an accident: systems for alerting (e.g., smart home/car/wearable), systems in the responding stage (e.g., ambulance), and in the curing stage (e.g., hospital). Objectives We define the International Standard Accident Number (ISAN) as a unique token for interconnecting these ICT systems and to provide embedded data describing the circumstances of an accident (time, position, and identifier of the alerting system). Materials and Methods Based on the characteristics of processes and ICT systems in emergency care, we derive technological, syntactic, and semantic requirements for the ISAN, and we analyze existing standards to be incorporated in the ISAN specification. Results We choose a set of formats for describing the embedded data and give rules for their combination to generate an ISAN. It is a compact alphanumeric representation that is generated easily by the alerting system. We demonstrate generation, conversion, analysis, and visualization via representational state transfer (REST) services. Although ISAN targets machine-to-machine communication, we give examples of graphical user interfaces. Conclusion Created either locally by the alerting IoT system or remotely using our RESTful service, the ISAN is a simple and flexible token that enables technological, syntactic, and semantic interoperability between all ICT systems in emergency care.
32
Rudel'son, Lev E., Stanislaw N. Smorodskiy, and Victoriya A. Chernyshyova. "DYNAMIC DISCIPLINE OF PARALLEL SERVICE IN CONCEPT FLIGHT AND FLOW – INFORMATION FOR A COLLABORATIVE ENVIRONMENT." Civil Aviation High TECHNOLOGIES 21, no. 6 (December 26, 2018): 79–91. http://dx.doi.org/10.26467/2079-0619-2018-21-6-79-91.
Full textAbstract:
The International Civil Aviation Organization (ICAO) has published documents regulating the measures aimed to increase the intensity of flights. It is supposed to introduce qualitatively new principles of air traffic management based on the technical achievements in the field of communication, navigation and surveillance. The existing dispatching service technology is based on the principle of regulating the flow of aircraft through the feedback mechanism. The plan of the airspace utilization is used as the model for the management process. Deviations in the measurand of the aircraft movement from the calculated values can create prerequisites for potentially conflict situations and require the intervention of air traffic controller. The adjustment tool is a new distribution of the aircraft in their place, time and height. Following the instructions of the dispatcher, the pilot either proceeds to the bypass route, or changes either the altitude or speed. Minimal interference in the actions of the pilot is one of the criteria for assessing the controller’s work. The essence of ICAO's proposals is in the transition from the "tracking" system which responds to the deviations from the balanced model to the control system which predicts the tendencies to changing the air situation in real time. In order to realize this intention, every ground center and every crew should have consistent information about the real situation in the air and its development, so that each new intention (decision) is modeled, agreed on by the colleagues and fixed in flight plans. To reach the success in co-regulation of the situation it is important to have computer support in the field of aeronautical maintenance of decision-making, as well as high-speed algorithms for assessing the current parameters of the air traffic servicing process, such as handling capacity of aerodromes and terminals related to the changes being prepared. The article discusses the dynamic model of collective formation and flow maintenance using system-wide information. The model is built as a multi-channel system with priorities. Analytical estimates of the throughput are given. Criteria for the assessment are the indicators of the probability of failure and the average waiting time for maintenance by controller (refuses include the direction of the aircraft to the alternate aerodrome, repeated circle of landing, delayed departure, etc.). The proposed formulae are confirmed by the results of simulation computer experiments and statistical modeling.
33
Meena, K., C. Amuthadevi, and G. Sai Kumar. "Internet of Things based Accident Prevention and Detection System." International Journal of Engineering & Technology 7, no. 2.4 (March 10, 2018): 85. http://dx.doi.org/10.14419/ijet.v7i2.4.11171.
Full textAbstract:
Recent growth in technology makes our life faster and easier. This development in technologies leads to enhance the traffic hazards. In this paper, Internet of Things based accident prevention and detection system is proposed to deduce accidents and save human life. The vehicle performance has been continuously monitored for safety purposes. This technique is annoying to maintain speed balance to avoid accident and provide safety to the driver. Hence, a novel approach is proposed to avoid accidents and save the victims while accidents occur. Sensors are exploited to give alarm 'ON' when distance between two vehicles is too short. If accident happens, then the camera is automatically turned on and captures the images around 180 degree angles. This emergency alert information including the location is transferred to nearest police station, ambulance service and relatives through GSM modem. The major component of the project includes a Arduino, motion sensor, touch sensors, relay and GSM modem.
34
Xiong, Gang, Zhishuai Li, Huaiyu Wu, Shichao Chen, Xisong Dong, Fenghua Zhu, and Yisheng Lv. "Building Urban Public Traffic Dynamic Network Based on CPSS: An Integrated Approach of Big Data and AI." Applied Sciences 11, no. 3 (January 26, 2021): 1109. http://dx.doi.org/10.3390/app11031109.
Full textAbstract:
The extensive proliferation of urban transit cards and smartphones has witnessed the feasibility of the collection of citywide travel behaviors and the estimation of traffic status in real-time. In this paper, an urban public traffic dynamic network based on the cyber-physical-social system (CPSS-UPTDN) is proposed as a universal framework for advanced public transportation systems, which can optimize the urban public transportation based on big data and AI methods. Firstly, we introduce three modules and two loops which composes of the novel framework. Then, the key technologies in CPSS-UPTDN are studied, especially collecting and analyzing traffic information by big data and AI methods, and a particular implementation of CPSS-UPTDN is discussed, namely the artificial system, computational experiments, and parallel execution (ACP) method. Finally, a case study is performed. The data sources include both traffic congestion data from physical space and cellular data from social space, which can improve the prediction performance for traffic status. Furthermore, the service quality of urban public transportation can be promoted by optimizing the bus dispatching based on the parallel execution in our framework.
35
ДЕМЕНЕВ, Алексей, Alexei DEMENEV, Алина ИВАНОВА, and Alina IVANOVA. "STUDYING THE EFFICIENCY OF THE AUTOMATION THE MAINTENANCE MONITORING SYSTEMS OF APARTMENT BUILDINGS." Services in Russia and abroad 11, no. 5 (August 7, 2017): 116–22. http://dx.doi.org/10.22412/1995-042x-11-5-10.
Full textAbstract:
The present article describes the operation principles of the sphere of housing and communal services, taking into account the existing set of problems. Based on the development of a set of measures for their elimination control system for apartment buildings undergoing a number of changes aimed at improving the quality of the services provided. In connection with this, the article marked individual ongoing projects of changes in the monitoring system of apartment building. The authors note the priority of state policy in the sphere of housing and communal services, using effective information technology, resulting in a growth in the level of technical equipment of engineering objects. The article analyzes the examples of usage and marks positive results of recourse to the principle of extensive using implemented information technologies. The authors consider the task of dispatching service reflected in legal acts regulating the its activities, and implementation issues from the point of dispatch practical use, as well as the principle of monitoring system, its objectives and main components. The article presents the scheme of consumer communication and authority of monitoring system, analyzes aspects of the application of computerized management of apartment buildings, introduction, development plan and improving the monitoring system based on the introducing the automatic control; and makes a number of proposals for improvement of monitoring system by expanding the list of automated processes, including the cases of ongoing projects.
36
Fuller, Gordon W., Samuel Keating, Steve Goodacre, Esther Herbert, Gavin D. Perkins, Andy Rosser, Imogen Gunson, et al. "Prehospital continuous positive airway pressure for acute respiratory failure: the ACUTE feasibility RCT." Health Technology Assessment 25, no. 7 (February 2021): 1–92. http://dx.doi.org/10.3310/hta25070.
Full textAbstract:
Background Acute respiratory failure is a life-threatening emergency. Standard prehospital management involves controlled oxygen therapy. Continuous positive airway pressure is a potentially beneficial alternative treatment; however, it is uncertain whether or not this treatment could improve outcomes in NHS ambulance services. Objectives To assess the feasibility of a large-scale pragmatic trial and to update an existing economic model to determine cost-effectiveness and the value of further research. Design (1) An open-label, individual patient randomised controlled external pilot trial. (2) Cost-effectiveness and value-of-information analyses, updating an existing economic model. (3) Ancillary substudies, comprising an acute respiratory failure incidence study, an acute respiratory failure diagnostic agreement study, clinicians perceptions of a continuous positive airway pressure mixed-methods study and an investigation of allocation concealment. Setting Four West Midlands Ambulance Service hubs, recruiting between August 2017 and July 2018. Participants Adults with respiratory distress and peripheral oxygen saturations below the British Thoracic Society’s target levels were included. Patients with limited potential to benefit from, or with contraindications to, continuous positive airway pressure were excluded. Interventions Prehospital continuous positive airway pressure (O-Two system, O-Two Medical Technologies Inc., Brampton, ON, Canada) was compared with standard oxygen therapy, titrated to the British Thoracic Society’s peripheral oxygen saturation targets. Interventions were provided in identical sealed boxes. Main outcome measures Feasibility objectives estimated the incidence of eligible patients, the proportion recruited and allocated to treatment appropriately, adherence to allocated treatment, and retention and data completeness. The primary clinical end point was 30-day mortality. Results Seventy-seven patients were enrolled (target 120 patients), including seven patients with a diagnosis for which continuous positive airway pressure could be ineffective or harmful. Continuous positive airway pressure was fully delivered to 74% of participants (target 75%). There were no major protocol violations/non-compliances. Full data were available for all key outcomes (target ≥ 90%). Thirty-day mortality was 27.3%. Of the 21 deceased participants, 14 (68%) either did not have a respiratory condition or had ceiling-of-treatment decision implemented that excluded hospital non-invasive ventilation and critical care. The base-case economic evaluation indicated that standard oxygen therapy was probably cost-effective (incremental cost-effectiveness ratio £5685 per quality-adjusted life-year), but there was considerable uncertainty (population expected value of perfect information of £16.5M). Expected value of partial perfect information analyses indicated that effectiveness of prehospital continuous positive airway pressure was the only important variable. The incidence rate of acute respiratory failure was 17.4 (95% confidence interval 16.3 to 18.5) per 100,000 persons per year. There was moderate agreement between the primary prehospital and final hospital diagnoses (Gwet’s AC1 coefficient 0.56, 95% confidence interval 0.43 to 0.69). Lack of hospital awareness of the Ambulance continuous positive airway pressure (CPAP): Use, Treatment Effect and economics (ACUTE) trial, limited time to complete trial training and a desire to provide continuous positive airway pressure treatment were highlighted as key challenges by participating clinicians. Limitations During week 10 of recruitment, the continuous positive airway pressure arm equipment boxes developed a ‘rattle’. After repackaging and redistribution, no further concerns were noted. A total of 41.4% of ambulance service clinicians not participating in the ACUTE trial indicated a difference between the control and the intervention arm trial boxes (115/278); of these clinician 70.4% correctly identified box contents. Conclusions Recruitment rate was below target and feasibility was not demonstrated. The economic evaluation results suggested that a definitive trial could represent value for money. However, limited compliance with continuous positive airway pressure and difficulty in identifying patients who could benefit from continuous positive airway pressure indicate that prehospital continuous positive airway pressure is unlikely to materially reduce mortality. Future work A definitive clinical effectiveness trial of continuous positive airway pressure in the NHS is not recommended. Trial registration Current Controlled Trials ISRCTN12048261. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 7. See the NIHR Journals Library website for further project information.
37
Füzéry, Anna K., and Gerald J. Kost. "Point-of-Care Testing Practices, Failure Modes, and Risk-Mitigation Strategies in Emergency Medical Services Programs in the Canadian Province of Alberta." Archives of Pathology & Laboratory Medicine 144, no. 11 (October 27, 2020): 1352–71. http://dx.doi.org/10.5858/arpa.2020-0268-oa.
Full textAbstract:
Context.— Emergency medical services (EMS) programs have been using point-of-care testing (POCT) for more than 20 years. However, only a handful of reports have been published in all of that time on POCT practices in field settings. Objective.— To provide an overview of POCT practices and failure modes in 3 of Alberta's EMS programs, and to propose risk-mitigation strategies for reducing or eliminating these failure modes. Design.— Details about POCT practices, failure modes, and risk-mitigation strategies were gathered through (1) conversations with personnel, (2) in-person tours of EMS bases, (3) accompaniment of EMS personnel on missions, (4) internet searches for publicly available information, and (5) a review of laboratory documents. Results.— Practices were most standardized and robust in the community paramedicine program (single service provider, full laboratory oversight), and least standardized and robust in the air ambulance program (4 service providers, limited laboratory oversight). Common failure modes across all 3 programs included device inoperability due to cold weather, analytical validation procedures that failed to consider the unique challenges of EMS settings, and a lack of real-time electronic transmission of results into the health care record. Conclusions.— A provincial framework for POCT in EMS programs is desirable. Such a framework should include appropriate funding models, laboratory oversight of POCT, and relevant expertise on POCT in EMS settings. The framework should also incorporate specific guidance on quality standards that are needed to address the unique challenges of performing POCT in field settings.
38
Sterlyagov, S. P., V. M. Patudin, and A. S. Avdeev. "CRM SYSTEM AS A TOOL FOR SUSTAINABLE DEVELOPMENT OF MANAGEMENT COMPANIES OF THE HOUSING AND COMMUNAL CLUSTER." Economics Profession Business, no. 3 (September 12, 2022): 121–30. http://dx.doi.org/10.14258/epb202246.
Full textAbstract:
This article consinders the problem of designing sustainable development tools for manager organizations of hoursing and communal service. The problem of applying the process approach to the management of apartment buildings is discussed in the example of the system of relationships between the owners of premises and management companies. The main business processes in a managing organization company are identified, which make up the pool of business processes of the CRM system as a tool for customer focus and sustainable development. On the example of the business process of dispatching and emergency maintenance of an apartment building, the technology of implementing a process approach to for managing the pool of business processes of the CRM system. When designing a mechanism for managing business processes in a CRM system for a management company, it is proposed to use processes and performance indicators of service management (ITSM) as a specialized option for implementing a process approach to management, which is widely used to manage services in IT companies. Proposal have been developed interation to methodological and technological approaches to solving the problem of creating a CRM system standard for client-oriented managing following organization in accordance with the new strategy for the development of housing and communal services. A cloud-based implementation of information support for managing relationship between managing organizations and owners of apartment buildings as a tool for sustainable development of the housing and communal cluster in also proposed.
39
Lecky, Fiona, Wanda Russell, Gordon Fuller, Graham McClelland, Elspeth Pennington, Steve Goodacre, Kyee Han, et al. "The Head Injury Transportation Straight to Neurosurgery (HITS-NS) randomised trial: a feasibility study." Health Technology Assessment 20, no. 1 (January 2016): 1–198. http://dx.doi.org/10.3310/hta20010.
Full textAbstract:
BackgroundReconfiguration of trauma services, with direct transport of traumatic brain injury (TBI) patients to neuroscience centres (NCs), bypassing non-specialist acute hospitals (NSAHs), could potentially improve outcomes. However, delays in stabilisation of airway, breathing and circulation (ABC) and the difficulties in reliably identifying TBI at scene may make this practice deleterious compared with selective secondary transfer from nearest NSAH to NC. National Institute for Health and Care Excellence guidance and systematic reviews suggested equipoise and poor-quality evidence – with regard to ‘early neurosurgery’ in this cohort – which we sought to address.MethodsPilot cluster randomised controlled trial of bypass to NC conducted in two ambulance services with the ambulance station (n = 74) as unit of cluster [Lancashire/Cumbria in the North West Ambulance Service (NWAS) and the North East Ambulance Service (NEAS)]. Adult patients with signs of isolated TBI [Glasgow Coma Scale (GCS) score of < 13 in NWAS, GCS score of < 14 in NEAS] and stable ABC, injured nearest to a NSAH were transported either to that hospital (control clusters) or bypassed to the nearest NC (intervention clusters). Primary outcomes: recruitment rate, protocol compliance, selection bias as a result of non-compliance, accuracy of paramedic TBI identification (overtriage of study inclusion criteria) and pathway acceptability to patients, families and staff. ‘Open-label’ secondary outcomes: 30-day mortality, 6-month Extended Glasgow Outcome Scale (GOSE) and European Quality of Life-5 Dimensions.ResultsOverall, 56 clusters recruited 293 (169 intervention, 124 control) patients in 12 months, demonstrating cluster randomised pre-hospital trials as viable for heath service evaluations. Overall compliance was 62%, but 90% was achieved in the control arm and when face-to-face paramedic training was possible. Non-compliance appeared to be driven by proximity of the nearest hospital and perceptions of injury severity and so occurred more frequently in the intervention arm, in which the perceived time to the NC was greater and severity of injury was lower. Fewer than 25% of recruited patients had TBI on computed tomography scan (n = 70), with 7% (n = 20) requiring neurosurgery (craniotomy, craniectomy or intracranial pressure monitoring) but a further 18 requiring admission to an intensive care unit. An intention-to-treat analysis revealed the two trial arms to be equivalent in terms of age, GCS and severity of injury. No significant 30-day mortality differences were found (8.8% vs. 9.1/%;p > 0.05) in the 273 (159/113) patients with data available. There were no apparent differences in staff and patient preferences for either pathway, with satisfaction high with both. Very low responses to invitations to consent for follow-up in the large number of mild head injury-enrolled patients meant that only 20% of patients had 6-month outcomes. The trial-based economic evaluation could not focus on early neurosurgery because of these low numbers but instead investigated the comparative cost-effectiveness of bypass compared with selective secondary transfer for eligible patients at the scene of injury.ConclusionsCurrent NHS England practice of bypassing patients with suspected TBI to neuroscience centres gives overtriage ratios of 13 : 1 for neurosurgery and 4 : 1 for TBI. This important finding makes studying the impact of bypass to facilitate early neurosurgery not plausible using this study design. Future research should explore an efficient comparative effectiveness design for evaluating ‘early neurosurgery through bypass’ and address the challenge of reliable TBI diagnosis at the scene of injury.Trial registrationCurrent Controlled Trials ISRCTN68087745.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 20, No. 1. See the NIHR Journals Library website for further project information.
40
Lin, Hui, Pei Liu, Wei Li, Lian Peng Zhang, and Ya Zhou Ji. "Construction of Digital Mine and Key Technologies." Advanced Materials Research 524-527 (May 2012): 413–20. http://dx.doi.org/10.4028/www.scientific.net/amr.524-527.413.
Full textAbstract:
In China, the mine is facing a stern challenge over its environmental protection, the limitation on its structure and function within its subsystem, optimization of its limited manpower, financial and material resources and its sustainable development. Digital mine is come up with to deal with all these problems. The Digital Mine can be liken to “a logistics supply chain”, the basic characteristic is the high-speed network, with broadband and two-way communication system, used as “path map”, which shall make sure the fast delivery of all the data within all the relevant enterprises in the country; It consists of vehicles, which refers to the techniques of Mine CAD, virtual reality, mine simulation, scientific calculation, artificial intelligence, visualization and office automation; goods, which refers to mine data and mind application model; package, which refers to 3DGM(3-Dimensional Geographical Model) and data mining; security system, which refers to the collection and renewal system of mine data; and dispatching system, which refers to MGIS(Mine Geographical Information System), the common carrier of the entire information and office decisions, controlling the use and operation of all vehicles as well as all of the goods production and the package system. The basic structure of the Digital Mine is composed of two parts: digital ground and digital mine. The digital ground is a management information system based on the EPR (Enterprise Resource Planning) and spatial information infrastructure and information system based on 3S technology and computer network. The digital mine regards the mine geology and surveying data as basic information data for spatial positioning, furthermore, inputting other relevant information if necessary, such as mining working-face, excavating working-face, underground chamber, mechanical and electronic equipments, ventilation and safety device, underground pipeline and communication and others, forming a spatial database. Thus, the entire mine’s information system of management and service and decision support system is established. The Digital Mine is a huge systematic project, involving 3S (GIS, GPS, RS), IT (Information technology), mine science, virtual reality technology and visualization technology. Based on computers and network communication, the Digital Mine realizes the digitization of storing, transporting, expressing and applying of all the relevant spatial data and attribute data, including mine construction, exploration, development, mining, environmental protection and control. In addition, it is also a huge artificial intellectual system that integrates digital construction, digital exploration, digital mining, digital environmental protection and digital forecasting based on data dictionary technology, data warehouse technology, WebGIS, virtual reality technology, multimedia technology, CASE technology and artificial intelligence technology.
41
Xia, Tianqi, Shuzhe Huang, Xuan Song, Ruochen Si, Xiaoya Song, Ryosuke Shibasaki, and Kyoung-Sook Kim. "Evaluating transport time in emergency medical service via GIS: an observational study of Tokyo." Abstracts of the ICA 1 (July 15, 2019): 1–2. http://dx.doi.org/10.5194/ica-abs-1-408-2019.
Full textAbstract:
<p><strong>Abstract.</strong> Emergency medical service (EMS) is one kind of medical services which focuses on providing first-time rescue to victims of sudden and life-threatening emergencies. Since a lot of studies have pointed out a close relation between the increase of cost time before the patient accommodated to the hospital and the increased risk of mortality, a reasonable distribution of EMS facilities can shorten the transportation time from the scene to the hospital and is critical to ensure the quality of the EMS system.</p><p>With the development of geographic information science and technology, GIS provides the visualization and analysis approaches for the distribution of the EMS cases, ambulance cars and hospitals as well as the ability of measuring road network distance, which results in the popularity of research with GIS based analysis approaches in the field of public health and EMS system. Despite of the prosperity in such kind of studies, most of them focused on evaluating EMS system by observational case analysis while paying less attention on the emergency medical resource distribution.</p><p>With the concerns we mentioned above, this research conducts spatial and temporal analysis for evaluating the transportation time via several GIS methods and take the EMS cases in Tokyo 23 wards as a case study. In addition to the observational studies with EMS case data and several spatial and temporal factors, we pay more attention on evaluating the distribution of cases and hospitals from both sides of demand and supplement. In addition, we also check several assumptions that are widely used in accessibility analysis on public health. As far as we know, our work is first research on detailed hospital distribution analysis in Tokyo area based on observations.</p><p>
42
Turnbull, Joanne, Catherine Pope, Alison Rowsell, Jane Prichard, Susan Halford, Jeremy Jones, Carl May, and Valerie Lattimer. "The work, workforce, technology and organisational implications of the ‘111’ single point of access telephone number for urgent (non-emergency) care: a mixed-methods case study." Health Services and Delivery Research 2, no. 3 (February 2014): 1–140. http://dx.doi.org/10.3310/hsdr02030.
Full textAbstract:
BackgroundNHS 111 represents a fundamental change in the way that urgent care is delivered. It is underpinned by a computer decision support system (CDSS) and involves significant labour substitution, in particular the greater use of non-clinical staff to deliver services.ObjectiveTo investigate four core features of health-care innovation and change in relation to the new NHS 111 telephone-based service for 24/7 access to urgent care, namely the way in whichworkandworkforceare organised for this new service and how thetechnologyandorganisational contextshape the way in which services are delivered.DesignComparative mixed-methods case study of NHS 111 providers.SettingsFive NHS 111 sites, characterised by differences in organisational size, form and ethos and in the type of workforce employed and professional roles and skill mix.MethodsThe study combined ethnographic and survey methods. Non-participant observation was conducted at NHS 111 call centres and their linked urgent care centre(s) (UCCs; a total of 356 hours). Six focus groups were conducted with 47 call advisers, clinicians and organisational managers. An online survey was administered to call centre and UCC staff (n = 745) to ask their views about NHS 111; trust in NHS Pathways; and communication and information sharing (response rate: 41% for call centre staff, 35% for UCC staff).ResultsClinical assessment by call advisers is characterised by high levels of communication (including negotiation, communication and translation) and ‘emotion’ work, extending the work beyond simple operation of a CDSS. At most sites clinical advisers supported call advisers in clinical assessment but also played an important role in managing and sanctioning dispositions, notably emergency ambulance dispositions. Clinicians at UCCs have experienced a loss of control over their everyday work, which is now shaped by call centre workers. The Directory of Services, which provides information about locally available services, is key to delivering an integrated urgent care system. Trust in the CDSS is higher amongst call advisers than amongst clinical staff but there is widespread belief that the CDSS is risk averse. Staff often develop workarounds to ‘make the technology work’. There is considerable variation in how NHS 111 is organised and delivered, shaped by the organisational history and the professional culture of the organisations involved. Some sites were driven more by rationing and systemising, pursuing the NHS 111 vision of ‘right care, right place, right time’, whereas others were driven more by an ethos of what they perceived was a more patient-centred service.ConclusionsNHS 111 is primarily founded on a network of different organisations providing different aspects of the service. This network is primarily enabled through technological integration. Successful integration also requires understanding and trusting relationships between different providers, which were lacking in some sites. Underpinning NHS 111 with non-clinical workers offers significant opportunities for workforce reconfiguration, but this is not a simple substitution of labour (i.e. non-clinical staff replacing clinical staff). There is a significant organisational structure that is necessary to support and ‘keep in place’ both the CDSS itself and non-clinical workers using the CDSS.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
43
Aminigbo, Leonard Michael Onyinyechi, and Olusola Gabriel Omogunloye. "Developing Geospatial Database For Emergency Response; A Case Study of Fire, Health And Security Facilities in Rivers State." International Journal of Information Systems and Informatics 3, no. 2 (June 30, 2022): 81–106. http://dx.doi.org/10.47747/ijisi.v3i2.712.
Full textAbstract:
Effective and efficient emergency management and response requires having the right information within the shortest possible time frame in order to save lives and property, this also involves the free flow of the right information in the right format, to the right person, in the right time to make the right decision. The aim of this research is to evaluate benefits of the use of Geoinformatics technology in emergency management to assist in planning and acting as a decision support system to Fire, Health and Security emergency managers. In this research, Rivers state fire stations were evaluated as a unit of emergency delivery system, the research examined the role of Geoinformatics in evaluating the performance of emergency fire service delivery based on response time and fire station distribution. Using ArcGIS Network analysis and an annual fire incident record from year 2000-2012, the study revealed that the functional fire stations operating in Rivers state were unable to cover the entire populated regions within 5 minutes response time. In the case of this research the primary question that was addressed was; "Does everyone have access to rescue services within five minutes of travel time?" The research concluded by proposing the location of three fire stations using location allocation tool to help reduce the burden of other fire station and ensured ninety five percent (95%) wider coverage and reduced response time. This research also recommended that more efforts should be channeled towards curbing the practice of illegal and crude ways of refining petroleum products in the state; hence the result of the partial correlation of the variables associated with causes of fire incidents in Rivers State indicates a huge influence of kerosene explosion. The nearest neigbour index (RN) of 0.59 for Hospital indicates a clustered pattern of distribution of health facilities in Rivers State, hence there should be deliberate policies to ensure regular pattern of distribution which allows spatial equidistance to these facilities Due to the unavailability of current Population data the research was carried out using 2006 population data of the study area which do not extensively cover the remote communities This researcher suggested the following areas for further study; The spatial distribution of fire incident in Rivers state in relation to the underlying social composition of the population using derivative index analysis, the use of web based GIS for effective emergency responds could be a viable area to explore. The spatiotemporal location and relocation of stationary ambulance service in a bid to provide even service delivery within the city
44
Wachiradilok, Porntip. "Emergency Patients with Mental Crisis Accessing Emergency Medical Services in Thailand." Prehospital and Disaster Medicine 34, s1 (May 2019): s126. http://dx.doi.org/10.1017/s1049023x19002723.
Full textAbstract:
Introduction:Emergency responders face an increasing number of calls involving people with behavioral and mental crisis issue. Integrated multi-agency schemes involving ambulance, police and mental health services are now being developed to provide urgent and emergency care pathways for these vulnerable patients.Aim:The objectives were to study the situation, characteristics, issues, and accessibility to emergency medical services (EMS) and appropriate treatment for emergency patients with a mental crisis in Thailand.Methods:The sample included 26,511 mental crisis patients accessing EMS. Data were obtained from the database of the Information Technology for Emergency Medical System between 2015-2017 and from stakeholders from four provinces distributed regionally using focus groups and in-depth interviews. The data were analyzed using descriptive statistics and content analysis.Results:The number of patients with mental crisis accessing EMS increased in the past three years. Most patients are male in the working age group from the Northeastern area during the raining and winter season, especially between September and October. During patient encounters with maniacal attacks, assistance will be requested from the police and the emergency medical units. The response depends on the experience and community capability. The emergency responder teams had insufficient knowledge and skills. Emergency rooms in most hospitals lack specific caring unit. Psychiatric hospitals have different criteria for admitting patients. Most had no fast track system and even refuse admittance.Discussion:Mental crisis patient calls with EMS were rising. However, accessibility to appropriate service centers was still an issue. Most hospitals lack prioritized access and staffs had insufficient knowledge and skills. Cooperation among the police, emergency medical operation team and the rapid psychiatric emergency team is need to be reinforced.
45
Kalinin, Maxim, Dmitry Zegzhda, and Evgenii Zavadskii. "Protection of Energy Network Infrastructures Applying a Dynamic Topology Virtualization." Energies 15, no. 11 (June 3, 2022): 4123. http://dx.doi.org/10.3390/en15114123.
Full textAbstract:
Rapid progress of computing and info-communication technologies (ICT) has changed the ecosystem of power production and delivery. Today, an energy network is a complex set of interrelated devices and information systems covering all areas of electric power operations and applying ICT based on open standards, such as IEC 60870, IEC 61850, and IEC 61970. According to IEC 62351, the energy networks are faced with high cybersecurity risks caused by open communications, security requirements rarely considered in the energy facilities, partial and difficult upgrades, and incompatibility of secure tools with industrial solutions. This situation results in new security challenges, e.g. denial of service attacks on the connected controllers, dispatching centers, process control systems, and terminals. IEC 62351 describes possible ways to comprehensive security in the energy networks. Most of them used in traditional networks (e.g., firewalls, intrusion detection systems) can be adapted to the energy networks. Honeypot systems as a protection measure help us to mitigate the attacks and maintain necessary security in the networks. Due to the large scale of an energy network and heterogeneity of its components, a new design, deployment, and management strategy for the honeypot systems are required. The paper suggests a new method for organizing a virtual network infrastructure of a hybrid honeypot system and a dynamic management method that adapts the network topology to the attacker’s actions according to the development graph of potential attacks. This technique allows us to dynamically build virtual networks of arbitrary scale. Because of the similarity of the virtual network to the virtualized origin and providing the level of interactivity of its nodes corresponding to real devices, this technique deploys an energy network indistinguishable from the real one for the attackers. A prototype of our honeypot system has been implemented, and experiments on it have demonstrated the more efficient use of the computing resources, the faster reaction to the attacker’s actions, and the deployment of different sizes of virtual networks for the given limits of the computing resources.
46
Pakhomov, Yu, N. Shulga, and L. Piddubna. "ON THE QUESTION OF THE EFFECTIVENESS OF NETWORK TECHNOLOGIES IN AUTOMATED GAS SUPPLY SYSTEMS." Municipal economy of cities 1, no. 161 (March 26, 2021): 267–73. http://dx.doi.org/10.33042/2522-1809-2021-1-161-267-273.
Full textAbstract:
The topical issues of development of automated control systems of gas control stations (GCS) and ways of reliable and economical functioning of the gas supply system in modern conditions have been considered in the article. The implementation of European innovative technologies, which are associated with using the modern equipment, telemetry tools to transmit the equipment operation parameters to the dispatcher control panel are the one of the ways to increase the safety and efficiency of GCS performance. The characteristic of the modern complex of telemetry, the raising of efficiency, reliability and safe operation of the gas supply systems due to the possibility of monitoring, technological control and management from the central dispatcher control room are given. The complex of telemetry helps to prevent emergency situations at facilities and to ensure control over unauthorized entry into the GCS premises by unauthorized persons. The article discusses the use of the automated system of operative-dispatching management (ASODM). It is a multi-level automated system that ensures the reliable functioning of the gas supply system at all levels of the hierarchy. It has been shown that the result of the creation of the ASODM are equipping of the control object with microprocessor control and management devices, the integration of various automation tools into a single information management system. It has been proven that the development of ASODM of GCS on the basis of local control and management modules using traditional approaches to creation of automation systems and using the cellular telephone communication as data transmission channels based on GSM-technologies are most rational. The digital control device, which is made on the technological platform of the programmable logic integrated circuit (PLIC), is the main element of the local control and management module. Digital control device (PLIC controller) is a relatively inexpensive and reliable equipment in an automated local GCS control system. The method of data transmission via GSM / GPRS wireless communication channel is considered. The use of GSM-modems and GPRS technology allows to remove restrictions on the distance of data transmission, as well as allows to fully automate the process of transmission and processing of information. The use of GSM / GPRS-technologies in the vehicles of the emergency dispatch service is also shown. The dispatcher can fully monitor the movement of the car with registration on the map of the city where the car is located.
47
Hutchings, Owen Rhys, Cassandra Dearing, Dianna Jagers, Miranda Jane Shaw, Freya Raffan, Aaron Jones, Richard Taggart, Tim Sinclair, Teresa Anderson, and Angus Graham Ritchie. "Virtual Health Care for Community Management of Patients With COVID-19 in Australia: Observational Cohort Study." Journal of Medical Internet Research 23, no. 3 (March 9, 2021): e21064. http://dx.doi.org/10.2196/21064.
Full textAbstract:
Background Australia has successfully controlled the COVID-19 pandemic. Similar to other high-income countries, Australia has extensively used telehealth services. Virtual health care, including telemedicine in combination with remote patient monitoring, has been implemented in certain settings as part of new models of care that are aimed at managing patients with COVID-19 outside the hospital setting. Objective This study aimed to describe the implementation of and early experience with virtual health care for community management of patients with COVID-19. Methods This observational cohort study was conducted with patients with COVID-19 who availed of a large Australian metropolitan health service with an established virtual health care program capable of monitoring patients remotely. We included patients with COVID-19 who received the health service, could self-isolate safely, did not require immediate admission to an in-patient setting, had no major active comorbid illness, and could be managed at home or at other suitable sites. Skin temperature, pulse rate, and blood oxygen saturation were remotely monitored. The primary outcome measures were care escalation rates, including emergency department presentation, and hospital admission. Results During March 11-29, 2020, a total of 162 of 173 (93.6%) patients with COVID-19 (median age 38 years, range 11-79 years), who were diagnosed locally, were enrolled in the virtual health care program. For 62 of 162 (38.3%) patients discharged during this period, the median length of stay was 8 (range 1-17) days. The peak of 100 prevalent patients equated to approximately 25 patients per registered nurse per shift. Patients were contacted a median of 16 (range 1-30) times during this period. Video consultations (n=1902, 66.3%) comprised most of the patient contacts, and 132 (81.5%) patients were monitored remotely. Care escalation rates were low, with an ambulance attendance rate of 3% (n=5), emergency department attendance rate of 2.5% (n=4), and hospital admission rate of 1.9% (n=3). No deaths were recorded. Conclusions Community-based virtual health care is safe for managing most patients with COVID-19 and can be rapidly implemented in an urban Australian setting for pandemic management. Health services implementing virtual health care should anticipate challenges associated with rapid technology deployments and provide adequate support to resolve them, including strategies to support the use of health information technologies among consumers.
48
Pandor, Abdullah, Praveen Thokala, Steve Goodacre, Edith Poku, John W. Stevens, Shijie Ren, Anna Cantrell, Gavin D. Perkins, Matt Ward, and Jerry Penn-Ashman. "Pre-hospital non-invasive ventilation for acute respiratory failure: a systematic review and cost-effectiveness evaluation." Health Technology Assessment 19, no. 42 (June 2015): 1–102. http://dx.doi.org/10.3310/hta19420.
Full textAbstract:
BackgroundNon-invasive ventilation (NIV), in the form of continuous positive airway pressure (CPAP) or bilevel inspiratory positive airway pressure (BiPAP), is used in hospital to treat patients with acute respiratory failure. Pre-hospital NIV may be more effective than in-hospital NIV but requires additional ambulance service resources.ObjectivesWe aimed to determine the clinical effectiveness and cost-effectiveness of pre-hospital NIV compared with usual care for adults presenting to the emergency services with acute respiratory failure and to identify priorities for future research.Data sourcesFourteen electronic databases and research registers (including MEDLINE In-Process & Other Non-Indexed Citations, MEDLINE, EMBASE, and Cumulative Index to Nursing and Allied Health Literature) were searched from inception to August 2013, supplemented by hand-searching reference lists and contacting experts in the field.Review methodsWe included all randomised or quasi-randomised controlled trials of pre-hospital NIV in patients with acute respiratory failure. Methodological quality was assessed according to established criteria. An aggregate data network meta-analysis (NMA) of mortality and intubation was used to jointly estimate intervention effects relative to usual care. A NMA, using individual patient-level data (IPD) and aggregate data where IPD were not available, was carried out to assess whether or not covariates were treatment effect modifiers. A de novo economic model was developed to explore the costs and health outcomes when pre-hospital NIV (specifically CPAP provided by paramedics) and standard care (in-hospital NIV) were applied to a hypothetical cohort of patients with acute respiratory failure.ResultsThe literature searches identified 2284 citations. Of the 10 studies that met the inclusion criteria, eight were randomised controlled trials and two were quasi-randomised trials (six CPAP; four BiPAP; sample sizes 23–207 participants). IPD were available from seven trials (650 patients). The aggregate data NMA suggested that CPAP was the most effective treatment in terms of mortality (probability = 0.989) and intubation rate (probability = 0.639), and reduced both mortality [odds ratio (OR) 0.41, 95% credible interval (CrI) 0.20 to 0.77] and intubation rate (OR 0.32, 95% CrI 0.17 to 0.62) compared with standard care. The effect of BiPAP on mortality (OR 1.94, 95% CrI 0.65 to 6.14) and intubation rate (OR 0.40, 95% CrI 0.14 to 1.16) compared with standard care was uncertain. The combined IPD and aggregate data NMA suggested that sex was a statistically significant treatment effect modifier for mortality. The economic analysis showed that pre-hospital CPAP was more effective and more expensive than standard care, with an incremental cost-effectiveness ratio of £20,514 per quality-adjusted life-year (QALY) and a 49.5% probability of being cost-effective at the £20,000-per-QALY threshold. Variation in the incidence of eligible patients had a marked impact on cost-effectiveness and the expected value of sample information for a future randomised trial.LimitationsThe meta-analysis lacked power to detect potentially important differences in outcome (particularly for BiPAP), the intervention was not always compared with the best alternative care (in-hospital NIV) in the primary studies and findings may not be generalisable.ConclusionsPre-hospital CPAP can reduce mortality and intubation rates, but cost-effectiveness is uncertain and the value of further randomised evaluation depends on the incidence of suitable patients. A feasibility study is required to determine if a large pragmatic trial of clinical effectiveness and cost-effectiveness is appropriate.Study registrationThe study is registered as PROSPERO CRD42012002933.FundingThe National Institute for Health Research Health Technology Assessment programme.
49
Hammami, Sondes, and Aida Jebali. "Designing modular capacitated emergency medical service using information on ambulance trip." Operational Research, February 11, 2019. http://dx.doi.org/10.1007/s12351-019-00458-4.
Full text
50
Quy, Vu Khanh, Nguyen Van Hau, Dang Van Anh, and Le Anh Ngoc. "Smart healthcare IoT applications based on fog computing: architecture, applications and challenges." Complex & Intelligent Systems, November 17, 2021. http://dx.doi.org/10.1007/s40747-021-00582-9.
Full textAbstract:
AbstractThe history of human development has proven that medical and healthcare applications for humanity always are the main driving force behind the development of science and technology. The advent of Cloud technology for the first time allows providing systems infrastructure as a service, platform as a service and software as a service. Cloud technology has dominated healthcare information systems for decades now. However, one limitation of cloud-based applications is the high service response time. In some emergency scenarios, the control and monitoring of patient status, decision-making with related resources are limited such as hospital, ambulance, doctor, medical conditions in seconds and has a direct impact on the life of patients. To solve these challenges, optimal computing technologies have been proposed such as cloud computing, edge computing, and fog computing technologies. In this article, we make a comparison between computing technologies. Then, we present a common architectural framework based on fog computing for Internet of Health Things (Fog-IoHT) applications. Besides, we also indicate possible applications and challenges in integrating fog computing into IoT Healthcare applications. The analysis results indicated that there is huge potential for IoHT applications based on fog computing. We hope, this study will be an important guide for the future development of fog-based Healthcare IoT applications.