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Tesi sul tema "Emergency medical services"

Autore: Grafiati

Pubblicato: 4 giugno 2021

Ultima modifica: 30 luglio 2024

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1

Smith, Leanne. "Modelling Emergency Medical Services". Thesis, Cardiff University, 2013. http://orca.cf.ac.uk/47743/.

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Emergency Medical Services (EMS) play a pivotal role in any healthcare organisation. Response and turnaround time targets are always of great concern for the Welsh Ambulance NHS Trust (WAST). In particular, the more rural areas in South East Wales consistently perform poorly with respect to Government set response standards, whilst delayed transfer of care to Emergency Departments (EDs) is a problem publicised extensively in recent years. Many Trusts, including WAST, are additionally moving towards clinical outcome based performance measures, allowing an alternative system-evaluation approach to the traditional response threshold led strategies, resulting in a more patient centred system. Three main investigative parts form this thesis, culminating in a suite of operational and strategic decision support tools to aid EMS managers. Firstly, four novel allocation model methods are developed to provide vehicle allocations to existing stations whilst maximising patient survival. A detailed simulation model then evaluates clinical outcomes given a survival based (compared to response target based) allocation, determining also the impact of the fleet, its location and a variety of system changes of interest to WAST (through ‘what-if?’ style experimentation) on entire system performance. Additionally, a developed travel time matrix generator tool, enabling the calculation and/or prediction of journey times between all pairs of locations from route distances is utilised within the aforementioned models. The conclusions of the experimentation and investigative processes suggest system improvements can in fact come from better allocating vehicles across the region, by reducing turnaround times at hospital facilities and, in application to South East Wales, through alternative operational policies without the need to increase resources. As an example, a comparable degree of improvement in patient survival is witnessed for a simulation scenario where the fleet capacity is increased by 10% in contrast to a scenario in which ideal turnaround times (within the target) occur.

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2

Thor, Danielle Claire. "Ethics in Emergency Medical Services: A Contextual Analysis". Master's thesis, Temple University Libraries, 2019. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/592304.

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Urban Bioethics
M.A.
The modern concept of Emergency Medical Services (EMS) has grown from its humble volunteerism origins to a multidisciplinary enterprise, outstretched into the realms of both healthcare and public service. As the American EMS community continues to assume greater responsibilities and further develop its professional standards, the moral foundations of this field open themselves to more thorough scrutiny. Upon examination, the major deficit in the ethical structuring of EMS becomes glaringly obvious: it exists as a piecemeal collection of its medical and militaristic counterparts unified by theoretical generalizations that avoid its inherently unique structure. If EMS wishes to matriculate into complete professionalism, or even continue its assumption of critical responsibilities surrounding the health and safety of others, then it must also develop and maintain its own individual ethical framework from which it operates. In doing so, an urban bioethical approach rooted in context-driven analysis and pragmatic solutions may provide the best guidance and protections for all those who interact with the EMS system while respecting the values of this distinctively prideful service.
Temple University--Theses

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3

Anderson, Mindi S. "Integrating Emergency Medical Services Into the Patient-Centered Medical Home". Thesis, Capella University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10288192.

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Abstract Emergency medical services (EMS) for nonemergent or low-acuity calls is a new normal. EMS agencies spend a majority of time providing primary care services through the 911 system. They are utilized currently to fill the primary care gap subconsciously. The EMS system is activated as a patient navigator for primary care services. EMS agencies in the state where the research occurred have responded to the gap in care management by creating innovative programs such as community health emergency medical services (CHEMS). Creation of CHEMS programs have become one of the most monumental concepts for change in the field on both a state and national level. EMS has sought ways to meet the goals of the Triple Aim by exploring CHEMS as the state transitions to value-based care. Leaders are searching for innovative ways to close the gap in the primary health care system through a patient-centered medical home (PCMH) model. The action research study stimulated innovative thinking to support coordinated care across the evolving continuum of the health care system. The study captured the current awareness from community health care leaders who have had a recent opportunity to explore the idea of integrating EMS into the PCMH model through semi-structured interview sessions. Major findings in the thematical analysis discovered the current way both EMS and a PCMH function in a silo system that could potentially utilize each other to effectively provide managed care. Joint efforts could offset overutilization of EMS services for calls that have no apparent life threats. EMS would allow for a PCMH to conform to the Patient Protection and Affordable Care Act standards of care management, contributing to the integration of Triple Aim objectives. Collaboratively, EMS and an established PCMH will impact the delivery of preventative, quality and cost-efficient care. The theory of organizational culture change is based on three common characteristics: culture is shared, is intangible, and affects human behavior. The conceptual framework of the research study was based on the chronic care model. Patients with comorbidities potentially utilize the health care system more than a healthy patient to seek reassurance that their health is managed.

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4

Baldridge, Kenan S. "Emergency medical services in the Rochester region of New York state organization, services and systems /". Akron, OH : University of Akron, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=akron1177640876.

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Thesis (Ph. D.)--University of Akron, Dept. of Public Affairs and Urban Studies, 2007.
"May, 2007." Title from electronic dissertation title page (viewed 05/06/2008). Advisor, Raymond Cox, III; Committee members, Ralph Hummel, Nancy Grant, Lawrence Keller, Dena Hanley; Department Chair, Sonia Alemagno; Dean of the College, Ronald F. Levant; Dean of the Graduate School, George R. Newkome. Includes bibliographical references.

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5

Bryan, Cornelia. "Gender Pay Disparities Within the Emergency Medical Services". Youngstown State University / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=ysu1299768239.

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6

George, Taylor A., e Taylor A. George. "2016 Arizona Statewide Emergency Medical Services Needs Assessment (ASENA)". Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/626310.

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Emergency Medical Services (EMS) is an institution and product of public health, health care, and public safety that is chopped and scattered across multiple jurisdictional deployment methodologies throughout Arizona. To fully-asses the EMS needs of the state, those jurisdictions are considered as a whole; for it is the whole that makes a system, and a system is what truly impacts patient outcomes. Evaluating the ""whole"" is the genesis and driver of the 2016 Arizona Statewide EMS Needs Assessment (ASENA). The primary objective of ASENA is to establish a current ""snap-shot"" of EMS in the state while simultaneously identifying needs and/or areas that can be targeted for further analysis and/or improvement as part of Population Health Management and Emergency Medical Services Integration under the AZ Flex Grant funded by the U.S. Health Resources and Services Administration (HRSA). In addition, the secondary objective of ASENA is to compare and contrast this current ""snap-shot"" with data obtained in a more narrow needs assessment conducted in 2001, allowing comparison of changes in Arizona's critical access EMS system over 15 years. To accomplish this, a 105-question needs assessment survey tool was developed and distributed to EMS agencies throughout the state. The fully-vetted survey tool collected information pertaining to sixteen core functional sections. Eighty-six agencies fully-completed the needs assessment survey tool, with respondents evenly distributed across the state's four EMS coordinating regions and representative of the various service-delivery methodologies. The combined service areas of the respondents cover over 85% of the state's population. Arizona's statewide EMS system is well organized and positioned to deliver advanced levels of prehospital care for the vast majority of its citizens and visitors, with some variation between urban and rural regions. Key needs identified relate to: patient care reporting between EMS providers, emergency departments and receiving hospitals; quality assurance activities; education and skills training programs; dispatch system capabilities; mass casualty and public health preparedness; equipment and supplies; and more robust use of data and analyses to inform continuous EMS system improvement.

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7

Carrington, Jody L. "The nature and impact of emergency medical services work". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ60218.pdf.

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8

Sullivan, Kendra. "Simulating rural Emergency Medical Services during mass casualty disasters". Thesis, Manhattan, Kan. : Kansas State University, 2008. http://hdl.handle.net/2097/779.

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9

Elliott, Ross W. "Measuring disaster preparedness of local emergency medical services agencies". Thesis, Monterey, California. Naval Postgraduate School, 2010. http://hdl.handle.net/10945/5112.

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CHDS State/Local
Approved for public release; distribution is unlimited
Emergency Medical Services (EMS) plays a key role in disaster response. Yet, determining how much preparedness is enough to achieve an acceptable level of preparedness is challenging. After conducting an extensive literature review, it is evident no nationally accepted method exists to evaluate an EMS system's level of disaster preparedness systematically. Research was conducted to define the skills and equipment that local emergency medical services agencies (LEMSA) or a similar entity needs to perform strategic disaster response duties and identify performance indicators for measuring preparedness. Using an appreciative inquiry approach, surveys and interviews of EMS personnel from across the nation were conducted. Interview questions focused on the positive aspects of each response with an effort to understand what might be possible in future events. Research subjects had first-hand experience in managing the EMS response during a disaster. Multiple types and sizes of events were studied. A framework for defining minimum standards for adequate disaster preparedness for LEMSAs is constructed, including core EMS disaster response roles; essential competencies; skills needed to perform the core roles; and tools or equipment used for core roles. Training strategies for developing experience, competencies, and skills are identified, and metrics listed for measuring the level of preparedness.

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10

Studnek, Jonathan R. "Evaluation of Back Problems among Emergency Medical Services Professionals". The Ohio State University, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=osu1225909761.

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11

Smith, Michael William. "Utilizing Control in Emergency Medical Services: Expertise in Paramedics". The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1291139651.

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12

Crowe, Remle. "An Assessment of Burnout among Emergency Medical Services Professionals". The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1531751856368551.

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13

Kemp, Malcolm. "Expanding the Role of Emergency Medical Services in Homeland Security". Monterey California. Naval Postgraduate School, 2013. http://hdl.handle.net/10945/32845.

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CHDS State/Local
Emergency Medical Services (EMS) has an established nationwide workforce that has not participated in homeland security as a full partner. EMS is a profession in transition that is looking to establish its identity and expand in ways that enhance its overall mission. This thesis explores the role of EMS in response, recovery, acting as intelligence sensors, participation in fusion centers, and syndromic surveillance to see if there are practical applications and logical integrations that could provide value to homeland security. EMS has an opportunity to take advantage of new models and technologies to meet the needs of the citizens and to improve the outcomes of patients. EMS should consider what expanded roles in homeland security enhances the EMS profession, improves security at home, and meets current goals of EMS across the nation. Comparative analysis, application, evaluation, measurement, and vulnerability assessment provided several potential new roles for EMS in homeland security.

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14

Al-Mutairi, Daifallah. "Emergency medical services physicians in the SRCS : a case study". Thesis, University of Essex, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.433543.

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15

Lin, Junwei, e 林俊伟. "Overcrowding in emergency departments in Hong Kong and interventions to improve emergency care". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193798.

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Background Emergency department (ED) overcrowding has become a worldwide problem over the past few years, which has been reported in USA, Canada, New Zealand and Australia. For the past two decades, ED overcrowding has also become a controversial issue in Hong Kong, due to high demand for emergency service and misuse of emergency services. In 2002, although there was a charge for emergency department visit which led to a markedly decrease (19.1%) of total attendance, but now the rising trend of ED overcrowding seems to resurface during past few years. This paper aims to review and synthesis causes of ED overcrowding and possible interventions so as to provide possible recommendations for emergency care in Hong Kong. Methods Literatures on ED overcrowding and potential interventions were searched from PubMed, Google Scholar and Google to locate all relevant articles in English up to May 2013. Through PubMed, ED was described using “Emergency Medicine [MeSH]” OR “emergency department” OR “emergency”, and overcrowding was described using “Crowding [MeSH]” OR “crowded” OR “overcrowding” OR “overcrowded” OR “congestion”, and interventions was described using “interventions” OR “solutions”. Besides, relevant emergency medicine literatures published from the Hong Kong Journal of Emergency Medicine were also reviewed. Results I identified and reviewed relevant articles and found that ED attendance has been steadily rising during the past decades in Hong Kong. Although the causes may be somewhat different between different countries, causes of ED overcrowding could be related to easy access to emergency services, barriers to primary care as well as specialist care, and the rising aging population which might be an important underlying cause. As the problem of ED overcrowding will have significant negative impact on patient outcomes, such as unnecessary death, two common interventions to the problem are increasing the resources and demand management. Apart from increasing resources within emergency departments to cater for the increasing demand, it is of highly significance to improve community and primary care for the needs of older people who will contribute a great proportion to ED overcrowding in the future. Conclusion Semi-urgent and non-urgent visits do account for a great proportion among the total attendance, so it is important triage these patients to alleviate the overcrowding. What’s more, pressure on EDs can be related to a significant increase in the number of elderly patients who may require more investigation or admissions, and need much longer time to manage. As a result, future health policies should focus more on the aging population to improve emergency care.
published_or_final_version
Public Health
Master
Master of Public Health

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16

Tan, Huiyi. "A study on prehospital emergency medical service system status in Guangzhou /". View the Table of Contents & Abstract, 2007. http://sunzi.lib.hku.hk/hkuto/record/B38479886.

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17

Baldridge, Kenan Stone. "Emergency Medical Services in the Rochester Region of New York State: Organization, Services and Systems". University of Akron / OhioLINK, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=akron1177640876.

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18

Millar, Bernadette Theresa. "Becoming and being: a critical realist study into the emergence of identity in emergency medical science students, and the construct of graduate attributes". Thesis, Rhodes University, 2014. http://hdl.handle.net/10962/d1013175.

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This critical realist thesis seeks to understand how student, graduate and professional identities emerge in Emergency Medical Science (EMS) students at a South African University of Technology (UoT) as well as in professional paramedics in the Emergency Medical Care Services (EMCS). It further considers the construct of graduate attributes (GAs) and its relationship to emergence of identity and influence on curriculum design. The research design is that of a case study. The theoretical framework is critical realism whose depth ontology posits three domains of reality. Causal powers and generative mechanisms exist in the Real domain which cause events or phenomena to emerge in the Actual domain that are experienced in the Empirical domain. Using retroduction one may come to explore some of the causes for the event. Using Bhaskar’s concepts of identity, the self, absence and emergence, ontology and four-planar social being, a Bhaskarian explanatory framework of identity to explore the emergence of identity has been created. In exploring graduate attributes, a critical realist question is posed: “What must the world be like for GAs to exist” to explore the possibilities of the existence of GAs. It was found that student identity emerges diachronically in three moments, while professional paramedic identity starts to emerge during the third year of study mainly through the structure, culture and agency of workplace-based learning. In answer to the critical realist question it was found that GAs emerge from the neoliberalist commodification of universities. In seeking an alternative to GAs, traits and attitudes were explored. It was found that these emerge from curriculum, interplay of departmental structure, culture and agency of and from students’ being which makes them ontologically radically different from GAs. This study concludes that student, graduate and professional identities emerge from a person’s core constellational identity diachronically within four-planar social being and the interplay of structure, culture and agency. GAs cannot be related to the emergence of identity and curriculum design because of their ontology; however, if traits and attitudes are substituted for GAs, a close relationship does exist between emergence of identity, traits and attitudes and curriculum design.

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19

Nagula, Prasad. "Redesigning the patient care delivery processes at an emergency department". Diss., Online access via UMI:, 2006.

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20

Cimona-Malua, T. C. "“Waiting time of patients who present at Emergency department of Saint Rita’s hospital, Limpopo Province, South Africa.”". Thesis, University of Limpopo (Medunsa Campus), 2010. http://hdl.handle.net/10386/539.

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Thesis (M. Med. (Family Medicine)) -- University of Limpopo (Medunsa Campus), 2010.
Title: Waiting time of patients who present at Saint Rita’s hospital Emergency Department (ED), Limpopo province, South Africa. Objective: To determine the waiting time for stable patients who present at Saint Rita’s hospital ED, to determine where the longest time is spent by patients in ED and to identify the area of inefficient patients flow. Methods: A descriptive cross-sectional study was conducted in the ED of Saint Rita’s Regional hospital in the province of Limpopo, South Africa. During a one week period, Monday to Friday in July 2010, a daily random sample of 30 patients was monitored. The time In and Out of each step in the process of care was recorded. Waiting time was defined as the time from arrival of the patient in the ED until the start of the consultation by the Medical Officer. Time elapsed was calculated for various steps in care. Demographic data, diagnosis and acuity based on the SATS were obtained from patient’s record. Data capturing was done in window excel and data analysis done using the statistical software SPSS 17. Results: The mean waiting time for stable patients was 252.3 minutes. The mean EDLOS was 360 minutes for stable patients. Result show that 80% of patient attending Saint Rita’s ED are non-urgent (SATS: Green) cases. There was fluctuation of waiting times from Monday to Friday; with Monday having the longest waiting time and Tuesday the shortest waiting time. The waiting time for unstable patients (SATS: Red or Orange) is Zero minute. Patients spent the longest time waiting for registration (60 minutes) and for triage (57 min waiting for vitals and 28 minutes waiting for history taking). Interestingly the extremity of age: the youngest and oldest had lowest waiting time in ED. Areas of inefficient patient flow were registration and triage. Conclusion: This study has determined the waiting time for stable patients attending Saint Rita’s Regional Hospital ED. It has shown that waiting time in ED fluctuates with the day of the week. It has also shown that waiting time in ED varies with age of the patient and volume of patients in ED. Registration and triage have been identified as areas of inefficiency patients flow and recommendations for improvement have been formulated. Sustainability of the performance requires regular follow up from the hospital management.

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21

Coplen, Chris Rolland. "Emergency medical service training for California peace officers". CSUSB ScholarWorks, 1989. https://scholarworks.lib.csusb.edu/etd-project/438.

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22

Carlson, Greg P. "Hostile workplace violence directed toward rural emergency medical services (EMS) personnel /". Menomonie, WI : University of Wisconsin--Stout, 2007. http://www.uwstout.edu/lib/thesis/2007/2007carlsong.pdf.

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23

Holland, William Mark. "Fire/Emergency Medical Services and coping methods mitigating traumatic stress symptomatology /". Lynchburg, Va. : Liberty University, 2008. http://digitalcommons.liberty.edu.

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Crowe, Remle P. "An Assessment of Burnout among Nationally-Certified Emergency Medical Services Professionals". The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1452245440.

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Van, Huyssteen Nina. "A legal analysis of the emergency medical services in South Africa". Diss., University of Pretoria, 2016. http://hdl.handle.net/2263/60108.

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The purpose of this dissertation is to analyse the Emergency Medical Services (EMS) in South Africa from a legal point of view. The researcher has practical experience in the EMS and this has given her insight as to how the EMS operates, the grey areas in this unique profession and how the EMS is regulated by the South African law. A brief background of the EMS is given as well as how the system operates now and what EMS providers deal with on a day-to-day basis. This provides a clear picture of how diverse and unpredictable the EMS profession truly is. How the law regulates the EMS is discussed and all the grey areas from a medico-legal point of view are pointed out and analysed. During this discussion, the researcher makes use of her practical experience to explain why certain situations EMS providers have to deal with on a regular basis are so complex and why the EMS is in need of a better regulatory framework. The grounds of justification in medical law are also discussed and applied to the pre-hospital environment. The researcher made use of the EMS of the United States of America (USA) and the EMS of Australia in the comparative section, analysed how their respective EMS systems operates and how it is regulated by the law. This is ultimately compared to the EMS of South Africa and recommendations were made as to how the regulation of the EMS system, as a whole, can improve in the future.
Dissertation (LLM)--University of Pretoria, 2016.
Public Law
LLM
Unrestricted

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26

Johnston, Janice Mary. "Ambulatory care: a comparison of event and episode utilisation patterns". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1998. http://hub.hku.hk/bib/B31237125.

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Wong, Chi-pang, e 黃志鵬. "The impact of the establishment of emergency medicine ward at accident& emergency department on hospital admission". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45174416.

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Tan, Huiyi, e 譚惠儀. "A study on prehospital emergency medical service system status in Guangzhou". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B40052163.

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Gibson, Nicholas P. "The epidemiology of acute asthma managed by ambulance paramedics in the prehospital setting in Western Australia /". Connect to this title, 2006. http://theses.library.uwa.edu.au/adt-WU2007.0142.

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Bertrang, Allyn L. "Highway and roadway risk management techniques for emergency responders". Online version, 2009. http://www.uwstout.edu/lib/thesis/2009/2009bertranga.pdf.

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Wani, Bhavika. "Systems Engineering of a Medical Emergency Drone – AmbiFly". University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1613740749331087.

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Brim, Carla B. "A descriptive analysis of non-urgent emergency department utilization". Online access for everyone, 2006. http://www.dissertations.wsu.edu/Thesis/Spring2006/c%5Fbrim%5F040606.pdf.

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Price, Devin Todd. "Emergency Medical Services First Responder Certification Level's Impact on Ambulance Scene Times". ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5933.

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Abstract (sommario):

The foundation of modern-day emergency medical service (EMS) systems began in 1966, based on hospital medical care. Demand for evidence to support prehospital practices that have been in existence for the past half-century has continued to grow; yet, researchers have not adequately explored the relationship between the medical certification level of emergency first responders and the amount of time an ambulance spends on the scene. The purpose of this quantitative study was to examine and compare ambulance scene times for emergency responses when basic life support (BLS) certified first responders or advanced life support (ALS) first responders are first on the scene, and whether the level of first responder training reduces the time spent on the scene by a paramedic ambulance. A final research question dealt with whether there is a relationship between how long the first responder is on the scene and the amount of time an ambulance spends at the scene of an emergency. The publicly available archival data used for the study were from a community that had BLS and ALS first responders. Data analysis involved t-tests of the hypotheses for the first 2 research questions and a linear regression analysis of the hypotheses for the third research question. The findings showed that there is a clear difference in ambulance scene times based on the certification level of the first responders. Advanced life support first responders significantly reduced the scene time of ambulances when they arrived at the scene prior to the ambulance. Positive social change could result from this study if understanding the impact that ALS first responders have on ambulance scene times leads EMS planning managers to deploy resources more strategically, thus improving the efficiency of the public safety system and saving lives.

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Adamiak, Grazyna Teresa. "Påverkan av organisatoriska och miljömässiga faktorer på tillgänglighet till akutsjukvården /". Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3997.

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Moore, Simon Peter. "Delays in the emergency department and their effects on the ambulance provider". CSUSB ScholarWorks, 2002. https://scholarworks.lib.csusb.edu/etd-project/2067.

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Barley, Kim Wayne. "The development of a marketing plan for an emergency medical service". Thesis, Port Elizabeth Technikon, 2002. http://hdl.handle.net/10948/120.

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The research problem addressed in this study was to develop a comprehensive marketing plan that would help an emergency medical service (EMS) in the Nelson Mandela Metropolitan Municipality (NMMM), capture a significant market share and gain a competitive advantage over competitors. To achieve this object, a literature study to determine the key components of a marketing plan was undertaken and used as a theoretical model in developing an actual marketing plan. In addition to the literature study, an empirical study was conducted to identify the key issues critical to the development of a marketing plan for the EMS. The survey method used, based on the key components gained from the literature study, consisted of an in-depth scan of the macro-environment and thorough market investigation of the target industry. The investigation involved the general management and senior personnel from the local emergency medical industry, medical aid schemes and private hospitals and clinics delimited in the study. The results of the above literature study were finally combined with the results of the empirical study and a marketing plan for an emergency medical service was developed. This study concludes with recommendations applicable for the implementation of the actual marketing plan.

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Wheater, Kerry Lee. "Spouses’ experience of secondary trauma among emergency services personnel". University of the Western Cape, 2016. http://hdl.handle.net/11394/5004.

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Magister Artium (Social Work) - MA(SW)
Emergency services personnel are potentially exposed to events involving trauma, suffering and tragedy on a daily basis, which could consequently lead to secondary trauma and post- traumatic stress symptoms. The images and feelings that are associated with continuously being exposed to traumatic situations are not limited to the emergency services personnel, who are primarily exposed to the event, but these events can also have an effect on the significant others in their environment, such as their spouses. The aim of this study was to explore and describe the experiences of secondary trauma among the spouses of emergency services personnel. The research study followed a qualitative research approach, which provided in-depth descriptions and understandings of the participants’ secondary trauma experiences. The research design was explorative and descriptive in nature. Purposive sampling was used to select eight (8) participants, who were the spouses of emergency services personnel. The data was collected by means of semi-structured individual interviews and was analysed according to Creswell. Various research findings indicated that secondary trauma was prevalent in the emergency services industry and, in this current study, most participants indicated that it impacted their marital relationships. The experiences of secondary trauma among the spouses of emergency services personnel stemmed from their partners’ repeated exposure to trauma, managing everyday job stress, safety fears, behavioural changes, dealing with their partners’ emotional reactivity and emotional withdrawal from the family, following trauma exposure. Based on some of the suggestions provided by all the participants, the researcher concluded the study with recommendations for future practice and future research, the main recommendation being that organisational support systems be made available to spouses and families of emergency services personnel.

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O'Brien, Adrianne, e Adrianne O'Brien. "Comparing Staffing Models for Fire Based Mobile Urgent Medical Services". Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/626318.

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Background: Comparing Full-Time (FT) and Part-Time (PT) staffing models for a mobile integrated health (MIH) program established by a local Fire Department. Objective: Determine if the program is sustainable and which staffing model is more effective at obtaining sustainability. Design: Quality Improvement project with retrospective data review. Setting: Green Valley Fire District in Green Valley, Arizona. A predominant retirement community. Target: The residents of the Green Valley Fire District. Interventions: Utilizing the RE-AIM framework, a retrospective review of the data collected by the previously implemented MIH Program in Green Valley was completed. The framework was utilized to review relevant data and determine if the program has achieved the expected outcomes, and maintained a sustainable and transferable MIH program. Measurement: Decrease in emergency medical (EM) calls for service with the implementation of the MIH program. Comparing staffing models for consistency in services. Results: The results showed a decline in EM calls for service with the MIH program, and more consistency in availability and patient services with the FT staffing model. Limitations: The demographics of the community limit the generalizability and transferability of the data obtained from the project. Additional data should be collected and analyzed both retrospectively and for successive years to substantiate the benefits and continue to improve the effectiveness of the MIH program. Conclusions: The program could be used as a model for other MIH programs, with adjustments made for the respective community. The value or sustainability of any MIH program cannot be limited to revenue solely. Other perspectives of value added service and cost savings must also be considered. Significance: This study highlights the effectiveness of an MIH program in a small retirement community and shows the benefit of a FT staffing model versus a PT staffing model for consistency of patient care and daily program operations. There are also multiple aspects of value to an MIH program, some of which are difficult to conceptualize and measure based on historical models of healthcare delivery and Fire Department Services. Further review of these types of programs is needed to establish the overall benefits of MIH.

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Leung, Chi-hang Vincent. "Consultation pattern of non-urgent patients of Accident & Emergency Department". Click to view the E-thesis via HKUTO, 2005. http://sunzi.lib.hku.hk/hkuto/record/b39724189.

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40

Strome, Trevor L. "Design and development of a computerized emergency medical services-based injury surveillance system". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape17/PQDD_0004/MQ34423.pdf.

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41

Vile, Julie. "Time-dependent stochastic modelling for predicting demand and scheduling of emergency medical services". Thesis, Cardiff University, 2013. http://orca.cf.ac.uk/43186/.

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As the prominence of the service sector is increasing in developed nations, new and exciting opportunities are arising for operational researchers to develop and apply models which offer managers solutions to improve the quality of their services. The development of time-dependent stochastic models to analyse complex service systems and generate effective personnel schedules are key to this process, enabling organisations to strike a balance between the provision of a good quality service whilst avoiding unnecessary personnel costs. Specifically within the healthcare sector, there is a need to promote efficient management of an Emergency Medical Service (EMS), where the probability of survival is directly related to the speed of assistance. Motivated by case studies investigating the operation of the Welsh Ambulance Service Trust (WAST), this thesis aims to investigate how operational research (OR) techniques can be developed to analyse priority service systems subject to demand that is of an urgent nature, cannot be backlogged, is heavily time-dependent and highly variable. A workforce capacity planning tool is ultimately developed that integrates a combination of forecasting, queueing theory, stochastic modelling and optimisation techniques into a single spreadsheet model in order to predict future demand upon WAST, set staffing levels, and optimise shift schedules and rosters. The unique linking together of the techniques in a planning tool which further captures time-dependency and two priority classes enables this research to outperform previous approaches, which have generally only considered a single class of customer, or generated staffing recommendations using approximation methods that are only reliable under limited conditions. The research presented in this thesis is novel in several ways. Primarily, the first section considers the potential of a nonparametric modelling technique known as Singular Spectrum Analysis (SSA) to improve the accuracy of demand forecasts. Secondly, the main body of work is dedicated to adapting numerical queueing theory techniques to accurately model the behaviour of time-dependent multi-server priority systems across shift boundaries and evaluate the likelihood of excessive waits for service for two customer classes. The final section addresses how shifts can be optimally scheduled using heuristic search techniques. The main conclusions are that in addition to offering a more flexible approach, the forecasts generated by SSA compare favourably to those obtained using traditional methods, and both approximate and numerical modelling techniques may be duly extended to set staffing levels in complex priority systems.

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Shum, Kwok-leung, e 沈國良. "The relationship between management and staff in the Fire Services Department: the case of the ambulancemen". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1997. http://hub.hku.hk/bib/B31965635.

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To, Mei-kuen Erica. "Workplace violence in Accident & Emergency Department of Hong Kong". Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B42577469.

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44

Iorio, Cristina. "Detecting and referring battered women : an emergency department case study". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0024/MQ50699.pdf.

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45

Bentley, Melissa. "A National Assessment of Ideal Cardiovascular Health among Emergency Medical Service Professionals". The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1480456097279235.

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46

Stedman, Robert W. "An evaluation of the level of service and delivery costs of fire and emergency medical service in Waukesha County, Wisconsin". Online version, 2000. http://www.uwstout.edu/lib/thesis/2000/2000stedmanr.pdf.

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47

Quinn, Nicole M. "A model for nationwide patient tracking". Thesis, Monterey, California : Naval Postgraduate School, 2009. http://edocs.nps.edu/npspubs/scholarly/theses/2009/Sep/09Sep%5FQuinn.pdf.

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Abstract (sommario):

Thesis (M.A. in Security Studies (Homeland Security and Defense))--Naval Postgraduate School, September 2009.
Thesis Advisor(s): Richter, Anke ; Bergin, Richard. "September 2009." Description based on title screen as viewed on November 5, 2009. Author(s) subject terms: Patient Tracking, Public Health, Emergency Medical Services, Patient Movement, Evacuation, Public Health Preparedness. Includes bibliographical references (p. 139-140). Also available in print.

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48

Al, Jahdal K. H. A. "Efficiency of emergency medical services response to road traffic accidents in Riyadh, Saudi Arabia". Thesis, Swansea University, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.635686.

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Road traffic accidents are a prolonged and on-going problem of modern times. The objective of this study is to characterise the distribution of road traffic accidents with Riyadh City and provide recommendations and suggestions to improve the existing emergency medical services system. A pilot study was undertaken using two forms designed for collection of the data; one was for the Red Crescent Society (RCS) and one was for the police. The above mentioned forms were applied for a period of two weeks, one week in the wet season and the second in the dry season, plus many meetings and interviews with people with relevant responsibilities in the health field. A comprehensive review was undertaken of both the RCS and Public Safety documents. The findings suggest the need to construct safety programmes to modify the behaviour of the individual at risk, the vehicle and the environment. In addition the study provides an evaluation of the present emergency medical services system and the means to improve it. Thus the findings should be of value in determining the need to improve the system and to make more efficient and better emergency medical services available.

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Smith, Hezedean. "Attitudes of Emergency Medical Services Stakeholders in Barbados| A Convergent Parallel Mixed-Methods Study". Thesis, University of Phoenix, 2019. http://pqdtopen.proquest.com/#viewpdf?dispub=13805641.

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This convergent parallel mixed-methods study was conducted to examine the attitudes of emergency medical services (EMS) stakeholders based on the “EMS Agenda for the Future.” A sample of 104 accident and emergency (A&E) doctors, prehospital EMS providers, and A&E nurses in Barbados participated. The tripartite model of attitudes (beliefs, affect, and behavior) was used as the theoretical underpinning. Data collected using electronic surveys and information from semi-structured interviews were analyzed. affect and belief measures exists across the three groups of EMS stakeholders. The application of regression models confirmed that a significant relationship between affect and belief measures of the EMS stakeholders existed. A significant relationship also exists between belief and behavior measures of prehospital EMS providers. This research places on improving public health by addressing the beliefs, affect, and behaviors of EMS stakeholders.

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Paschal, Beverly J. "16PF® Traits as Predictors of Emergency Medical Service Worker Tenure". ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2226.

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The United States is experiencing a severe shortage of Emergency Medical Service (EMS) paramedics. The job outlook for paramedics (EMT-P) for the years 2012-2022 is predicted to increase by 23%-33%, which is much faster than the 4% average increase of other first-response professions. The average tenure of paramedics is less than 4 years. There is a significant gap in the literature concerning paramedic personality traits and tenure. The primary objective of the current study is to provide empirical data on the personality traits possessed by long-term paramedics (5+ years), and compare them to those with shorter tenure (< 5 years). Using Allport's Trait Theory, I predicted that personality would affect paramedic longevity. The 6 personality traits tested were warmth, reasoning, emotional stability, liveliness, social boldness and openness to change. A socio-demographic questionnaire, determined the length of their EMS career, while the 16PF® Assessment, tested their personality traits. Using t tests, Mann-Whitney U tests, and a set of regression analyses, data were examined to determine if length of career and personality traits predicted paramedic tenure. The research sample consisted of long term paramedics and former paramedics. The results showed that of the 6 personality traits, only warmth was a significant predictor of paramedic tenure. A logistic regression showed for every additional point in warmth, the odds of leaving EMS prior to 5 years increased by a factor of 2.77. This study provides support for positive social change by helping EMS to learn how to increase recruitment and tenure. It also helps by advising EMS agencies to attend to the mental and emotional health of their paramedics by being aware of the level of their warmth personality trait.

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