A comparative study of emergency service response intervals in Johannesburg, South Africa and the North West Ambulance Service, United Kingdom

Abstract

Background: The primary role of an Emergency Medical Service (EMS) is to respond to an emergency incident within the shortest possible time. As a consequence, response times have historically been used as a key indicator of EMS performance. The City of Johannesburg Emergency Management Services (CoJEMS) provides an EMS to the citizens of the greater Johannesburg metropolitan area in South Africa. The CoJEMS are expected to respond to emergency incidents within 15 minutes, which is the national norm. Before this study there was no complete up-to-date data set or literature describing the extent to which the CoJEMS were meeting this target. The absence of accurate data relating to responsetime intervals was seen as problematic as it limits EMS managers’ abilities to make informed decisions concerning quality management, benchmarking and improvement strategies. Aim: The aim of the study was to investigate, document and describe the time taken by the CoJEMS to complete activities routinely associated with the activation of and response to an emergency incident and to compare these with the response times achieved by the North West Ambulance Services (NWAS) in the United Kingdom. Methods: The research methods included a literature review to identify generic activities that occur from the moment an emergency happens until the patient arrives at a medical facility for treatment. Following this a spreadsheet that was designed to capture the time taken to complete each of the identified activities. Data from 784 calls for the CoJEMS and 786 calls for NWAS were recorded onto the spreadsheet and analysed descriptively. Results: The NWAS had a median overall response time of just 10 min 45 seconds. The median overall time for COJEMs was over twice as long, at 23 min 16 seconds. Conclusion: The NWAS outperformed the CoJEMS in the majority of response-time intervals and the CoJEMS median of 23 min 16 seconds exceeded the national norm and standard of 15 min. Many of the extended CoJEMS response times could be linked to delays in communication between the calltaking department and the EMS dispatch, coupled with a lack of availability of EMS vehicles. Further studies are recommended to determine the reason for the lack of available CoJEMS vehicles, as well as ways to encourage a closer relationship between the different departments within the CoJEMS central communications centre