It is that time of year for resolutions and reflection.  As I ponder this thought, the topic that sticks out to me is about what really constitutes a “High Performance EMS”.  As we look back over the past year of the High Performance EMS social network (including our Twitter and Facebook feeds as well as this blog) one of the recurring comments that disturbs me is that “response time doesn’t matter”.  This causes me concern in two ways – first, that the primary measure of performance is overwhelmingly always “response time” and the other is that this simple measure is deemed to not really be important.  So, for the next few posts, I will discuss various characteristics that I feel do matter in becoming a truly high performing EMS system.

Part 1: Response Time

This past February, Elsevier published an excellent newsletter (EMS Insider, Volume 39, Number 2) focused on EMS response times and included articles such as “The Great Ambulance Response Time Debate Continues” in which the author, Teresa McCallion, laid out many of the facts.  For instance, the article recites the “MedStar example” from Super Bowl XLV suggesting that “very few EMS calls” in that prospective two week study actually “required an immediate response.”  It is important to note that this statement did not go so far as to say that response time is meaningless in all cases – just that it is far less limited in most.  Then as counterpoint to dismissing response times altogether, the public conflict at EMSA in Oklahoma City was brought up where at least one politician complained of the number of excluded calls required in order to reach a 90% response time compliance rate.   (more…)