When does your response time clock start?

[Amhet1]

With very little work, a person can find that departments start their "response time" clock at various times. Many use the shortest time to make the numbers look good. The true "response time" is from the time the emergency is known to exist to arrival of YOUR service.

From the patients' point of view, we know that 10 minutes can feel like 20-30 minutes or more. If we are here for the patient, shouldnt the clock start when the patient/callers clock starts?

The caller finds the patient, panics, regains control, helps the patient, calls 911, give information, answers questions, hangs up, panics some more, then finally relaxs when the crew walks in the door.

1) We typically hear of call-takers spending 1-3 minutes to get patient information, situation and address. (3 minutes)

2) Another 1-2 minutes for the dispatcher to assign the call (5 minutes)

3) 1-2 minutes for the vehicle to get enroute (7 minutes)

4) and travel time to the scene (8:59) (9 to 16 minutes or more)

I know that is sounds rather far-fetched for an urban system to have 10-20 minutes to make patient contact, but those are also some documented times for some departments.

The underlying problem is benchmarking. When you compare your times to another service the definition of "response time" needs to be uniform so as to compare apples to apples. In this situation, EMS remains in a "pre-NEMSIS/pre-NFIRS". At some point, NHTSA will fund a project to create those definitions. Again, EMS remains behind the power curve in that LE and Fire have the necessary peices and support to compare those apples to apples. There is no question that EMS does the right thing 99.9% of the time. We just have a problem in proving it.

What is your opinion on when the clock should start?

Do you, on your PCR, record any times prior to going enroute?

Does your software/dispatcher track any times prior to dispatch?

[Just Plain Ruff]

optimum is to have at least 2 dispatchers.

ONe takes the call, addy comes up on the screen, as soon as the person says I need a bambulance then the 2nd dispatcher starts the ambulance.

Once more info comes in like complaint then they put that out.

That would be ideal, fast quick and to the point but it takes 2 dispatchers to do it

[JakeEMTP]

Our response time begins once dispatch has toned us out. I mean, it's kinda unfair to begin it at the time of the call to 911. All our times are recorded and awaiting us in the EMS room at the hospital, or faxed to our station if we " No Transport". Is it ideal? As I have stated in other threads, this is the only service I have worked for so I have nothing to compare it too. It works for us.

On the call report, there is an entry for what time the call is taken, another for the time dispatched. We have to record these as well as the en route, on scene etc. on our PCR's.

[JPINFV]

That would be ideal, fast quick and to the point but it takes 2 dispatchers to do it

My old company did that. On weekends there was a dispatcher and a call taker during the day and on weekdays there were 2 dispatchers ("north" and "south") as well as 2-3 call takers. Depending on the current load, it wasn't uncommon for a unit to be told to start heading towards a facility (for an "emergency" or non-emergent call) before the call taker had put in enough information into the computer for the call to be officially "dispatched."

[hr:a5ea68d2df]

Our response time begins once dispatch has toned us out. I mean, it's kinda unfair to begin it at the time of the call to 911.

Depends on who runs 911 dispatch. The official call time for a company should start at the time notification is made. If, for example, the 911 operator transfers the call to the ambulance company, then time should start at that time. Yes, crews shouldn't be punished for periods of time before they are dispatched, but the clock for a company should start when the call reaches the dispatcher of call taker. Now for a system wide view, the time starts when the call is made regardless of how many links there are before a crew is actually started.

[AnthonyM83]

Maybe I shouldn't have replied to the poll, because our system is a bit different.

PD answers the 911, forwards to FD Comm Center, then dispatch it to appropriate fire station and ambulance company computers simultaneously.

Our company's time starts clicking from time the computer beeps (They have 8:59 min to have unit arrive). The ambulance crew itself has 8 min to arrive from time the local ambulance station rings.

[JakeEMTP]

Depends on who runs 911 dispatch. The official call time for a company should start at the time notification is made.

You're correct JP. I took the title to the thread as when does "My" response time start, not the systems. After re-reading the OP's post, I see where I erred.

[Amhet1]

Anthony makes an interesting point in that rural EMS is significantly different in many respects.

When I first started in this business, i ran with a small volunteer service that ran 2-3 calls a week. It wasnt cost-effective for anything but a volunteer service. Our situation was similar to Anthony's in that we would respond when we got called. Looking back, our system was AFU.... but it was all pre-911.... the most advanced peice of equipment we had was a HERN/HEAR radio to contact the hospitals..... Our nearest hospital was 30 minutes away running hot. Being pre-911, we had a 7-digit line answered by local PD. Once they got the information, they had to call each crewmember individually, and it could take anywhere from 5-15 minutes for the crew to get there.... Luckily, if one person was between the call and the shed, the ambulance could meet the other staff member enroute.

But back to the benchamrking discussion, that raises another issue.... To benchmark EMS, we also need to define the service in some way. My personal thought on it is to stratify the data based on population density of the coverage area. To simplify, base the population density on the county the service is in or the county they have the greater coverage area (if they cover parts of more than one county). This is the most logical idea I can come up with because that is the most common denominator I can come up with.

It would be illogical to benchmark a large urban service serving 500,000 people over 35 sq miles to a volunteer service covering 1,500 people over 3,000 sq miles.....

[Amhet1]

You're correct JP. I took the title to the thread as when does "My" response time start, not the systems. After re-reading the OP's post, I see where I erred.

I left the title sort of ambiguous for a couple reasons... 1) I dont know what Im doing yet and 2) to see some thoughts and opinions without getting too specific.

I would like to play devils advocate for a sec here.... Jake mentioned that their services clock starts when they get toned out...... what happens when you arrive on scene and the family is irrate because it took ya 25 minutes to get there? Your records say that it only took 7 minutes from tone-out to arrival..... Props due to SF FD for that true situation....

And dont worry, there are no "errors" here, just some fact and opinion

[strippel]

Our time starts at dispatch.

We have no control over dispatching, as that is done by county government, and all EMS agencies are independent non-profit.

The county dispatching program, which we have access to, keeps track of when the phone rings, and then all associated unit times. Our charts have spaces for all those times. Our PI person does keep track, and makes charts and graphs.

There have been many times where the answer to dispatch times have been 2-5 minutes, which is totally unacceptable. Prior to advanced dispatching programs, experienced dispatchers hers could send out a call in about 45 seconds. As soon as the dispatcher could figure out the municipality, everything else was simple.

Now, all the information must be entered into the program, and it decides who to send. Only the computer can decide, due to ambulance and fire consolidations, and "closest available" ALS unit. So were are at the mercy of the dispatcher/typist. Also, the dispatcher has to ask all the questions on the flip cards, as they do priority dispatching and pre-arrival instructions.

We get "yelled at" if it takes more than 3 minutes to respond, but there are always extenuating circumstances. Main reason is very old low band radio dispatching. Many times, pagers will not activate inside the hospitals. Some dispatchers will place the ambulance available on arrival at the hospital (not good). Other dispatchers won't put you available when you call in (even worse). Actual responding times are not heavily criticized, as we can go blocks in the city, or miles in the country.

[jmp6753]

Our response time begins when the call is received at the dispatch center. We have 7:59 to have a unit arrive on-scene.