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POSITION STATEMENT
* The response interval is defined as the elapsed time from emergency medical services (EMS) dispatch notification to the time of arrival on scene.
* Response interval performance standards should be developed using a broad-based consensus process that realistically assesses the resources and attributes of the community.
* Fractile response intervals should be calculated and used instead of mean response intervals to assess performance within an EMS system.
* Medical directors should have the authority to lead the establishment of response interval performance standards and possess the resources needed to monitor response interval data.
* The dispatch process should be carefully analyzed and streamlined. Calls should be prioritized based on severity and response interval performance standards established for emergent, urgent, and nonurgent complaints.
* Assessment of response intervals should be ongoing and change should be incremental.
INTRODUCTION
Since its inception, the concept of prehospital care has centered on rapid response, treatment, and rapid transport to an emergency care facility. Awareness of EMS has driven public demand for timely responses by EMS. However, financial constraints limit the number of units, personnel, equipment, and resources available to a system.
Many systems are setting response interval performance standards as a way of measuring EMS quality. This is a complex undertaking that entails considering medical and patient care issues, financial, political, and social factors, and the public's perceived needs.
Except for cardiac arrest,1 there is little or no scientific evidence suggesting a causal relationship between response interval and improved patient outcomes. There is little evidence linking improved response intervals to improved survival in critical trauma,2 and there is no literature suggesting that rapid response intervals improve outcome for noncritical patients. However, there is a public expectation that when EMS is requested, an ambulance will appear within a reasonable time no matter what the complaint. The definition of "reasonable time" can vary considerably between communities of varying population density.
It is the purpose of this paper to provide guidelines for establishing response interval goals, not to define ideal response intervals.
DISCUSSION
Response interval goals will vary from community to community. Medical necessity and community expectations must be weighed against logistics and resources. Predetermined EMS response interval performance standards should be developed using a broad-based consensus process that...