Patientenorientierte Planungskriterien für die Logistik in der Notfallrettung

Response time targets as the central planning indicator for logistical decisions in emergency medical services have been debated for years. Two main shortcomings are the inability to differentiate between the needs of patients and the binary nature of response time targets, which do not correlate with how the conditions of the patients develop over time.

The objective of the presented work is to develop planning indicators that allow for a better integration of patient’s needs into logistical planning. The goal is to define patient categories. For each category, a utility function shall be defined that reflects how utility from the patient’s perspective develops depending on the relevant time intervals during the emergency response.

The patient categories and utility functions were defined in several workshops with emergency and intensive care physicians as well as representatives from coordination centers and ambulance organizations. The patient categories were mapped to the diagnoses from the so called minimal emergency dataset MIND4.0 and the statewide consented dispatch keywords.

Six patient categories and two additional call response categories were defined. For each patient category, a utility function was estimated that shows utility from the patient’s perspective depending either on the response or the prehospital time.

The needs of the patients can be integrated better into logistical planning through the categories and utility functions compared to response time targets. The meaningfulness of the utility functions can be further improved in the future by measuring the medical outcome of each patient and combining the data of emergency departments with emergency medical service data.