Improvement of Ambulance Response Times in Karachi, Pakistan

NCT02743169 | Withdrawn

• 1 other identifier: IRB00085859
• Study Type: observational
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

The investigators hypothesize that spatial analysis of the location data of ambulance calls can improve prehospital care provided by Aman Foundation in Karachi, Pakistan by decreasing ambulance response times for high acuity patients. In Aim 1, the investigators will develop a conceptual framework for prehospital care in low- and middle-income countries (LMICs) to anchor this project in Aims 2 and 3. In Aim 2, the investigators will analyze the location of calls to identify geographic areas with delayed responses for patients with higher severity of illness. As part of their quality assurance/quality improvement practices, Aman Foundation routinely collects location data from GPS devices in their ambulances for each call. Based on the analyses in Aim 2, in Aim 3 the investigators will position ambulances where there are clusters of delayed ambulance calls for high acuity patients to improve response times. This period will be compared with a previous, control period and will be analyzed to identify possible new clusters.

Conditions

Emergencies

Keywords

Geographic Information Systems; Spatial Analysis; Emergency Medical Services

Outcome Measures

Primary Outcomes (1)

• Ambulance Response Time

  Time from when a call comes to the call center to the time the ambulance arrives at the patient.

  18 months

Study Arms (2)

Standard Practice

This group will consist of ambulance calls under the standard practice of Aman Foundation for ambulance placement.

Post-Intervention

This group will consist of ambulance calls after the spatially-optimized placement of ambulances.

Other: Spatially-Optimized

Interventions

Spatially-Optimized OTHER

Spatial analysis of retrospective data will be used to optimize the placement of ambulances to decrease response time from the time the call is received until the time the ambulance arrives at the patient's location.

Post-Intervention

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult patients in Karachi, Pakistan who call Aman Foundation and request an ambulance.

You may qualify if:

• Aman Foundation uses The Medical Priority Dispatch System (MPDS), a commonly used five-tier triage system that includes the following categories (from least to most acute) "alpha," "bravo," "charlie," "delta," and "echo." For the analyses in Aim 2 and Aim 3, we will only examine calls for "delta" and "echo" patients.

You may not qualify if:

• Ambulance calls for transport of patients from one healthcare facility to another or calls in which the patient refused transport will be excluded from the analysis.

Sponsors & Collaborators

• Johns Hopkins University: lead

Study Sites (1)

Aman Foundation

Karachi, Pakistan

Location

MeSH Terms

Conditions

Emergencies

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Kiemanh Pham, MD, MPH

  Johns Hopkins School of Medicine

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 13, 2016
• First Posted: April 19, 2016
• Study Start: April 1, 2017
• Primary Completion: June 29, 2020
• Study Completion: June 29, 2020
• Last Updated: August 26, 2020

Record last verified: 2020-08

Locations

PA (1)