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10 July 1972 "Iiterlaf-VOliPegit4ttii GEORGIA INSTITUTE OF TECHNOLOGY OFFICE OF RESEARCH ADMINISTRATION RESEARCH PROJECT INITIATION • Date: 10 July 1972 —11;6 Type Agreement Inierim Reports Final; Report :::„ :Mr. James Cobh Georgia Regional Medical Program 938 Peachtr.ee St., NJ. Atlanta, ' Georgia 30309 COP I ES -TO: Principal Investigator Library School Director Rich Electronic Computer Center 'Dean of the College Photographic Laboratory Director, Research Administration '1- Director, Financial Affairs (2) it Security-Rewrts-Property Office Patent Coordinator GEORGIA INSTITUTE OF TECHNOLOGY OFFICE OF RESEARCH ADMINISTRATION RESEARCH PROJECT TERMINATION Date: 13 April 1973 ;Project Tit16-;, ilvcroved Envargency Medical System for Metropolitan Atlanta" . ' 1 Project No:, 11-605 Principal Investigator: Harcist E. ey Sponsor: Aseiniation of Georgia, Georgia Regional Medical Program Effective Termination Date: March 31, 1973 Clearance of Accounting Charges: 1Vril 30, 1973 Grant/Contract Closeout Actions Remainin • Final. Report (-101i vexed March 30, 1973 Assigned to: Health Systems Research Center COPIES TO Principal Investigator Library, Technical Reports SE(ctiern School Director Rich Electronic Computer Center Dean of the College Photographic Laboratory Director, Research Administration Project File Director, Financial Affairs (2) Other Security-Reports-Property Office Patent and Inventions Coordinator RA-4 (6-71) DISCLAIMER: This document has been proofed and its original formatting has been retained. A Comprehensive Plan and S ystems Design for . An ImprovedImproved. Emergency Medical System for Metropolitan Atlanta Developed by the Health Systems Research Center John W. Coyle (Project Manager), Mark S. Blum, and Oren L. Reinbolt Under contract with the 1 I • 7" 3 Georgia Regional Medical Program Health Systems Research Center Georgia Institute of Technology Atlanta March 1973 SELECTED HSRC REPORTS The present report and other publications of the Health Systems Research Center are available in either hard copy or microfilm from University Micro- films, 300 North Zeeb Road, Ann Arbor, Michigan 48106. When ordering a publication from the list below, refer to the appropriate Hospital Abstract number. An Impnoved Emotgency Medical System 40A Met/topotitan Ateanta, A Comp/Lehenive nan and Sys temps Design, Final Report to the Georgia Regional Medical Program, March 1973, 566 pp. (Hospital Abstract #10150 OU). Pkogitam in Hooitat and Medicat Systems Fine Report and Evatuation, USPHS Grant No. D02 AH 01056, February 1973, 238 pp. (Hospital Abstract #10050 MN). FZ6ca.e Cont/Loa ion Hooitat Depaittments, Program Bulletin No. 7, USPHS Grant No. D02 AH 01056-05, October 1972, 203 pp. (Hospital Abstract #09499 AC). Anatyzi4 o6 Optima_ Radiog/Laphic Location Netwokks, Final Report, USPHS Grant No. HS 00179, October 1971. Volume I: Summary, 20 pp. (Hospital Abstract #RLO-7441) Volume II: A Methodology for Evaluating the Radiographic Facilities Location-Allocation Problem, 223 pp. (Hospital Abstract #RLO-7442) Volume III: Computer User's Manual, 108 pp. (Hospital Abstract #RLO-7443) Volume IV, Part 1: A Short-Range Forecasting Model for Radiological Services, 60 pp. (Hospital Abstract #RLO-7444) Volume IV, Part 2: Computer Simulation of Radiographic Operations, 71 pp. (Hospital Abstract #RLO-7445) Volume IV, Part 3: A Procedure for Identifying Radiology Performance Goals and Criteria, 40 pp. (Hospital Abstract #RLO-7446) Volume IV, Part 4: An Approach to Selecting a Preferred Alternative, 43 pp. (Hospital Abstract #RLO-7447) Systems Anatyziz o6 Meclicat Recotds in Geongia, Final Report, USPHS Contract No. HSM 110-70-349, September 1971. Volume I: Project Summary, 58 pp. (Hospital Abstract #MRO-7741) Volume II: State of the Art Review, 135 pp. (Hospital Abstract #MRO-7742) Volume III: Methods Manual, 325 pp. (Hospital Abstract #MRO-7743) Tice. nanning oi Ctinice Facititia i on Medicat Education: A Syztero Appiwach, Program Bulletin No. 6, USPHS Grant No. 2 D02 AH 01056-04, August 1970, 349 pp. (Hospital Abstract #MD2-5900) Odantitative Method's ion Evatuating Hozpitat Daigns, Program Bulletin No. 5, Final Report, NCHSRD Research Grant No. HM 00529, August 1969, 239 pp. (Hospital Abstract #DE 1026). Hooitat Management Systems Anatyst Training Ptowtam, Final Report, W. K. Kellogg Foundation Grant, August 1966, 67 pp. (Hospital Abstract #PE 2015). Diooutbte Vv sub Reptoces6ed Hospite Supptie/s, Final Report, USPHS Research Grant No. GN 5968, June 1964, 77 pp. (Hospital Abstract #45). AN IMPROVED EMERGENCY MEDICAL SYSTEM FOR METROPOLITAN ATLANTA John W. Coyle, M.S., Project Manager Mark S. Blum, BIE Oren L. Reinbolt, M.S. A Comprehensive Plan and Systems Design developed by the Health Systems Research Center Under contract with the Georgia Regional Medical Program Health Systems Research Center Georgia Institute of Technology Atlanta March 1973 PREFACE The present document contains a systems design and a comprehensive plan for an improved emergency medical services (EMS) system for metropolitan Atlanta. The plan was developed in the period July 1, 1972 through Febru- ary 28, 1973 by the Health Systems Research Center of the Georgia Institute of Technology at the request of the Georgia Regional Medical Program (GRMP). At the present time, a coordinated system for efficiently and effec- tively providing emergency medical services does not exist in metropolitan Atlanta. The objectives of the project described herein were to examine the present means of delivering EMS in metropolitan Atlanta, to analyze in detail the subsystems considered to be essential to the effective performance of modern EMS systems, and to culminate with the development of a comprehensive plan for improving the EMS system in metropolitan Atlanta to reflect the state of the art. Special attention was devoted to the hospital emergency facilities, vehicles and equipment, ambulance attendant training, dispatch and control, and communications. In addition, the EMS plan addresses the areas of public education, disaster planning, and evaluation and financing of the EMS system. The plan includes a recommendation for an organization to coordinate the metropolitan EMS resources in an effective and efficient manner. Chapter 1 of this document is a summary of the project and outlines the development of the plan, from the initial involvement of HSRC with the Metropolitan Atlanta Council for Health some four years ago to the present com- prehensive EMS plan. Chapter 2 presents a summary of recommendations by HSRC for improving the metropolitan Atlanta EMS, based upon the detailed analyses presented in Chapter 3 through Chapter 14. The final two chapters of this plan, Chapter 15 and Chapter 16, present a cost estimate and suggested imple- mentation schedule for the improved EMS system for metropolitan Atlanta. The successful development of the plan was due to the efforts of various individuals, institutions, and groups to whom credit is gratefully extended. To attempt to list the literally dozens of people, in Georgia and around the nation, who provided valuable information to the project is to risk omitting the names of some individuals. Nevertheless, members of the following agen- cies and organizations in the Atlanta Area are deserving of special credit, and specific individuals are cited throughout the present document in those chapters to which the individuals provided input. Atlanta Area Physicians Atlanta Area Police and Fire Chiefs Atlanta Area Hospital Administrators Communications Manufacturers Civil Defense DeKalb Area Technical School Emergency Health Unit of the Department of Human Resources Division of Physical Health EMS Task Force of the Atlanta Regional Commission Georgia Heart Association Georgia Hospital Association Grady Memorial Hospital Metro Ambulance Service Military Personnel at Fort McPherson and Dobbins AFB Southern Bell Telephone Company Important contributions were made to the project by the following on behalf of the Health Systems Research Center: Mark S. Blum, Eve Carroll, Iris Mitchell, Russell G. Overton, Oren L. Reinbolt, and Nelson F. Sayford. Our special thanks are given to Eve Carroll, who single-handedly typed this document under pressure of time at considerable inconvenience to herself. In particular, our sincere appreciation is extended to Dr. J. Gordon Barrow and the Staff of the Georgia Regional Medical Program. The citizens of metropolitan Atlanta and those interested in improving emergency medical services owe their gratitude to the Georgia Regional Medical Program for its foresight in supporting the development of the plan presented herein for an improved EMS system. John W. Coyle EMS Projects Manager Harold E. Smalley Director Health Systems Research Center Atlanta March 30, 1973 iv TABLE OF CONTENTS PAGE PREFACE iii TABLE OF CONTENTS vii LIST OF FIGURES xiii LIST OF TABLES xv CHAPTER 1 - SUMMARY OF THE EMERGENCY MEDICAL SERVICES SYSTEM PLANNING PROJECT 1 INTRODUCTION 1 EMS PROJECT BACKGROUND 1 HSRC INVOLVEMENT WITH EMS 7 EMS PLANNING PROJECT APPROACH 9 OVERVIEW OF THE EMS PLAN 13 STEPS TO BE TAKEN IN THE NEAR TERM 15 CHAPTER 2 - SUMMARY OF RECOMMENDATIONS FOR THE METROPOLITAN ATLANTA EMS SYSTEM 17 INTRODUCTION 17 RECOMMENDATIONS 17 CHAPTER 3 - EMS SYSTEM ORGANIZATION 25 INTRODUCTION 25 RATIONALE FOR NO-CHARGE AMBULANCE SERVICES 26 THE ROLE OF COUNTY GOVERNMENT 26 TRANSPORTATION SUBSYSTEM 29 EMERGENCY FACILITIES SUBSYSTEM 30 PROVISION OF TRAINING 30 EMS COORDINATING AGENCY 30 INTERACTION BETWEEN COMMUNITY AGENCIES AND
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