Urgences-santé Ambulance Service serves a population of 2.3 million people distributed on the islands of Montreal and Laval, a territory of 744 square kilometers. The population density of Montreal is 3,700 inhabitants/km2 and in Laval the density is 1,500 inhabitants/km2. Moreover, because of displacements related to the various economic activities, the population on the territory increases by almost 175,000 people each day.
The territory's health network includes 16 hospital complexes for general, specialized, and university teaching hospitals, 3 psychiatric care centers, 2 pediatric care complexes, and 13 community health and social services centers. The metropolitan area in particular also includes an international airport, an extensive subway network, a dense and complex transport system, a dense urban core and a great number of people flowing to and from the downtown area. The geobase representing this territory includes over 58,385 streets/roads/highways.
Urgences-santé is the most important EMS organization in Canada and ranks sixth in North America. It handles more than 355,000 emergency calls are received annually, more than 270,000 ambulances are dispatched to incidents resulting in approximately 210,000 patient transports completed each year.
The fleet of dispatchable resources is comprised of approximately 182 vehicles:
|138||Ambulances (BLS and ALS)|
|1||Mobile command post|
|1||Media relations vehicle|
|1||UST (Technical Support Unit) vehicle|
|6||Reserve ambulances for training|
|1||Community relations vehicle|
|8||Other vehicles multiple patient transport, advance care vehicles|
The Centre de communication santé (CCS) (Operations Center) is comprised of the following work stations:
|7||Dispatcher stations plus 1 dispatcher team leader station;|
|9||Call taker stations plus 1 call taker team leader station;|
The key performance indicators
The CCS manages 5 distinct zones. These zones are reflected both in the CAD and in the Mapping applications. There is a Dispatcher assigned to each zone, display filters exist per zone for Call Cards and resources, and the Mapping displays the zone boundaries.
Emergensys' CAD environment incorporates the following critical Key Performance Indicators (KPIs):
Also noteworthy to the Urgences-Santé EMS program are:
- The elaborate rule-set used to drive the Ambulance Recommendation function
- The Ambulance Activities Management function
E-MS CAD supports a rigorous rule-set as part of the Recommendation Protocol. This includes both a default rule-set, plus the capability to add additional rules that are specific to client business processes.
The Urgences-santé EMS system requires Response Plans that take into account the following rules:
- The response is predicated on the call type
- The availability of specific types of vehicles which have the capacity to respond to the call
- The partial and conditional availabilities of the vehicles including substitute vehicles (takes into account resource status and resource activity)
- The estimated time of arrival (ETA)
- The schedule of the vehicles (proximity to activities and/or end of shift)
- The overall deployment of the fleet (based on manned service points)
- The current workload of each vehicle
- The duration of inactivity of the vehicles since their last assignments
- Specific addresses may have a predefined response plan
Urgences-santé is required to adhere to its Collective Agreements for ambulances and as a result must respect 56 pre-defined EMS resource activities.
These activities are managed by the E-MS CAD Administrator and are prominently displayed in the Dispatchers List of Resources for each resource by resource color tag, status, and description. Activities can be assigned to resources by both the Dispatcher and the MCAD vehicle operator.
Each resource activity is processed by a complex algorithm that takes into account the following:
- Type of activity;
- Whether it has an associated alarm;
- Whether it can be automatically reassigned if interrupted;
- Whether there are mandatory pre and post activities associated with the activity;
- Timers associated with the activity duration, i.e. lunch is 45 minutes;
- Whether warnings should be issued to Dispatchers related to resources on activities during
- Recommendation functions.
Activities can be assigned to resources by both the Dispatcher and the MCAD vehicle operator.