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EMS News in Focus
by Arthur Hsieh

Why more ambulances won’t fix Chicago dispatch problems

If there are ways to increase the effectiveness of system operations, throwing more ambulances at the problem isn’t necessarily the fix.

By Arthur Hsieh

The head of most EMS operations is the communication center. The responsibility is huge. It is the first point of contact for the community when reporting medical emergencies.

Communicators coordinate the system’s resources, trying to match the appropriate unit to the appropriate incident. Dispatchers use various forms of technology to help make those decisions: software, GPS, dispatch algorithms, among others.

The system has to be able to send the appropriate resources at the right time to avoid going to a zero-level condition. Sometimes that’s unavoidable, but regulating the system to minimize a zero-level condition can help reduce the possibility.

That’s why it doesn’t make sense that Chicago dispatchers basically throw calls out on the air. Reading the article about a city-issued memo to keep an ambulance shortage quiet made me think of the 1970s' TV show "Taxi." Maybe Chicago ambulances are yellow in color?

How does Chicago keep track of their resources? It seems a little strange that a dispatcher doesn’t know where the units are at any given time.

While Chicago is a big system, other similarly sized systems seem to be able to tell which ambulance should go where at any point in time. Is this a sign of a larger issue?

If there are ways to increase the effectiveness of system operations, throwing more ambulances at the problem isn’t necessarily the fix.

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at
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Anna Menchaca Anna Menchaca Thursday, March 27, 2014 6:21:17 PM Obviously , you are not as an expert as claimed. Chicago has a state of the art 911 center, second only to New York. The 911 center knows exactly where each unit is, and can actually see them move on a screen if need be. The problem is no unit is available. With a city almost 3 million people, which does not include visitors, daily commuters, and university students ( not found on any census records) And a city that spans 235 square miles , including 6 interstates . And only 60 ALS ambulances. Approx. 90 percent of all calls received by the 911 center ( approx 550,000) are EMS related. We have all the bells and whistles as far as technology. But thanks for your expert analysis.
David Newton David Newton Saturday, March 29, 2014 9:19:35 PM Anna, do you know what you would do to fix this problem? I would like to hear your thoughts.
Mark Dewdney Mark Dewdney Saturday, March 29, 2014 9:35:39 PM Chicago's 18th District becomes North America's 7th-largest city, all by itself, from 9-5 M-F. To assert that congestion and lack of proper units plays NO part is disingenuous at best.
Dale Loberger Dale Loberger Sunday, March 30, 2014 11:54:18 AM Art is correct that more resources is not necessarily the answer if you are not using what you have efficiently. More of the same is just more. What almost 200 high performance EMS services across North America (but not Chicago) do is not only constantly track vehicles but position them closer to anticipated demand before the call comes in. This not only cuts response time, but shortens distance medics travel under lights and sirens to improve safety as well as cut overall call time. The dispatch center must always know location and status of every vehicle to be able to dispatch effectively given the service level at any moment. Dynamic SSM systems like MARVLIS are proven to reduce costs and improve response time at both large and small agencies. Chicago may well need additional resources, but effective and efficient use is no longer optional.
Casey McLemore Casey McLemore Sunday, March 30, 2014 12:47:19 PM Maybe they should take some advice from the 2 best ambulance services in the country; Tulsa and Seattle. Tulsa is one of the busiest services. They average 10 calls per 12 hour shift.
Anna Menchaca Anna Menchaca Saturday, April 05, 2014 8:30:56 PM Yes, first of all due to the fact that EMS has been neglected for years, we start from the bottom. And many of these programs will not see results for years to come. OK let me start by clarifying the misconception and inaccuracy of the idea that we do not know where our ambulances are at, and because we are so disorganized and confused with lack of state of the art vehicle and dispatch technology. That is not the case, Chicago has a state of the art 911 center, we have GPS on all our vehicles, we status with a computer, so there is absolutely no confusion as to they do not know where the ambos are at. Its that NO ONE IS AVAIL , when that hot call comes in and someone is lying on the pavement, causing the dispatcher to plead and broadcast " Is anyone Avail. Downtown"? " Is anyone Available out of so and so hospital" did people not read the memo. The memo States give as little as possible information to not elude to the fact we have nothing ALS to send. The reason that memo came about was because of an investigation that we were having issues. And that memo was to hush the thuth. So they can down play it and those who have no clue because you don't work here , can keep posting untruths and conjecture. This week 2 alderman proposed a vote action for a full scale investigation. They are going to find years of neglect that has led to this crisis. The neglect is the anatomy of this crisis.
Anna Menchaca Anna Menchaca Saturday, April 05, 2014 8:40:55 PM Thank You , I work an Ambo. Downtown , and in the last 10 years with the population of the west and south loop the population has grown 114 percent adding about 250,00 people , and quess how many resources have been added. Zero , the downtown area swells to 2 million computers daily, now throw in a festival another million, oh and we still have to take care of those other approx 3 million people who live here. We have added one ALS ambo in 18 years.
Phillip Aguet Phillip Aguet Sunday, April 13, 2014 10:50:09 PM they dont pay ambo 10 enough.
Alex Wharrie Alex Wharrie Friday, April 25, 2014 1:45:05 PM Time to remove paramedics and EMTs from the fire services and make a state run ambulance service. This will save millions in duplication of services, eliminate waits and standardize prehospital care throughout the state. You need an ambulance with paramedics on a medical call, not fire trucks and you certainly don't been 8 people on 97% of medicals calls.

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