Modelling Emergency Medical Services

Emergency Medical Services (EMS) play a pivotal role in any healthcare organisation. Response and turnaround time targets are always of great concern for the Welsh Ambulance NHS Trust (WAST). In particular, the more rural areas in South East Wales consistently perform poorly with respect to Government set response standards, whilst delayed transfer of care to Emergency Departments (EDs) is a problem publicised extensively in recent years. Many Trusts, including WAST, are additionally moving towards clinical outcome based performance measures, allowing an alternative system-evaluation approach to the traditional response threshold led strategies, resulting in a more patient centred system. Three main investigative parts form this thesis, culminating in a suite of operational and strategic decision support tools to aid EMS managers. Firstly, four novel allocation model methods are developed to provide vehicle allocations to existing stations whilst maximising patient survival. A detailed simulation model then evaluates clinical outcomes given a survival based (compared to response target based) allocation, determining also the impact of the fleet, its location and a variety of system changes of interest to WAST (through ‘what-if?’ style experimentation) on entire system performance. Additionally, a developed travel time matrix generator tool, enabling the calculation and/or prediction of journey times between all pairs of locations from route distances is utilised within the aforementioned models. The conclusions of the experimentation and investigative processes suggest system improvements can in fact come from better allocating vehicles across the region, by reducing turnaround times at hospital facilities and, in application to South East Wales, through alternative operational policies without the need to increase resources. As an example, a comparable degree of improvement in patient survival is witnessed for a simulation scenario where the fleet capacity is increased by 10% in contrast to a scenario in which ideal turnaround times (within the target) occur

DEMSEE (2007: Istanbul)

It is true that Electricity is a pillar for our present Civilization and Culture. One should also recognize that Electricity is the finest useable form of Energy and therefore the most precious. Deregulation of Electricity Markets aims ultimately to make almost everyone responsible for the way electricity is generated, distributed and used. It aims to let fair market rules result in a Market Operation that will advance this sense of responsibility for everybody. This is particularly important in view of the present delicate state of the Environment which should for Humanity’s sake be preserved, at all costs. And indeed, we are lucky in the sense that the current Information Technologies and Information and Communication Technology will allow us to live up to our responsibilities concerning rational electricity usage as well as the preservation of the environment. However, a strong, wide and lasting commitment is necessary, i.e. political will by every nation, to achieve progress with respect of the environment. ...ELECTRIC POWER SUPPLY: THE ENGINEERING CHALLENGES AND THE CONTRIBUTION OF CIGRE / Jean KOWAL, 1 -- SUBSIDIES IN WHOLESALE ELECTRICITY MARKET / Osman SEVAİOĞLU, 8 -- GASEOUS DIELECTRICS IN POWER TRANSMISSION AND DISTRIBUTION / Loucas G. CHRISTOPHOROU, 13 -- INFRASTRUCTURE DEVELOPMENT AND POWER SYSTEM SECURITY ISSUES IN A LIBERALIZED ENVIRONMENT IN SOUTH-EASTERN EUROPE (SEE) -- Evangelos LEKATSAS, 20 / NATURAL HAZARDS, GLOBAL CLIMATE CHANGE AND ENERGY PRODUCTION -- Menas KAFATOS, 27 / EDUCATIONAL EXPERIMENT KIT STUDIES ON RENEWABLE ENERGY SOURCES -- Özcan ATLAM, 32 / AN EFFECTIVE SET OF I.C.T. TOOLS FOR TEACHING & LEARNING OF RENEWABLE ENERGY SYSTEMS (RES) -- S. KAPLANIS, E. KAPLANI, 41 / A GIS WEB – APPLICATION FOR POWER SYSTEM OF CRETE -- J. SYLLIGNAKIS, C. ADAMAKIS, T.M. PAPAZOGLOU, 48 / DIAGNOSTIC REVIEW OF A BLACKOUT IN RHODES -- T. M. PAPAZOGLOU, E.J. THALASSINAKIS, C. TSICHLAKIS, N.D. HATZIARGYRIOU, 55 / REAL-TIME TRANSFORMER DYNAMIC LOADING APPLICATION-IMPLEMENTATION AND PRACTICAL USE -- S. KRSTONIJEVIĆ, N. ČUKALEVSKI, G. JAKUPOVIĆ, N. DAMJANOVIĆ, S. CVETIĆANIN, 62 / A COMPARISON OF THE PERFORMANCE RATIO OF PHOTOVOLTAIC MODULES AT DIFFERENT TILT ANGLES -- E. DRAKAKIS, F. MAVROMATAKIS, Y. RANGHIADAKIS, P. TZANETAKIS and I. FRAGIADAKIS, 69 / ON THE MAXIMIZATION OF THE COST-EFFECTIVENESS OF A PV PLANT -- S. KAPLANIS, E. KAPLANI, 75 / INTEGRATED SOFTWARE, FOR IMPULSE VOLTAGES ESTIMATION, IN HIGH VOLTAGE NETWORKS WITH DISTRIBUTED GENERATION -- Stavros LAZAROU, Eleftheria PYRGIOTI, Dimosthenes AGORIS, 83 / NEW 400 kV INTERCONECTION OHL KOSOVO - ALBANIA AND TRANSMISSION NETWORK CONCEPT OF KOSOVO -- S. LIMARI1, K. BAKIC, K. ROBO, L. AHMA, 92 / DEREGULATED ELECTRICITY MARKET IN SOUTH – EASTERN EUROPE: ACTIVE NETWORKS -- Venizelos EFTHYMIOU, 102 / CO2 EMISSIONS FROM THE USE OF FOSSIL FUELS IN CRETE – GREECE -- John VOURDOUBAS, Antonios PITARIDAKIS, Charalampos LITOS, 109 / SURVEY OF POWER EXCHANGES – ORGANIZATION AND RESPONSIBILITIES -- O. GJERDE, O.B. FOSSO, 1J. BOGAS, 114 / FREQUENCY PERFORMANCE MONITORING AND ANALYSIS IT SUBSYSTEM FOR a TSO’s CONTROL CENTRE: ARCHITECTURE AND INITIAL EXPERIENCE WITH ITS USE -- Goran JAKUPOVIĆ, Ninel ČUKALEVSKI, Nikola OBRADOVIĆ, 121 / MARIN POLLUTION AND EFFECTIVE USE OF THE RTV SILICON COATINGS IN CRETAN POWER SYSTEM -- Emmanuel J. THALASSINAKIS, 128 / MONTE CARLO PROCEDURES FOR SIMULATING REAL TIME CONTINGENCES AND SETTING OPTIMAL REDISPATCHING STRATEGIES IN MULTI-AREA SYSTEMS -- S. BENINI, A. LEONI, P. PELACCHI, D. POLI, 136 / COMPARING DIFFERENT APPROACHES TO SOLVE THE UNIT COMMITMENT PROBLEM CONSIDERING HYDRO-PUMPED STORAGE STATIONS -- Yiannis A. KATSIGIANNIS, Emmanuel S. KARAPIDAKIS, 147 / ROOF INTEGRATED SOLAR PARABOLIC COLLECTORS SIMULATION ANALYSIS -- G. BARAKOS, S. KAPLANIS, M. PETRAKIS, A. SPYROGIANNOULAS, 154 / THE ROLE OF A POWER EXCHANGE FOR ENERGY TRADING AND POWER GENERATION INVESTMENT -- Bakatjan SANDALKHAN, 161 / HEURISTIC BASED SYNCHRONOUS GENERATOR EXCITATION CONTROL FOR USE IN A DEREGULATED ENVIRONMENT OF ISLAND POWER SYSTEMS -- Yannis L. KARNAVAS, Nicolaos P. POLYZOS, 169 / INNOVATIVE EDUCATION, TRAINING AND DEVELOPMENT PRACTICES AT THE ELECTRICITY AUTHORITY OF CYPRUS -- George ASHIKALIS, 177 / WIND FARMS EXPERIENCE IN CRETE ISLAND -- Antiopi GIGANTIDOU, Ioannis STEFANAKIS, N.D. HATZIARGYRIOU, 186 / PUBLIC KEY INFRASTRUCTURE AS A NEW TECHNOLOGY ENABLING ELECTRONIC AUCTIONS USED IN THE CONTEXT OF ELECTRICITY MARKET RESTRUCTURING: AN ASPECT OF THE COMPLEX GLOBAL ECONOMY -- John K. SAKELLARIS, 195 / THE LIBERALIZATION OF THE ELECTRIC POWER MARKET IN SOUTH – EASTERN MEDITERRANEAN -- Dimitris SARRIS, 202 / DETERMINATION OF COST STAGES OF TRANSMISSION LINE PRODUCTS FROM LONDON METAL EXCHANGE TO FINAL CONSUMER -- Sedat KARABAY, Ahmet ŞEN, 205 / NON-INTRUSIVE, ON-LINE RESIDENTAL METERING BASED ON BROADBAND COMMUNICATION -- Ali İNAN, Themis PAPASTERGIOU, 213 / CONTRIBUTION OF LANDFILL GAS ELECTRICITY GENERATION TO ENERGY BALANCE OF CRETE ISLAND: AN ECONOMIC, ENVIRONMENTAL AND SUSTAINABLE ASSESSMENT USING LEAP MODEL -- A. A. TSAVE, E. S. KARAPIDAKIS, P. M. SOUPIOS, 2181st ed

The Future of 9-1-1: New Technologies and the Need for Reform

Our nation\u27s 9-1-1 system\u27s success to date belies the fact that its core premises will not continue to serve it effectively and it has come to a critical juncture. In particular, the balkanized nature of 9-1-1 operations that differ across jurisdictions and are supported by Byzantine funding mechanisms obscure a simple but profound development: our nation\u27s emergency system is not keeping up with or taking advantage of technological change. Because the system continues to work and policymakers largely do not appreciate the system\u27s technological limitations, decision makers not only fail to focus on this challenge but instead are all too willing to raid 9-1-1 funds to put them to other uses. Accordingly, our emergency communications networks are unable to accommodate what is increasingly viewed as basic functionality inherent in many of today\u27s advanced technologies. This Article sets forth a coherent vision concerning the opportunity to transition to a next generation 9-1-1 network. To be sure, the United States\u27 9-1-1 system is hardly a monolith and prescriptions for its evolution cannot be reduced to simple one size fits all solutions. In practice, the system is comprised of numerous jurisdictions (including over 6000 Public Safety Answering Points); myriad governance structures and controls which vary across jurisdictions; a ballooning number of service providers; and a diversity of funding amounts and models that differ across jurisdictional boundaries. The result, not surprisingly, is a fractured and complicated system where policy is highly contingent on parochial and often political perspectives. To reform today\u27s balkanized 9-1-1 landscape, we recommend that: (1) clear leadership and vision embrace the need to transition the 9-1-1 system to a next generation architecture; (2) more effective state oversight provide both the funding and logistical support necessary to make this happen; and (3) localities should remain responsible for providing access to 9-1-1, but that they must be supported from higher levels of government as well as industry to exercise that responsibility. In short, there is an important opportunity for thoughtful leadership and vigilant policy reform that will serve the goals of 9-1-1 emergency response far more effectively than the policies currently in place