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After the Crash - After the Crash A Case Study of the...

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After the Crash: A Case Study of the London Ambulance Service Computer Aided Dispatch System Nancy L. Russo, Northern Illinois University Guy Fitzgerald, Brunel University The London Ambulance Service (LAS) is one of the largest ambulance services in the world. Its area of responsibility covers 7 million people, and an area of 620 square miles. The LAS comprises 70 ambulance stations, 700 vehicles (around 400 ambulances, plus helicopter, motorcycles, and other patient transfer vehicles) and over 3,000 people (670 paramedics, 300 control staff). On average, the Service responds to more than 2,000 emergency calls per day. The demand for emergency services has increased steadily over the years with a growth rate of over 16% in recent years. In 1990 a system to automate the dispatching of ambulances provided by IAL (a subsidiary of British Telecom) was scrapped just before implementation due to problems relating to ‘load test performance criteria’ (Page et al., 1993) at a cost of £7.5million (approximately 10.8 million dollars). The next Computer Aided Dispatch system went live on Monday, October 26, 1992. Beynon-Davies (1995) reports that on that night "a flood of 999 calls apparently swamped operators’ screens… and that many recorded calls were wiped… causing a mass of automatic alerts to be generated, indicating that calls to ambulances had not been acknowledged”. The operators were unable to deal with the messages that the system was producing and unable to clear the queues that developed. These queues slowed the system and when ambulances completed a job they were not cleared. Thus the system had fewer and fewer resources to allocate.
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The result was chaos in the emergency service. Multiple vehicles appear to have been sent to some incidents and for others the closest vehicle was not dispatched. One ambulance arrived to find the patient dead and taken away by undertakers, another ambulance answered a `stroke' call after 11 hours 5 hours after the patient had made their own way to hospital (Finkelstein and Dowell, 1996). Crews reported ambulances from far afield passing them on the way to a call for which they were better placed. The crews became very frustrated by the delays in arriving at the scene and the angry reaction from the public. Crew frustration also led to an increase in radio traffic with crews querying the allocations or requesting further information. This caused radio bottlenecks and further delay of ambulance mobilizations. The system staggered on over the long hours of October 26 and on into the 27 th , but was clearly not viable. Finally at 2 p.m. on the 27 th the LAS reverted to a semi- manual method of operation. Calls continued to be taken on the system (including use of gazetteer 1 ) but the incident details were printed out and allocation of ambulances was done manually. The mobilization of ambulances continued to be done via the system.
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