EMRI model - Indiagovernance.gov.in

Study of Emergency Response Service (EMRI Scheme)assessors, including the members of this team, who have visited emergency rooms tostudy the EMRI in operation. The tremendous gratitude and praise of the familymembers of the accident victim for the timely arrival of this angel of mercy when heard infirst person is most convincing and moving. And there are thousands of families inwhich the lives of loved ones have been saved, who would be willing to shower EMRIwith praise and call for the strengthening of this system- whatever it takes to do so.b. Rising Utilization: The utilization rates are typically low in the first year, but seem toincrease considerably in the second year and continue to increase every yearafterwards. This could explain the differences seen between Rajasthan which is 6-9months old, Gujarat where it is one-and-half years old and Andhra Pradesh which isthree years old. In a recent estimate for the first 17 days of February, Rajasthan had 4.3dispatches per ambulance, Gujarat had 5.4 and Andhra had 8.1 ambulance trips perday. Utilisation is not related only to the duration of MOU, as revealed from the fact thatGoa, a recent start up has 4.5 ambulances dispatched per day, whereas Uttaranchal hasonly 2.7 ambulance trips per day (Annex A-16).c. Pattern of Utilization: Much of the utilization is medical emergencies. In Andhra Pradesh(using the national EMRI report for 17 th February – annex A-16) it accounts for 96.7%, inGujarat it accounts for 98.7% and in Rajasthan it accounts for 84.4%. In Rajasthan thereis a substantial degree of usage by the police department (almost 15.4%), a level whichnone of the other eight states comes anywhere near. Of the medical emergencies, thelargest proportion is pregnancy related accounting for 22% in Andhra Pradesh, 37% inGujarat and 27% in Rajasthan. The second most common reason is trauma accountingfor 20% in Andhra Pradesh, 21% in Gujarat and 40% in Rajasthan. The other highfrequency cause is acute abdomen, which is about 15.7% in Andhra Pradesh but only4.5% in Gujarat and 3.2% in Rajasthan. All other causes range less than 5% and includeanimal bites, epilepsy, cardiovascular emergencies, respiratory emergencies, suicidesand poisonings and acute abdomen.d. Quality of services: It has two dimensions – one is the promptness with which theambulance arrives and the second is the care provided en-route. On the latter there isinvestment in training a cadre of paramedical staff and equipping the ambulances withall the necessary equipment and consumables. This is laudable. There are also movesto institutionalize such training and create a new human resource dedicated toemergency care. The training infrastructure at EMRI Hyderabad is impressive. There areclassrooms training, hostels for the trainees, training equipment, and training protocols,and processes in place for testing and certifying skills. The same intensity may not beavailable in all the states, given the rate of expansion, but there is a commitment toreach quality on this. The system is aware of every aspect of quality of care duringtransport, before reaching the health facility and they are working to improve thisdimension. In their own admission, there is more to be done, but they are seized of it. Onpromptness, the popular perception is of reaching every urban call within 20 minutes andNational Health Systems Resource Centre (NHSRC)19