Efficient pre-hospital emergency care can significantly improve healthcare outcomes. Difficulty locating the emergency is a significant challenge, contributing to inefficiency in pre-hospital care. The goal of this study was to describe challenges emergency medical response (EMS) teams face in Rwanda locating emergencies & to explore potential opportunities for improvement.
We conducted 21 in-depth interviews with 4 stakeholder groups representing the EMS response system in Rwanda: ambulance dispatchers, ambulance field staff, receiving hospital staff, & policymakers. Interviews covered participants' perspectives on the challenges related to locating an emergency, how challenges impact quality of pre-hospital care, & what opportunities exist for process/tool development. Audio recorded interviews lasted 30-90 minutes each. Transcripts were coded using NVivo into 3 domains: the process of locating an emergency, impacts of challenges, & opportunities for processes/tools.
The current process of locating an emergency was hampered by lack of supportive technology, dependence on individual's local knowledge to describe the location, & inefficient communication channels for sharing location (e.g., between caller, dispatch, ambulance). Challenges in locating an emergency led to longer response times, inconsistencies in rapid response based on an individual's knowledge of the area, & communication difficulties. Interviews also revealed 3 types of opportunities to improve the location of emergencies: technology to geolocate an emergency accurately & better time response, improvements in communication to allow for ambulance access to real-time interaction between the caller & dispatch, & better location data from the public.
Timely EMS response is essential for optimal clinical outcomes, but significant challenges exist in locating emergencies. There is an urgent need to implement locally relevant solutions to improve the efficient location of emergencies in Kigali, Rwanda.