An Emergency Medical Service (EMS) is a branch of emergency services dedicated to providing acute care outside the hospital setting. EMS is capable of providing care equivalent to any emergency department. The personnel or the paramedics are trained and equipped with Advanced Life Support (ALS) along with the Basic Life Support (BLS). One of the most crucial operational decisions in the EMS system is the placement of the medic units serving the community. There has been extensive research in this field providing solutions from heuristic methods to genetic algorithms. However, there is still room for research to identify more practical and complete solutions. This research endeavor proposes a holistic approach to identify best serving boundaries and the most optimum locations for the Mobile Intensive Care Unit (MICU) medics. In the first phase, detailed current state analysis was carried out. Key performance indicators were identified to measure the system and identify opportunities for improvement. A multi-criteria approach was used along with visual representation of the system to identify medic bases performing sub-optimally on the identified performance indicators. The second phase in the improvement process was to exploit all the possibilities of improving the system. This led to the design of three scenarios where the optimum locations and serving boundaries were calculated using the proposed model. The system performance was measured in each scenario to quantify the improvement due to relocation of medic units. The scenarios were compared in terms of the identified performance measures and a recommendation was made using the Analytic hierarchy approach.

The analysis revealed huge opportunities for improving response time and utilization of the system. The proposed alternatives have led to a reduction in both the system response time and overall utilization of the system. The proposed models resulted in a 19% reduction in response time, and 0.031% increase in treat ratio adding 620 treatments per year, without requiring any additional resources. In the third scenario, which required an additional medic unit, it improved system performance with a 28% reduction in response time and 0.042% increase in treat ratio adding 850 treatments per year. To the best of the author’s knowledge, the absence of documented literature in the field of operational improvement for EMS systems makes this research significant and unique.