2021 Volume 81 Issue 1 Pages 1-9
In April 2019, Showa University reformed its Emergency Medical Center at Showa University Hospital into a Department of Emergency Medicine as part of a project to revitalize the emergency medical care provided by the university. This paper aims to show how the reformation of the Emergency Medical Center has influenced the number of ambulance admissions and ambulance response rates. We tabulated and compared the following figures between the periods from April 2019 to March 2020 and from April 2016 to March 2019: the number of ambulance calls placed to Showa University Hospital, the rate of ambulance admissions in response, the number of calls not resulting in ambulance response, and the rate of nonresponse （based on that number）. Showa University Hospital received 7,516 ambulance requests and dispatched 7,228 ambulances （response rate of 96.2％） from April 2019 to March 2020. The results of the interrupted time-series analysis showed that the response rate over this period increased by 6.8％ （95％ CI, 2.4％-11.2％） compared to that from April 2016 to March 2019. There were multiple reasons for the improved response rate. Once the department was reformed, its purpose was more clearly understood. From April 2019, three important reforms were carried out altogether: more personnel were allocated during busier hours, a North American style of emergency medicine was adopted, and an emergency care system manual was introduced. As a result, these reforms in combination led to a significant increase in the number of ambulance calls. The Emergency Medical Center reformation increased the number of ambulances received by Showa University Hospital, which in turn improved healthcare in the community. We propose that similar reforms could be applied to other Showa University Hospitals.
