PUBLIC SAFETY TRAINING CENTERS IN CALIFORNIA

In order to determine the best locations for training centers in California, an understanding of the demographics of Emergency Medical Technicians (EMTs) and Paramedics and the overall demands of hospitals is needed. Demographic data such as age range, years of experience, and license type. Hospital data such as EMS Total Visits and ER Total Traffic were also examined. The location of already established EMS Agencies was also assessed.

The decisions on where to locate the training centers was based on the amount of EMTs and/or Paramedics in that county, the demand load of the hospitals in those counties (EMS Visits and EMS Admissions), the locations of other training facilities in the region or county, and the amount of EMTs and Paramedics that were trained at those facilities. For some regions which have a large area, there is a possibility that a long commute to a EMS Agency training facility would be a deterrent for those considering a career in the field.

Requirements

To gain the best understanding of the EMS demands of California, hospital utilization data from 2017 to 2020 was examined. The 2017 Hospital Utilization dataset included an Admitted from EMS variable, which indicated how many patients were admitted to the Emergency Department after being brought in by Emergency Medical Services (EMS). 2018-2020 datasets did not include this variable, though did include an Admitted from Emergency Department variable, which did not separate Emergency Department traffic based on walk-ins and EMS visits.  For analysis purposes, 2019 hospital utilization was used for training center recommendations due to the COVID-19 pandemic affecting hospitalization numbers in 2020.

The hospital utilization data also contained information on the level of severity of the cases brought in by EMS: non-urgent, urgent, moderate, severe, and critical. Depending on the number of different cases brought in, areas with a greater number of severe and critical cases would most likely benefit from a greater number of Paramedics, which have more advanced training.

Locating a new EMS Agency in California would also need to take into consideration existing agencies. There are a few agencies which are multi-county and may be better served by introducing another certification agency. This would be due to the burden of travel on people who are interested in becoming EMS (either EMTs or Paramedics) but are unable to make the commute to the training agency. In this instance, locating a training facility in the same region, in a different county, could possibly alleviate that barrier to entry. If multiple facilities are not created in the regional area, then the region may be divided into a new region, serving different counties. The EMS Agency Regions are: Central California, Coastal Valleys, Imperial, Individual Counties, Inland Counties, Mountain counties, North Coast, Northern California, and Sierra-Sacramento.

Data Wrangling

While performing the analysis, most variables were dropped form the Hospital Utilization datasets due to the size of the initial datasets and wanting to focus on variables that would be relevant to this research. Hospital Utilization kept Hospital ID, Name, Address, City, Zip Code, County, Latitude and Longitude, Hospital Classification, EMS related variables (Visits and Admits by case, where Visits were brought into the Emergency Department and Admits were admitted into the hospital from the ED), and Admitted from ED. A variable was created totaling the amount of EMS Visits. Additional created fields were the count of license types (EMT and Paramedic) held by each age range.

Advanced EMTs were dropped from the investigation, as there were not that many (such that dropping them had no observed impact on analysis) and the focus of this analysis is looking into training centers for EMTs and Paramedics. Out-of-state training centers were dropped from the investigation, as they were not relevant to the question of where to locate centers in California.

The names and locations (coordinates) of current EMS Agencies and training locations were manually entered.

Findings and Recommendations

In addition to the demographics of EMTs and the demand of hospitals, it would also be worth consideration to investigate the increasing turnover rates of EMS personnel. According to the American Ambulance Association, the turnover rate is in the range of 20 to 36 percent across the country which means that most EMS agencies are experiencing complete staff overhauls every 3-4 years (Moore, 2022). Questions that could be asked are if the turnover is related to compensation, mental health, work environment, and whether personnel leave to a new position or leave the field entirely.

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