ArticleQuality & safety in health care2006
Treating the clock and not the patient: ambulance response times and risk.
Article in Quality & safety in health care, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 66 citations in OpenAlex.
- Association of ambulance and helicopter response times with patient survival: A systematic literature review and meta-analysis.PloS one · 2025Pooled it
- The Impact of Indirect Transport to a Trauma Centre on Survival for Major Trauma Patients: A National Propensity-Adjusted Observational Study.International journal of population data science · 2026Observational
- Key Performance Indicators Applied in Medicine.International archives of otorhinolaryngology · 2025Article
- A Multi-Modality Conversation Analysis of Post Expansions Among Physicians in Ambulance: A Qualitative Descriptive Study.Journal of multidisciplinary healthcare · 2025Article
- Ambulance quality and outcome measures for general non-conveyed populations (AQUA): A scoping review.PloS one · 2024Article
- Mental health, well-being and support interventions for UK ambulance services staff: an evidence map, 2000 to 2020.British paramedic journal · 2021Article
- Investigating the Geographic Disparities of Amenable Mortality and Related Ambulance Services in Hungary.International journal of environmental research and public health · 2021Article
- Identifying quality indicators for prehospital emergency care services in the low to middle income setting: The South African perspective.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2019Article
- Association between the reported intensity of an acute symptom at first prehospital assessment and the subsequent outcome: a study on patients with acute chest pain and presumed acute coronary syndrome.BMC cardiovascular disorders · 2018Observational
- Prioritizing novel and existing ambulance performance measures through expert and lay consensus: A three-stage multimethod consensus study.Health expectations : an international journal of public participation in health care and health policy · 2018Article
- Patient satisfaction with prehospital emergency care following a hip fracture: a prospective questionnaire-based study.BMC nursing · 2018Article
- Developing quality indicators for physician-staffed emergency medical services: a consensus process.Scandinavian journal of trauma, resuscitation and emergency medicine · 2017Article
- Qualitative study of paramedics' experiences of managing seizures: a national perspective from England.BMJ open · 2016Article
- Evidence from the scene: paramedic perspectives on involvement in out-of-hospital research.Annals of emergency medicine · 2012Article
- Measuring quality in emergency medical services: a review of clinical performance indicators.Emergency medicine international · 2012Article
- Current challenges in the provision of ambulance services in New Zealand.International journal of emergency medicine · 2010Article
- Response time as a sole performance indicator in EMS: Pitfalls and solutions.Open access emergency medicine : OAEM · 2010Review
- Evaluating the views of paramedics, cardiologists, emergency department physicians and nurses on advanced prehospital management of acute ST elevation myocardial infarction.The Canadian journal of cardiology · 2009Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn a qualitative study of paramedics' attitudes to pre-hospital thrombolysis (PHT), the government target that emergency calls should receive a response within 8 minutes emerged as a key factor influencing attitudes to staff morale and attitudes to the job as a whole. A study was undertaken to examine paramedics' accounts of the effects on patient care and on their own health and safety of attempts to meet the 8 minute target.
methodsIn-depth semi-structured interviews were conducted with a purposive sample of 20 experienced paramedics (16 men) mostly aged 30-50 years with a mean length of service of 19 years. The paramedics were encouraged to raise issues which they themselves considered salient. The interviews were tape recorded, transcribed, and analysed according to the constant comparative method.
resultsThe paramedics argued that response time targets are inadequate as a performance indicator. They dominate ambulance service culture and practice at the expense of other quality indicators and are vulnerable to "fiddling". The targets can conflict with other quality indicators such as timely administration of PHT and rapid transport of patients to hospital. The strategies introduced to meet the targets can be detrimental to patient care and also have adverse effects on the health, safety, wellbeing, and morale of paramedics.
conclusionsThe results of this study suggest that the 8 minute response time is not evidence based and is putting patients and ambulance crews at risk. There is a need for less simplistic quality indicators which recognise that there are many stages between a patient's call for help and safe arrival in hospital.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.