Learning to dispatch volunteers to out-of-hospital cardiac arrests.

Survival for out-of-hospital cardiac arrest can be significantly improved through volunteer efforts. To shorten the time to good-quality cardiopulmonary resuscitation, some emergency call centers use mobile phone technology to rapidly locate and alert nearby trained volunteers. Some such community first responder systems use phased alerts: notifying increasingly many volunteers with built-in time delays. The policy that defines the phasing of alerts affects both response times, which have a direct relation to survival, and the burden on volunteers. We aim to optimize this policy, which involves trading off these two metrics. The policy may depend on real-time information: where the volunteers are observed in relation to the patient and how long triage took. A direct approach using dynamic programming yields some insights, but is too slow for real-time use. Our contribution lies in recasting this problem as a multi-class classification problem and solving it using empirical data from Auckland, New Zealand's community first response system. This case study shows that phasing the alerts based on real-time information provides important improvements relative to a competitive baseline that is indicative of current practice.