Evaluating EMS Systems

Emergency medical services are an important aspect in any community to help in reducing suffering since people are prone to sickness and accidents. This reason has prompted the necessity of coming up of an improved emergency medical services that is well aligned with emerging issues such as the possibility of a terror attack.


Evaluating EMS Systems


State University



Evaluating EMS Systems


Emergency medical services are an important aspect in any community to help in reducing suffering since people are prone to sickness and accidents. This reason has prompted the necessity of coming up of an improved emergency medical services that is well aligned with emerging issues such as the possibility of a terror attack.

A modern day EMS should be in a position to handle such issues with ease and a manner that reduces suffering among victims. Santa Clara has been alive to the need of coming up with a well-organized EMS system that incorporates most emerging issues posing threats to those living and working in that county.

Santa Clara County is located in California, in the center of Silicon Valley. It is bordered by Sunnyvale, Cupertino, and San Jose. The City is the home to some high-tech companies including Intel. As cited in Martinez, (2015) the World Health Organization (WHO) suggests that the social determinants of health are those: condition where people are born, live, grow, work. Some of the most important determinants include demography, hunger and food insecurity, income and poverty, and education among others. In this County, the Public Health Department works with local organizations to collect and analyze data so as to understand the impacts of social determinants to health. Moreover, the department and the local-based organization make recommendations for actions to address common health problems. In respect to the determinant of demography, Santa Clara County has more than 1.8 million occupants.

The region is the most populous in the San Francisco Bay area. At least every second in ten County occupants are above sixty-five years, and this number is expected to double in the next three decades. Santa Clara County is a diverse community. Nationwide, it is one of the largest counties where minority people are the majority. Approximately half of the population speaks other languages (not English). Also, thirty-eight percent (38%) of Santa Clara County residents are immigrants from different nations of the world. According to recent report, Santa Clara County has the highest number of middle-class income earners but one in every ten adults lives below the federal poverty level (Avery et. al., 2010). In the past decade, the County’s population has experienced a steady growth; with an increase of averagely 20,000 residents annually (Avery et. al., 2010). The EMS system faces a major challenge due to the fact that integrating medical services and facilities offering health care has been forthcoming.

The Demographics of EMS System in Santa Clara County

As stated by National Research Council (2008), the Santa Clara County EMS system serves the needs of almost 2.2 million residents and visitors. The diversity in the city is served by an equally diverse group of EMS system agencies including emergency ambulance providers, non-emergency ambulance contractors, air ambulance providers, fire service, hospitals, the public health department, and training organizations among many.

Fig 1: Source: (, 2015)

The County Ambulance provider, which is one of the most recent developments, began serving the County on July 2011. Today, the county has many emergency care services such as twelve hospitals, ten 9-1-1- responding hospitals, eight cardiac centers, ten stroke centers, one spinal center, and one burn specialty center (Martinez, 2015).

The enhancement of Emergency Service has been made possible after each hospital got equipped with modern EMS computer systems:

Fig 2: EMS equipment

All the facilities provide a high level of medical treatment and care in their respective specialties. The EMS facilities benefit all community members from decreased rates of mortality and morbidity. According to National Research Council (2008) each state has 250 EMS agencies where each agency is given a specific geographical area that it covers.

As posit by the Santa Clara Semi-Annual Report, (2014) this county’s EMS system is recognized by medics throughout California because of the diverse and large group of EMS system participants, the EMS Agency, and structure, delivery, and processes of the EMS system. However, there are some challenges facing this department such as uncertain future capacity and new emergency cases. To tackle such problems, the County developed a strategic plan that will close the existing gap in the system and to level up to an advanced health care system. The plan is based on three initiatives (Triple Aim Initiative) including: improving medical care, reducing costs, and improving both patient and stakeholder satisfaction. Besides the initiative, the EMS system is planning for disaster preparedness and response ahead of the 2016 Super Bowl 50 that will be held at Levis Stadium in Santa Clara County. Some of the latest developments include

Structural Attributes of the Virginia Beach EMS System

Geographic Scope

As noted by City of Santa Clara website, (2015) the mission statement of Santa Clara EMS System is to provide a cost-effective delivery system to its cultural diverse residents while attaining higher levels of patients’ satisfaction. In efforts to serve the potential increase of 140,000 newly insured residence of the city as well as meet the growing healthcare needs of this County, EMS Agency is in charge of regulating and delivering emergency medical services in Santa Clara. The EMS Agency (Metro) is the only organization that handles emergency cases in the county. All types of emergency health services are provided to people within the County and covers areas such as San Jose, Campbell, Los Altos, Mountain View, Santa Clara, Sunnyvale, Saratoga, Monte Serene, and Palo Alto. Also, the agency provides services to tourists visiting the County and that is why they are planning ahead of the 2016 Super Bowl 50 that will take place in Santa Clara. Nonetheless, some areas around the county such as San Antonio Valley lack meaningful access to regular emergency ambulance services (Avery, et al. 2010).

Hierarchy of Command and Enforcement

The highest in the hierarchy is a Battalion Chief, who is the overall coordinator of EMS System in Santa Clara. The second is a deputy chief responsible for training facilities and delivery of quality and effective health care. Next in line is a Firefighter engineer paramedic who serves under the deputy chief (Santa Clara County, 2014). The rest of the group is paramedics and Emergency Medical Technicians (EMT) evenly distributed to different areas within Santa Clara.

Divisions of Functions

The overall roles of all divisions within Santa Clara EMS System are training, system planning, and monitoring compliance, accreditation of personnel, providing quality health care standards, as well as disaster medical planning and response. As summarized by Martinez (2015) the divisions of the EMS System in the County include;

  1. Emergency Medical Service Division- it is responsible for admitting and training medical personnel to deliver emergency services to residents and visitors of Santa Clara County.

  2. Fire Department- to utilize Advanced Life Support (ALS) engine companies located at different fire stations 1, 3, 5, and 6.

  3. Ambulance services department- Contains paramedics that respond to emergency scenes, assess the situation, give first aid, treat and get patients ready for transportation to a nearby hospital if necessary.

Challenges facing the current EMS System

According to an assessment report on the Santa Clara EMS System, there are some critical issues affecting the capability and stability of the current delivery system (City of Santa Clara, 2015). There is insufficient capacity in the hospital and emergency department in the county. Most hospitals, in particular, the emergency departments are full on a daily basis and the response if slow due to the increased volume of emergency cases. More so, the growing population in the County greatly contributes to the inadequate capacity in the hospitals. The communication systems in Santa Clara’s EMS System are fragmented. Currently, there are ten public health safety answering points and seven emergencies medical dispatch (EMD) centers in the County’s EMS System.

The high number of centers causes poor variation in the emergency call reception and management processes (Avery et al., 2010). Also, the system culture lacks evidence-based research and data transparency. Hence, the system limits innovation and decisions are made from poor research with limited evidence. Fortunately, the County provides prevention EMS programs to its public. However, the programs are poorly coordinated, and they are not linked to any initiatives that would track the impacts. The County’s EMS System leadership structure is complicated, which affects the distribution of information (Scour, 2015). The confusion in leadership also impacts accountability that in turn discourages new investors to fund the systems.

EMS is usually faced by a number of financial issues but seems to become a thing of the past once the EMS TRUST fund projection is solicited into the budget of 2017 fiscal year.


The implementation of these recommended actions will incur a significant coast to the general fund of the EMS System, so as to serve increased demand of emergency health care, the future EMS System will require more hospitals and expand the emergency departments. The system should also need to set appropriate and realistic compliance measures and response standards. In other words, emergency patients should be attended to in the shortest time possible to reduce the mortality rate and save more lives. In the communications department, the county should update their 9-1-1 technology and equipment to serve the next generation of emergency cases. For an organized leadership structure, the EMS System requires qualified advisories and employs more personnel to head each department in the system. The formal structural organization helps in the flow of information and ensures that everything is accounted for.




Santa Clara County EMS System was launched to improve health care with the goal of satisfying the patient’s expectations. Indeed, the challenges facing the system are tremendous and cannot be ignored. Fortunately, the transformative and modern opportunities in the system are equally great if properly implemented. Finally, the EMS Agency and stakeholders need to collaborate to create a modified delivery system that is of high quality, organized, and culturally competent.















Avery, B., Beauregard, S., Luna, R., Reedy, A., Sills, E. (2010). Santa Clara County: Health Profile Report. California: Santa Clara County Public Health Department. Retrieved 12th October 2015,

City of Santa Clara the web. (2015). Emergency Medical Services. Retrieved, 12th October 2015,

Martinez, C. (2015). Santa Clara County EMS System Assessment Phase 1. Retrieved 12th October 2015,

National Research Council (U.S.). (2008). Regional emergency medical communications systems: A final report. Washington: National Academy of Sciences

Santa Clara County (Calif). (2004). County of Santa Clara ordinance code. Tallahassee, Fl: Municipal Code Corp.

Sathyan, J. (2010). Fundamental of EMS. New York: CRC Publishers

Semi-Annual Report. (2014). Santa Clara County Emergency Medical Services Agency.

Scour. (2015). County of Santa Clara: Emergency Medical Services. Retrieved 12th October 2015,