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How can children learn faster what brings an I've been in to an emergency sooner how do you get the right man in the right job the answer is computers only computers can cope with a diversity of municipal demands and to help you understand some of the uses of computers we bring to the series computers and modern city government Your host of these programs is the deputy city administrator a doctor in satyrs whose topic today is Lance's response faster Dr satyrs most of the uses of computers that we're familiar with lies tend to be clerical uses data processing associated with numbers associated with checks associated with utility bills and telephone bills and so on the emphasis in this series is how computers are being used by city government to bring direct benefits and improvements to the public for example through console's in the classrooms of our elementary schools finding jobs for the jobless fighting for clean air and in these various ways. Today however we're going to be discussing about a very different use even than those that I just mentioned we're going to talk about the computer as a tool for scientific management to help make important decisions to help managers to help the executives of the city make important decisions and in particular we're going to be talking about how we used computers to explore and analyze some novel ideas about ways to make ambulances respond faster our guests today are Mrs Lee Burke Holtz Eugene Clemens and Richard cool all are from our office the Office of Administration of the office of the mayor under deputy mayor Timothy W. Costello. Lee wanted to give us a brac background and fill us in a little bit on something called simulation what is simulation simulation is setting up a model that describes the behavior of a real life situation and then experimenting with it the real world may be represented in a model by numbers or some other symbols that can be readily manipulated for example airplane manufacturers can make a model built out of balsa wood and use it or various kinds of metals and test it in a wind tunnel that's one kind of model what's a computer model however what is computer simulation in a computer simulation the model consists of numbers that describe the behavior or logic symbols that describe the behavior of the real simulation reason we use a computer is that it's much faster and it can handle many more things and we can simulate a large period of time within a very small period of time OK a computer simulation was very successful I know in many of the glamorous areas of our society computer simulations been used in space exploration in the military and it's been very very effective in business and in helping to make some. Decisions as to where to build warehouses or where to locate certain kinds of facilities or docks and so on in order to reduce the amount of time it takes to to send goods from a factory to to the public consumer let's start talking about how we used computer simulation in the in the ambulance area and I guess First let's define the problem Mayor Lindsay asked Deputy Mayor COSTELLO Some time ago to examine the city's emergency ambulance service and to develop ways to make drastic improvements in the ambulance service of the city. Wanted to describe briefly for us Jeanne what is the can you describe very briefly how does the ambulance service work basically ordinarily basically the ambulances dispatched by the police communications division another word someone calls the police are not nine one one right after the Cause been received it is up to the dispatcher in the police headquarters to get in touch with the appropriate hospital dispatcher at that particular hospital who then takes husband's the call and we'll send whatever AM GOING TO is available. Subsequent to this the ambulance of course is on call not available and it sometimes there are periods when many cause must be held because of the huge volume of demand coming through the police nine eleven number OK Now the problem facing us was given this mode of operation of the ambulance service the fact that we had ambulances located in hospital garages sometimes one ambulance at a hospital sometimes three four as many as seven ambulances located at a particular hospital garage the question was How can we improve the ambulance service and in talking about improvements What was the actual measure we use lead to describe what is an impact happen to describe improvements to the improvement we wanted was the one that the patient the caller would want. Most and that is getting the response time getting the ambulance to him as quickly as possible so response time was what we measured are improved OK response time how much time elapsed between the time that someone calls for an ambulance and the time the amas appears at the scene now as I recall there were several different alternative ways that people were talking about improving the ambulance service One suggestion was simply to buy more ambulances and a second alternative was to establish more garages not only using not only the hospital garages but construct or rent additional garage space in various places in the city in order to station ambulances there and a third alternative was to do away with the concept of garages as such and simply use dispersed ambulance sites in other words curbside stations an ambulance stand located up the curb and critical places in the city and have an ambulance standing there ready for to respond to a call. Lee what are the different factors involved and how rapidly an ambulance if we look at the city as a whole and look at the ambulance service as a whole and we are concerned with the question of response time of ambulances one of the critical factors that determine how rapidly an ambulance will get to the scene of a call well it's true of course the number of ambulances is important but just more isn't the answer because also involved in is where these ambulances are located where the hospital is located and we mustn't forget the people where the calls come from how they're distributed and how many of these calls there are in a given area all of these things are going to affect response time OK so we were faced with a problem some months ago of trying to figure out what is the effect on response time of the number of ambulances the location of the hospitals the locations of ambulances the geographic distribution of calls for ambulance service and the frequency of calls now those are a lot of different factors to try to juggling. Keep in mind that any one time. And in particular trying to figure out which of those three alternatives more ambulances more garages or a dispersed ambulance system very difficult difficult to figure out how those three alternatives. Stack up against each other how these alternatives can be compared in terms of their effectiveness in reducing the response time. How do you analyze a problem how do you tackle the problem then in trying to figure out what's the relationship between these different factors that we're my friends medical model tenant supply that's right what we wanted to do was to build a mathematical model of the way the real ambulances operate and then we were able to experiment with it try out all of these alternatives without buying more ambulances without moving the ambulances that we did have in short without disrupting any of the present condition that we had we were able to try out all of our turned heads and then find out which one is the best before we made any real physical move and that's right that's one of the big advantages I guess of experimenting in a computer instead of experimenting out on the street is a fact you don't disrupt things by conducting your experiments that's true and so the key factor then is building a mathematical model what is a mathematical model Exactly well the to begin with we must make the model a representative of what really is so that we must go out and gather data about what the situation that we're modeling is we had to have data on the number of calls in the district how they were geographically distributed and of course we had to know the number of ambulances that we wanted to consider the location of our hospital and in our alternatives all the possible locations that we wanted to consider as possible targets OK what in file format is a mathematical look model look like is that essentially our Is it a series of a graph magically equations in a computer that's right OK so we went ahead and collected the appropriate How do we collect this data by the way. We did a number of different things we of course had the records that were made available to us by the Department of hospitals about the operations of their ambulances and then when we needed other things that the hospitals Department may not have been collecting we. We actually had people riding the ambulances seeing what went on and making records of this for us over a period of time that's right you just reminded me we had some urban core students who were with us for the summer and they were actually riding on ambulances and collecting data and so on I seem to recall that one of the important pieces of data was how long what the average speed of travel was how long it took an ambulance to get from point A to Point B.. How long did it take to build this mathematical model E O I would say about six months two people were working on this development and roughly six months time. When the mathematical model was finished and constructed how was it used what kind of experiments did you run on a model when we first tried different numbers of ambulances this would be the equivalent of purchasing more ambulances and we tried everything from the possible adding one more which perhaps was in the realm of doing logically all the way up to twenty more and Owen says which certainly was not within the realm of real life experiment then we also experimented with placing different numbers of ambulances in different locations and other words a computer would be fed this information about the mathematical model of the computer was structured in such a way that you could say or enter into the computer something like Let's try and see what happens to response time if we add one more ambulance or two more animals or three more animals or ten more embers of twenty more animals is and then the computer would go through all these calculations using the figures that we had fed before hand to calculate what the effect would be of response time under this particular situation with two three four ten twenty more ambulances I see. How many. How many different experiments are just another way of putting it what what what once you constructed the mathematical model. How many. How low how long was the experiment you cure carried out you can't add like several calls or why no we carried out over one hundred seventy thousand calls in that area and that represents doctor's advice something like three and a half years of operation of the hospital area that we were modeling I see and there are that's a very striking example of the value of experimenting on a computer rather than experimenting the street in other words we managed to compress the time to run experiments and we ran it in the computer experiment would've taken three and a half years that's right in calendar time we actually conduct an experiment of that duration on a computer really just a matter of hours of an hour or two of computer time all together I see what. What did the mathematical model show with the results rather of the experiments Lee what did we find out from it well the results showed us that by distributing the ambulances in different way we could improve response time up to about thirty percent and this could be accomplished with it rather in significant additional cost if we used our current resources better we could achieve a thirty percent reduction in response time that's a very important finding late because as you recognise and you've been in city government longer than I have as you recognise one of the classical solutions or classical fixes the people half your problem is get more of something if you'd like the ambulances to respond fast to the solutions to get more of them if you want the garbage collections to occur more frequently get more trucks get more this get more that one of the striking things you uncover in your in your analysis was the fact that we could do a lot more with the available ambulances and make of this rather striking improvement of thirty percent. In response to. I'm just by taking our present ambulances and and utilizing them in better ways by stationing them in better ways what is the strategy in terms of stationing them in better ways what does that mean exactly where would you locate them. Generally they would be located where the heaviest coral density is naturally there are other factors that are involved such as an appropriate kind of station but it is our geographical distribution primarily that would determine where a dispersed Dam going should be located Dick we haven't heard from you yet describe a little bit that rather striking map that you in came prepared with the the problem of hospitals showing the distribution of cause what of that show up well essentially the distribution of calls was in the in the Bronx for example was shown to be within a relatively confined area and listen in the South Bronx South Bronx area. On the map now the. What we had seen was that in certain pockets certain certain defined areas. The number of calls generated was for any given door was extremely high now what we had what we had done on that OK what really struck me on your map and you gliding over it is the fact that you have this very dense concentration of cause in one part of one part of the Bronx and also in a part of Queens but where were they at when the hospitals and the ambulances convention you located with a right in that area there you know the ambulances were located in the hospitals. In some cases extremely far away from the from the areas of high call density OK So in other words there was a part of town in many parts of town really where you could predict that there would be a lot of calls for emergency ambulance service just to test that we chose up that way you can predict that there can be a lot of calls for service there and what happens is that our. And it was located at a hospital rather distant from that point is assigned to that call it spends time running out to this remote area and then picks up the patient and goes dashing back to the hospital with a patient and main thing that the model showed is that we could be we we should expect rather substantial improvements and as a matter fact common sense tells you the same thing that you can expect a rather substantial improvement by taking the ambulances and locating the right in the middle of the areas where you would expect a lot of calls to come from and then instead of having to take a long time running from the garage over to the point of demand you'd be right there in the general area of the man and get to the particular patient much more rapidly treat him pick him up and deliver him back to the hospital if necessary. OK so we had the results from the computer in the computer suggested that some dramatic improvements could be made without drastically increasing the cost of operating the emergency ambulance service. One of the big problems that any Our analyst has to face is how do we go from OK here's a recommendation that seems to come out of this computer analysis and out of our mathematical model and out of our simulation. The next step I guess Jeanne was to try to convert that into real a real live test on the street and with the hospitals. What was involved in setting up an I am a test of this theory of ours this hypothesis Well you know what to do take it out of the computer and put it on the street. First we had to select what areas we wanted to try it out and. We selected two rather than just one because these two offered to different possibilities from their very geographic structure the Bronx with its heavy call density as a relatively limited distance however in Queens with slightly less density of call we'd find that the distances to be traveled are greater therefore in conducting this test we would be able once the time for analysis of it comes to determine whether the concept is correct in both instances in the distance matter and in the heavy density matter Dick how do we actually set up what is the experiment consists of what the Dick's moment consists of well the experiment consisted basically of having our ambulance crews. Record on on their trip tickets a series of time and mileage data now. With the Zambians is located these Look at these were located in and four places in the Bronx these were. Transit Authority garage and. Two On to health solutions are on the form of health and the last one was a maternity clinic. These these are all public facilities acquired like public facilities one of them was actually a neighborhood city hall I think on offer Robin you that's right what part of the Bronx is not by the way Gene what do I caught the South Central Bronx and it is a pocket of heavy called density week selected one a balance from each of the formulas suppose hospitals to participate in this experiment that's in Iraq Ratana Parker farting around Ochone on park slightly south of Perth took it on a park and flanking it on the east on the West and each hospital that participated each municipal hospital sent one ambulance into the sector of that heavy density area that was normally in its own hospital district and other words we had let's see what hospitals were involved in this. There was Bronx municipal hospital Fordham hospital Lincoln Hospital and Morris Ania City Hospital OK and the so we took an ambulance and we station our curbside there I say we I should point out that the department of hospitals operates the ambulance service and does a splendid job handling over half a million calls a year as a matter of fact and the Department of hospitals working with us conducted this experiment where we took the ambulances and Gene and Dick spent many many weeks and months working trying to select specific appropriate kinds of spots you mention kind of casually that we use the Metropolitan Transportation Authority garage in the West Farms area and a couple of District Health Center a neighborhood city hall but I for one know what an effort it was to try to you know look at the map and look at the density of cause and I try to find appropriate kind of space nearby where we could place the ambulances. What the wind to do we start an experiment that kind of experimental takes a great deal of coordination with all the different factors involved in setting up this test gene in setting up the test first after the determination of the area we had to enlist the whole hearted cooperation of first of the two principles number one the hospital apartment from the top administration through the various hospital administrations the transportation division down to the cruise themselves who are the vital backbone of the work. We had to the crews especially Add to be given a certain indoctrination because it was a new technique of operation that we were asking them to participate in them the police department also plays a very vital role since they are the dispatchers in the prime instance we had to get the cooperation of the police commissioner on down through the communications division and the dispatch dispatchers who work in the ambulance section to make sure that this added starter of a method of operation would be performed by them. As we had planned it out to give a proper testing them on a smaller scale but nonetheless vital there was the cooperation of the various city agencies private also private agencies and even of private sector apart from a semi public agency namely a gas station open all night long who volunteered to permit our ambulance to be there for a trial. It required that the traffic department would install signs outside of these selected installations in order that ambulance parking only would be allowed at that spot. It required cooperation all along the line of these agencies and it's only with that cooperation that we were able to put the show on the road one thing that was very pleasing and impressive to me was was in fact the splendid cooperation we got from the Department of hospitals of commission of Terenzio from the police department commissioner Leary from the Department of Health whose facilities we you know we were parked outside of on the Commissioner Roark the Metropolitan Transportation Authority under Dr Ronan who's a garage we're using up in the Bronx and the traffic department commissioner carried us off to a very promptly set aside that curbside space for ambulances and locked up a couple of the parking meters so that people couldn't park in there and put up some signs to want to make sure that space was safe for the ambulances So that's the out the up in just the general love picture of the devout experiments we are sort of these dispersed ambulance sites in various carefully selected locations in the Bronx and Queens. The police had a direct line to the to the ambulance station there and also could be in touch with the ambulance by two way radio. Dick what were the results of the experiment what we found what was found so far well although it may be somewhat premature to to stay definitively what the actual results are since the data have not been fully analyzed to develop we have interviewed and I have gotten some response from the field to the effect that ambulances are now at the dispersed at the spur stations I should mention responding to the scenes faster than police cars are and this is a major major discovery in a major finding which we're quite pleased about and I was I was quite. Alighted to hear one of the. Ambulance attendants and one of the ambulance drivers who are dedicated and highly motivated men announcing with considerable pride in their voice that hey we're getting to the scene of accident sometimes fasten the police are not just kind of rarely happened under ordinary operation and I know several of policemen expressed surprise at seeing the ambulance turn up so rapidly and even some patients at an ambulance I rode with the other day described our surprise at the rapid response of the ambulances. Well what we've heard today is something that really affects the life of every New Yorker. Medical emergencies are something that we're all afraid of and hopefully few of us have had to experience in our lives for ourselves or our family or friends but here we've seen a way in which modern computers and modern scientific methods utilizing mathematical models computer simulation some of these Space Age techniques of operations research and systems analysis how we applied these tools in city government to analyze this very vital area and to try to bring about improvements in the city's emergency ambulance service. Thank you Lee Burke Holtz Gene Clemens Dick coup for joining us today on this program ambulances respond faster Thank you Dr Service You've been listening to another broadcast of computers and modern city government if you have any questions about today's program or would like to receive a pamphlet titled introducing computers right to computers W N Y's to New York one hundred zero seven next week's topic is computer dispatch police so join us again next week at this time for another look at computers in modern city government.