Using CommonKADS models at EMS - Assignment Example

Using CommonKADS Models at Emergency Medical Services (EMS) Subject Number ISIT917 Subject Name: Business Intelligence and Knowledge Management Student Number Student Name Tutorial Day Tutorial Time: Tutor Due Date Date Submitted Declaration Using commonKADS models at EMS Table of Contents Declaration………………………………………………….……………..........…1 Table of contents………………………………..................2 Introduction……………..…………….........................3 MODELLING TOOL INSTALLATION AT EMS………………………….5 Table 1: Worksheet OM-organizational Model-1…………….……………….6 Table 2: Worksheet TM-Task Model-2……….……………………..………9 Table 3: Worksheet AM-3-Agent model-3 ………. …10 Table 4: Worksheet EM-4-Expert model-4-Task Analysis………11 Table 5: worksheet-OM-5(A) Agent IT support system……………..13 Table 6: worksheet OM-5(B)-Agent model: 4: Analysis for Nurse Dispatcher agent…18 Table 7: worksheet OM-5(C)-Agent Model: Analysis on procedure on initial AMI Medical……………………………….....................20 Table 8: worksheet: OM-5(D): Agent Model: Agent Analysis for paramedic Agent……….30 Fig.1: The new levels of Authority…………………32 Fig.2: New process tasks…………………………………….32 Fig.3:– Target new structure of EMS ………………………33 References…………….……………….....................34 Introduction This report is seeking to implement a knowledge based tool commonkads project model to model the product improvement of the services offered by EMS. The report therefore sets out to install this tool into the Ems service and to convey the advantages of using modelling as apart of business intelligence management. The problem addressed by this report is the knowledge deficit at EMS .we shall show that the deficit at EMS will be solved by installing commonKADS project model into the product modelling by analysing the gaps in the system and suggesting improvement tools to fill these gaps. The method or methodology is that we shall use the models of knowledge engineering .To do this we shall first show the targeted situation where we intend the EMS to go. The commomkads project models will then model the product. This report addresses the above problem by proposing a definition of knowledge based tool to address the deficit at EMS by installing Commonkads model to model the EMS product. The report therefore gives analysis to the problem then suggest various options or solutions and adopts the commonkads tool as the most efficient cost effective tool to fill gap of deficit at Ems with a knowledge tool. This tool is also reasonable easy in terms of business feasibility and technical feasibility. The report is structured into three sections, part one part two and part three. The purpose of the first part one is introduction to problem statement on problem being addressed, methodology and how this report addresses the problem of knowledge deficit and how the tool is modelling the problem and opportunities and solution proposed. Part two purpose is focused on OM 2, OM-3, and OM-4 three analysis of the core problem in variant aspects, Tasks and expert knowledge skills. Part three is purposed on focused on OM 5 analysis specific knowledge tools skills to be installed on measurable yardsticks of the implementation of the commonkads projects model on the product model. Modelling Tool installation at Emergency Medical Service Modelling here is defined to mean the installation of a predefined project model, which will be used to model the existing service into new product being designed. Our objective is to improve the EMS organisation by introducing a knowledge-based system. The expected use of this system is expected to result in improved tasks focus on improvement of the services at EMS from the problem level to the target solution level or desired goals and objectives fulfilling mission of EMS. We start from scratch with an idea of what the current problem is by analysis we come up with a design of the new product improvement .This is part of using the analysis is part of commonKADS tools the model. The tools serve as template models to help us analyse problems to identify gaps in knowledge. we fill those gaps by use of commonkads modelling. The desired outcomes are inbuilt in existing structures which we then model the desire according to coommkonKADs redesigned models ranging from design models, expertise models, organisational models, communication models, Agent models and knowledge Model. To do this we carry out product integration and the model project models .this process is called modelling. Product and process of modelling the product model is implemented using the commonkad project model. The challenge of commonKADS modelling solution using commonkads model here is that the whole is a process and the entire process is called the project model. Analysis of problem The problems facing Ems is deaths due to delays, which are avoidable by improving the EMS service. The main causes of these delay s is caused by genereral practitioners, patients delay as well as delays in commencing treatment. These EMS have discovered that the best way is to bypass the general practitioner and allow patients to call directly. However the biggest challenge here is that the nurse dispatcher do not have the knowledge to do intensive or diagnosis for cardiac diseases. This action will lead to a knowledge deficit at EMS once the GP are absent . we will use commonkads to address this shortage of knowledge and to fill the knowledge deficit within mission and budgetary limits of EMS. Alternative potential solution Educate the general practitioner about the need to refer client earlier and about his or her own delay. This will mean we integrate services of the general parishioner to merge their roles to encapsulate the mission of EMS . Then involve the heart foundation in creating awareness to the General practitioner as they may have financial interests and will view the EMS action as a way for taking away their esteemed clients. it will apppear as an way fo exposing their mediocrity as they are professionals and the best way to deal with professionals is to engage them in a participatory manner. This will mean retaining them while at the same time maintaining direct contact with patients. We have to expect reaction from bypassing the general practitioner.They are not going to be bypassed and clients will also trust them more as they are closer to patinets and most clients will always want their own personal physicians to advice them at a fee on medical matters. The conclusion for OM-1 analysis is that the problems of delays and the need to bypass the general practitioner while ensuring there is knowledge tool to ensure knowledge deficit problem is solved. The other solution which is not part of the EMS is using other ways to educate the general practitioner to reduce the GP delay and engaging the GP more constructively by enlisting their support to educate the patientst especially on self assessment.The patients trust the GP as they are familiar as emergencies are like accidents hence the GP is likey to be more effective in reducing his own delay once he is made aware that his delay is causing preventable deaths . The opportunity presented here is of the current situation of organizational objectives with the problems give us opportunity to install the commonkads tool to do this the OM-1 below is analysis usong analysis model in which we have a idea of the design EMS using the project design model this will then be modelled on the project model which we have integrated with the EMS product model by implementation into workable tasks and sub-tasks translated into new objectives of the target situation for EMS product servie. Once this is done the work of EMS management will be only of maintainance of the knowledge tool in bulding improved tasks into the organisation system.The system will then trigger better actions and better service as it pervades the whole organisation culture and practice.Thus the too merges theory and practice to realise mission . Table 1 – Worksheet OM-1; ORGANISATION MODEL-1 Organization Model Problems and Opportunities OM-1 Problems and Opportunities Delays in responding to AMI emergency cases Incorporate knowledge-based system to formulated solution Organizational Context Mission: Provide effective and efficient emergency response service to the people Operate within the budgetary requirement without sacrificing effectiveness and efficiency Goal: Send emergency response team in the shortest possible time Provide fast hospital transport on critical cases which necessitates it Streamline and strengthen coordination within the emergency service team Solutions 1. Reduce the delay by removing the GP in the process and allowing the patient to call directly to EMS 2. Coordinate with the Netherlands Heart Foundation and collaborate to develop a strategic plan on educational campaign for detecting early signs of AMI including the psychological aspects of the patient as well as stressing and locating available GPs within the area. 3. I involve the GP and retain GP as important collaborator of EMS . .support GP to do better by championing peers to improve services to patients. OM-2-ANALYSIS VARIANT ASPHECTS of EMS The biggest problem involves the delay task performance, which leads condition of AMI heart failure in Netherlands. To focus on the specificn task which are done ar not done will lead us to the main tasks that if it is performed well will mean no more delays at all.The delays means their is poor time mamgement by other the GP, the patient or the ambulance or the driver or the nurse dispatcher or the IT system has nor scheduled the dispatch schedule in the correct way or triage was not done correctly hence the delays is blamed on others. There could be problem of many false alarms leading to low morale in emergency staff and low motivation. A knowledge tool will assist us to get the main task which is not done correctly the several tasks that operate in it and then we shall identify whether it is the task or the task performer or how it is done, the knowledge the task ofd the performer and the knowledge needs to do it right. Here we focus more on the knowledge to do the task but we shall also need to know whether the task handler is motivated to do the task Task integration-om2 We focus on task process merge and task merge.Task analysis of dispatch and ambulance is transport.these two task should be merged and performed by one team not two separate entities.Make transport an integrated task by making sure ambulace tasks can be performed by a dispatcher and vice versa as one team. Two types of functions should be integrated together for one team action into both support and emergency and should not be distinguished at the EMS. Task integration of the three emergency management tasks of , communication task,task of Coordination, Task of medical care, and the ambulance task of transport together with the Support tasks of archiving, evaluation, policymaking, and supervision. To conclude these are the follwing additional solutions and new opportunityies to model trhe new organisational stcructure Thes recommendations for OM-2 are:- Use task integration instead of physical separation of task processes Integrate process based tasks with knowledge intensive task Alocate by task and knowledge deficit priority for our need to address the commonkads knowledge based tool.Those who have intensive know-how to pioneer re-engineering of the processes towards realisation of the mission of EMS. Resources have already been limited due to budgets constraints and need for being thrifty hence the only resource to build is capacity of staff by enriching their tasks and job roles The human resources have a resource deficit in terms of knowledge bassed tool available through enlarging the knowledge capacities of the current staff to increase triage levels in view of the elimination of the General practioner. Culture and power issue will be resolved by integration of all tasks into team tasks into action task and knowledge-based tasks. Knowledge Components The knowledge componets for task performnane will be recommended in table five below to incorporate new skills needed to perform the integrated tasks as in OM-2.see table . Table 2 – Worksheet OM-2 -variant asphects-MODEL Organization Model Variant Aspects Worksheet OM-2 Structure Buld a new structure based on task integration and process integration without increasing the current number of staff. This will align structure to process. Dispatch and ambulance are transport task. While the paramedic and triage nurse medical process tasks. Process Change to task oriented processes to create unity of purpose. The emergency management process involves five major tasks from the GP receiving the call from the patient until hospital transport. Figure 3 presents a high-level task level diagram. People New integrated skills needed for nurse paramedic and drivers External to the EMS, the GP plays a critical role in attending to patient’s call Managers of the GSSC and the MISS ensures adherence of the organization to mission and goals Managers of the EMS units supervise the entire operation Nurse dispatcher in the Dispatch Centre handles communication and coordination between emergency calls and the Ambulance Centre Paramedic carries out emergency medical care to patients transported Driver is in-charge in the mobilization of the ambulance System Manager handles the archiving function of the emergency services provided Resources Integrate task to message fro action or knowledge. Communication system to handle calls and coordinating task within the EMS and outside IT support system and infrastructure performing on-line emergency calls, off-line reservation and other information support systems Vehicle for hospital transport Temporary & immediate medical care equipment Knowledge Integrate the Different sets of knowledge assets which support the different personnel in performing the new integrated tasks within the process are detailed in table 4. Culture & Power Create TRAIN on job spirit and integrate power to avoid parallel reporting structures. There exist within the organization certain formal and informal relationships that may, in one way or another, affect how the personnel perform their tasks (refer to Figure 4). It should be noted that here is no existing social relationship that exists between the two units within EMS. OM-3(B) RECEIVING CALL TASK ANALYSIS MODEL TASK ANALYSIS Task Analysis Worksheet TM-(B) Task- Receive Call (Task 2 see Figure 3) Organization The task is performed by CLIENT AT EMS CONTROL CENTRE and is carried out in the DISPATCH FUNCTION of said organization. Goal and Value (TRIAGE OF PATIENTS)This task significantly affects the response time of the EMS to emergency case through an accurate and complete assessment of patient’s call. The objective of this task is to be able to evaluate if received calls from prospective patient warrants an emergency case. Dependency Flow Input task: Patients call Output task: TRIAGE, Ambulance dispatch, CORONARY THERAPY, transport to hospital (CORONARY THERAPY DURING TRANSPORT ON ROAD OR AIR RESCUE SERVICE) (HELICOPTER) ENVIRONMENTAL CONSTRAINTS: CONTROLLERS CENTRE REQUIRED CAPABILITIES: ABILITY TO TRIAGE AND CARRY OUT CORONARY therapy (CRT) Please see Figure 5 for diagram of the process flow. Objects Handled Input Objects: response of patient to baseline questions related to experienced condition, patient name and location Output Objects: case assessment, dispatch schedule Internal Objects: triage questionnaire Timing and Control This task is executed for every call received by the EMS. Triage of emergency cases is executed by the PARAMEDICS OR NURSE Dispatcher through the aid of the support system. Details of the call are logged into the emergency assessment database, which may or may not trigger a dispatch schedule. The dispatch schedule is NOT THE ONLY basis for the dispatch or non-dispatch BUT IT IS AN AID AS PARAMEDIC AND NURSE HAVE TRIAGE SKILLS of the ambulance service THIS DUE TO INCREASED CALLS TO FILTER(see Figure 5) Agents , PARAMEDIC, Nurse Dispatcher, IT support system, DRIVER, PATIENTS EMS CENTRE MANAGER, DOCTOR PARAMEDICS, COMMONKADS TOOL KNOWLEDGE SYSTEM MODELS Knowledge and Competence EVERY STAFF PARAMEDIC OR The Nurse Dispatcher OR MANAGERS should be able to DO TRIAGE AND to comfortably navigate the IT support system, which will provide full support in the execution of this task. Furthermore, the PARAMEDIC OR Nurse Dispatcher should also possess intensive knowledge on established symptoms of most or common medical conditions. Resources TRIAGE SKILLS TRAINING ,Computed salaries of staff time TRAIN on job PARAMEDICS, DRIVERS AND MANAGERS AND Nurse Dispatcher receiving calls for a 24hr service available 7 times a week 365 DAYS A YEAR WITH NIGHT SHIFTS AND LEAVE SCHEDULES Month development time of TRAIN on job SKILL UPGRADING AND IT staff to enhance the IT support system integrating the features illustrated in Figure 5 Quality and Performance The following key performance indicators can be used to gauge quality of task execution: .1. Average time to take calls with appropriate assessment 2. Total number of dispatch that results to hospital transport 3. Percentage of morbidity and mortality rates within the cases received 4. STAFF TURNOVER RATE DUE TO SKILLS UPGRADE OR STRESS. 5 RATE OF STAFF MEDICAL SICK LEAVES OR MORALE, 6. PATIENT FEEDBACK AND RATING OF THE NEW SERVICE PRACTICE C OR B. Table 3 (A) – Worksheet OM3 TASK MODEL OM-3 N. Task Performed By Where? Knowledge Asset Knowledge Intensive? Significance 1 Diagnose Patient EMS staff -PARAMEDIC / NURSE Patient’s home/EMS CENTRE Medical background to warrant correct assessment of symptoms for AMI TRIAGE SKILLS IT SYSTEM Highly Intensive Early (TRIAGE) diagnosis conducted increases the patient’s recovery from AMI 2 Call EMS PATIENT Patient’s home OR REGION /AREA -SELF ASSESSMENT/ EMS ASSEMT/ IT SUPPORT SYSTEM MEDIUM EARLY CALL SAVES LIVES 3 Receive Call Nurse Dispatcher EMS – CENTRE/ Dispatch Centre IT support system operations MEDICAL SKILLS TRIAGE SKILLS/ CORONARY THERAPY HIGHLY INTENSIVE Early receipt of emergency call initiates faster dispatch to patient hospital transport 4 Coordinate Ambulance Service Nurse Dispatcher/OR PARAMEDIC EMS – CONTROL CENTRE /Dispatch Centre IT support system operations PARAMEDIC MEDICAL TRIAGE SKILLS/THERAPY HIGHLY INTENSIVE EARLY ARRIVAL SAVES LIVES 5 Dispatch Ambulance Paramedic OR NURSE EMS –CENTRE Ambu-lance Service/REGION ROAD Procedures AMI med. Assistance / IT SUPPORT EMS CONTROL NURSE / PARAMEDIC SKILL/THERAPY HIGHLY INTENSIVE EARLY DISPATCH SAVES LIVES 6 Transport Patient to Hospital Driver/ PARAMEDIC/NURSE RELATIVES SELF ROAD, AIR RESCUE/ Geographic data of the area/TRIAGE SKILLS/THERAPY HIGHLY INTENSIVE EARLY TRANSPORT SAVES LIVES Table 4...WORKSHEET-AM-4-AGENT MODEL-4 AGENT FUNCTION TITLE OF AGENT AT EMS ROLE OF AGENT GOOD OR BAD FORM PLACE CONSTRAINTS TIME CONSTRAINTS QUALITY Know-edge Asset Pos-sessed By Used In Right Form? Right Place? Right Time? Right Quality? Medical background to warrant correct assessment of symptoms for AMI PARAMEDIC, NURSE DISPATCHER/ MANAGER DRIVER/ Patient diagnosis (Task 1) TRIAGE Yes Yes YES. TRIAGE SKILLS REDUCE time before diagnosis is done) Yes IT support system operations PARAMEDIC Nurse Dies- patcher/DOCTOR PARAMEDISC/DRIVER/PPATIENTS OWN IT SYSTEMS Coordination with Ambu- lance Service, STAFF LOG, WORK SCHEDULER FOR STAFF (Task 2&3) No (too limited, MUST BE IMPROVED URGENTLY YES. IT IS A SUPPORT TOOL. FOR TRAIN on job Yes. BUT IT CAN FAIL ON TECHNICALITY Yes BUT SOMETIMES EQUIPMENT MAY FAIL. Business and technical Feasibility of proposed solution The elimination of the GP is a very big problem for EMS. It Mau even affect the entire EMS processes because the GP is currently the main link or gateway to the patients. No patient will like to risk but patients trust the GP .it is true the GP will consider fees as a motivation and have interest in not being bypassed . This poses a strategic problem for EMS as per their mission and objectives the GP has a stake in operations of EMS as the main caller at EMS daily. To change this pattern and Tradition will be very hard and poses associated change management problems even for the patients who may not want to eliminate their GP. The Gps enjoy Geographical presence and is good intermediary so to speak. We should thereby use these geographical regions as the structural tool for expansion of EMS in its path for growth. The GPs are also within the seventeen municipalities where they can each set up a Sub-EMS centres by franchising the EMS. The Ems can benefit from service through stationing paramedics at the GPs clinics. Elimination of GPs may trigger more deaths due to triage problems hence a new need to spread EMS centres all over Netherlands. The heart foundations awareness campaign may take advantage of the GP to be more effective. The elimination of General practitioners increases of calls to EMS centre thereby creating a better opportunity for many patients to get educated by theEMS and heart foundations. Every call to EMS should be taken as an opportunityy point of contact with patients regardsless of their emergency situations to create awareness is heightened toward heart realted problems. The following main factors for the feasibility of commonkads knowledge tool for EMS are also envisaged:- To eliminate the General practitioners will lead to benefits of life for many patients due to elimination of the delays, which have been associated with many deaths of patients in emergency cases.this may also backfire and patients ionstead take themselves to Hospital bypassing the EMS centee which willlbe branded as bipartisan seen as sidelining and spoiling the good name of the general practitioners who are strong ven professionally as a interest group in the medical profession. This will add value to the patients who will now have less time to reach hospital as they have only one point of reference The Ems will benefit, as there will be no need for extra effort of coordination problems It shall also save costs for the GPs as they spent money calling on behalf of the patients of AMI Their will be some costs transfer from GP to the patients The EMS will have some more calls which may translate to some costs in case of making calls to get exact geographical locations of patients on emergency. The alternative solution of retaining the GP while simultaneously allowing patients to call directly is more feasible and will not have psychological resistance to change both at the EMS staff due to increased workload and at the Gps as they see this as an attempt to influence their lifeline clients. Their services are paid for hence their earnings from diagnosis will be eroded hence resistance to new EMS processes. The organisational changes will involve management by objectives and integration of tasks and processes in installation of a knowledge based system at EMS. These will lead to new Train on job rules and more differentiation due to the specific nature of tasks while they integrate with commonkads tool to merge into one product of saving live as per EMS mission statement. There will be no risks in terms of business and economic since the new tool utilizes the budget constraints already in pace and does not recommend any new budget but just a change in new skills needed as well as new processes and procedures. It is knowledge-based system, which requires only skills, as it is highly intensive in most instances. Technical Feasibility,advantages and disadvantages of the commonKADS This refers to the practical viewpoint of commonkads and it is not a complex tool and is easy to do the product tasks analysis using the models sets for commonkads. It may appear complex in terms of knowledge but the reasoning process is just as per the task analysis done above in the model tables. The main aspect involved are critically is knowledge specialization as the tool uses knowledge specific models for each tasks but integration has made its possible to do multi tasking per person hence saving on time and resources. The measurable factors will be the number of lives saved vis a vis the deaths in terms of mortality and morbidity rates in the past. We can use an average to compare the impact of the new modelling tool within an agreed time frame. The number of staff turnover will also help to know how staff are adapting to the new structures and new processes and enriched expanded roles. This is a simple tool to implement provided it is done step by step but the IT computerised system will be more or less useful and very effective use of technology as akey element of commonkADS tool as it will integrate all functions in the touch of a computer key in scheduling hence staff will need to upgrade their skills due to increased workload while their salaries will not increase. This may lead to low staff morale. The business and knowledge attributes for the staff at EMS will determine early implementation and success or failure of the proposed knowledge system. ---see Table OM-5(A), 5(B), and 5(C) Table 5–(A) Worksheet AM-2 for the IT Support System-AGENT ANALYSIS-2 AGENT ANALYSIS-IT SYSTEM CONTINUES IMPROVEMENT ACTION Name OF AGENT Possessed By Used In Domain IT Support System TRAIN on job-PARAMEDIC, Nurse Dispatcher, MANAGER, DRIVER Receive Call (cf. Task 2 in Figure 3) IT operations Nature of Knowledge Bottleneck/ skill upgrade. ACTION TO BE PERFORMED BY Formal, rigorous Empirical, Quantitative Heuristic, rules of thumb Highly specialized, Domain-specific Experience-based Action based Incomplete Uncertain, may be incorrect Quickly changing Hard to verify Tacit, hard to transfer Form of Knowledge Mind Paper Electronic Action Skill Other Availability of Knowledge Limitations in time Limitations in space Limitations in access Limitations in quality Limitations in form Table 5(B) Worksheet AM-2 AGENT MODEL-AGENT ANALYSIS: for the Procedures on Initial AMI Medical Assistance TABLE OM-5(b) Knowledge Item Worksheet TM-2 ACTION Name Possessed By Used In Domain Procedure on Initial AMI Medical Assistance Paramedic Ambulance Dispatch (cf. Task 4 in Figure 3) Medical field Nature of Knowledge Bottleneck/ skill upgrade. ACTION TO BE PERFORMED BY Formal, rigorous Empirical, quantitative Heuristic, rules of thumb Highly specialized, Domain-specific Experience-based Action based Incomplete Uncertain, may be incorrect Quickly changing Hard to verify Tacit, hard to transfer Form of Knowledge Mind Paper Electronic Action Skill Other Availability of Knowledge Limitations in time Limitations in space Limitations in access Limitations in quality Limitations in form Table 5(C) Worksheet AM-4; AGENT MODEL-AGENT ANALYSIS for Nurse Dispatcher Agent Agent Analysis-Nurse Agent Worksheet AM-4 Name Nurse Dispatcher Organization Personnel under the Dispatch Centre/ EMS control centre unit Involved In Receiving patient calls and coordinating emergency calls, (Task 2 and 3 see Figure 3) Communicates With Patients, Paramedic, manager, Drivers, DOCTOR paramedics Knowledge TRIAGE, Assessment, and determination of emergency calls supported by the IT Support System Other Competencies Additional skill to be developed is the agent’s listening ability and assessment of patient’s responses to standardize questions related to patient’s condition. CUSTOMER CARE SKILLS AND IT SKILLS AS WELL AS SKILLS FOR CORONARY myocardial THERAPY. TRAIN on job SKILLS UPGRADE Responsibilities and Constraints To receive calls from prospective patients and accurately capture conditions into the IT Support System To be able to provide accurate assessment data and forward it calls to the Ambulance Service that warrants hospital transport. TO BUILD TRAIN on job SPIRIT, CUSTOMER CARE SKILLS WITH OTHER Staff Table 5(D) – Worksheet AM-5: AGENT MODEL: AGENT ANALYSIS for Paramedic Agent Agent Analysis-Paramedic Agent Worksheet AM-5 Name Paramedic Organization Personnel under the Ambulance Service AND DISPATCH FUNCTION within EMS CONTROL CENTRE Involved In TRIAGE AND Ambulance dispatch, CUSTOMER CARE AND TRAIN on job, IT SYSTEMS SKILLS IMPROVEMENT (Task 4 see Figure 3) Communicates With Nurse Dispatcher, Driver, Patient, DOCTOR PARAMEDICS Knowledge Procedures for initial AMI medical assistance, medical background I.T. SYSTEM, CAN DRIVE ALSO, DOES TRIAGE, CAN BE A EMS MANAGER Other Competencies Appropriately assess condition of patient on-site vis-à-vis information forwarded by the Dispatch team. CUSTOMER CARE SKILLS, TRAIN on job SKILLS, IT SYSTEM SKILLS, Responsibilities and Constraints Provide immediate action to direct Driver to dispatch ambulance to patient’s location and initiate medical procedures to patient during hospital transport. OR AT HOME OR AT WORK. The possible constraint identified can be on the possible misinformation of the patient’s condition forwarded by the Dispatch team THIS IS ERADICATED BY OWN TRIAGE AND SKILLS TRANSFER TO THE DISPATCHER TEAM. Figure 2 – New Service improved Manager municipal social sanitary care  PARAMEDICS AND NURSE DISPATCHERS & DRIVERS TEAM (Receive Triage calls)(IT, INFORMATION SYSTEM, archiving scheduling)   IT SYSTEM, COMMONKADS TOOL, (TELEPHONE, MOBILES COMPUTERS   PATIENTS/GENERAL PRACTITIONERS (callers) Figure 3: New data flow improved IT system and commonkads tool (EMS Centre)  Paramedics, Nurses and ambulance drivers (evacuation and first aid Emergency treatment)  Patients & General practitioners Figure 3 – TARGET ORGANISATION STRUCTURE ON COMMONKADS MODELLING (DESIRED EMS AFTER IMPROVEMENT AND INTEGRATION OF TASKS) Manager municipal social sanitary care  Manager EMS CENTRE,   IT SYSTEM, COMMONKADS TOOL, paramedic, Nurses, Drivers, Archiving scheduling) (TELEPHONE, MOBILES COMPUTERS   PATIENTS/GENERAL PRACTITIONERS (callers) Conclusion This report has introduced the commonkads Model into Service model of the EMS. It has analysed the structures in order to discover the gaps in the knowledge tasks to fill the knowledge deficit at EMS. This has brought a focus on the specific tasks, the specific= knowledge gaps required to perform these tasks were analysed in OM 5 while the task structures were done on OM-2, OM-3 and OM-4. The elimination of the GP in OM0-5 analysis showed that this would have to be done gradually as the new skills required are highly intensive to perform the roles of diagnosis or triage for Acute Myocardial infarction (AMI) as well. To fill the General practitioners GAP will also need to integrate and involve the GP as a professional who is trusted by patients on other illnesses. Therefore, the installation of this tool recommends that the GP elimination be treated, as one option and introduced in phases first is to implement the new knowledge tool for internal capacity building before full-scale implementation. This ill gradually introduce the new skills integrated to processes of Ems by the new tool. This knowledge tool is now implemented and improvement in service should be felts across EMS immediately. References Theodorus van ECK, Pascal Antonius, (2001), a compositional semantic structure for multi-agent systems dynamics, Issues, Pascal van Eck, Schreiber, G. 1956, Knowledge Engineering and Management: the Commonkads methodology, MIT Press, Cambridge, Massachusetts. Read More