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Modeling Community First Responder Systems: Evaluating Impact, Guiding Recruitment, and Learning Dispatch Strategies
Modeling Community First Responder Systems: Evaluating Impact, Guiding Recruitment, and Le...
Modeling Community First Responder Systems: Evaluating Impact, Guiding Recruitment, and Learning Dispatch Strategies

상세정보

자료유형  
 학위논문 서양
최종처리일시  
20250211152706
ISBN  
9798384052852
DDC  
362.18
저자명  
Li, Hemeng.
서명/저자  
Modeling Community First Responder Systems: Evaluating Impact, Guiding Recruitment, and Learning Dispatch Strategies
발행사항  
[Sl] : Cornell University, 2024
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2024
형태사항  
163 p
주기사항  
Source: Dissertations Abstracts International, Volume: 86-03, Section: B.
주기사항  
Advisor: Henderson, Shane.
학위논문주기  
Thesis (Ph.D.)--Cornell University, 2024.
초록/해제  
요약In Community First Responder (CFR) systems, trained volunteers (CFRs) located near patients augment traditional emergency services by responding to alerts via a mobile app, especially for out-of-hospital cardiac arrests (OHCA) where rapid response is crucial. Volunteer efforts can significantly improve survival rates for OHCA.It is important to determine the number of volunteers needed and the recruitment locations to achieve a target performance level. We first model CFR presence using a Poisson point process, allowing us to compute response-time distributions for the first-arriving CFR. Combining this model with known survival rate functions, we deduce survival probabilities for OHCA scenarios. Using convex optimization, we then determine the optimal distribution of CFRs across a region to optimize either the fraction of fast responses or the patient survival rate. This optimal CFR location distribution provides a benchmark for the best possible performance with a given number of volunteers, offering insights into the feasibility of introducing a CFR system in a new region or guiding additional recruitment in existing systems.Additionally, we explore phased alerting policies for CFR systems, where volunteers are notified in stages with time delays, with the goal of maintaining high survival rates while minimizing so-called volunteer fatigue that can arise when more than a required number of volunteers respond to a single OHCA. The policy defining these delays impacts both response times, directly related to survival, and the number of redundant (exceeding the required number) volunteer arrivals. We evaluate the performance of CFR dispatch policies through Monte Carlo simulation. We then present a Markov Decision Process (MDP) formulation and a machine learning-based selection strategy for determining which volunteers to alert and when for each incident, effectively balancing patient survival and volunteer fatigue.We include a case study for both the CFR model and CFR dispatch strategies in Auckland, New Zealand, based on empirical data from their CFR system, GoodSAM. This comprehensive study provides a framework for improving CFR systems globally.
키워드  
Community first responders
키워드  
Multi-class classification
키워드  
OR in health services
키워드  
Out-of-hospital cardiac arrest
키워드  
Poisson point process
키워드  
Volunteer dispatch
기타저자  
Cornell University Operations Research and Information Engineering
기본자료저록  
Dissertations Abstracts International. 86-03B.
전자적 위치 및 접속  
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MARC

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■035    ▼a(MiAaPQ)AAI31488345
■040    ▼aMiAaPQ▼cMiAaPQ
■0820  ▼a362.18
■1001  ▼aLi,  Hemeng.▼0(orcid)0000-0002-9004-516X
■24510▼aModeling  Community  First  Responder  Systems:  Evaluating  Impact,  Guiding  Recruitment,  and  Learning  Dispatch  Strategies
■260    ▼a[Sl]▼bCornell  University▼c2024
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2024
■300    ▼a163  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  86-03,  Section:  B.
■500    ▼aAdvisor:  Henderson,  Shane.
■5021  ▼aThesis  (Ph.D.)--Cornell  University,  2024.
■520    ▼aIn  Community  First  Responder  (CFR)  systems,  trained  volunteers  (CFRs)  located  near  patients  augment  traditional  emergency  services  by  responding  to  alerts  via  a  mobile  app,  especially  for  out-of-hospital  cardiac  arrests  (OHCA)  where  rapid  response  is  crucial.  Volunteer  efforts  can  significantly  improve  survival  rates  for  OHCA.It  is  important  to  determine  the  number  of  volunteers  needed  and  the  recruitment  locations  to  achieve  a  target  performance  level.  We  first  model  CFR  presence  using  a  Poisson  point  process,  allowing  us  to  compute  response-time  distributions  for  the  first-arriving  CFR.  Combining  this  model  with  known  survival  rate  functions,  we  deduce  survival  probabilities  for  OHCA  scenarios.  Using  convex  optimization,  we  then  determine  the  optimal  distribution  of  CFRs  across  a  region  to  optimize  either  the  fraction  of  fast  responses  or  the  patient  survival  rate.  This  optimal  CFR  location  distribution  provides  a  benchmark  for  the  best  possible  performance  with  a  given  number  of  volunteers,  offering  insights  into  the  feasibility  of  introducing  a  CFR  system  in  a  new  region  or  guiding  additional  recruitment  in  existing  systems.Additionally,  we  explore  phased  alerting  policies  for  CFR  systems,  where  volunteers  are  notified  in  stages  with  time  delays,  with  the  goal  of  maintaining  high  survival  rates  while  minimizing  so-called  volunteer  fatigue  that  can  arise  when  more  than  a  required  number  of  volunteers  respond  to  a  single  OHCA.  The  policy  defining  these  delays  impacts  both  response  times,  directly  related  to  survival,  and  the  number  of  redundant  (exceeding  the  required  number)  volunteer  arrivals.  We  evaluate  the  performance  of  CFR  dispatch  policies  through  Monte  Carlo  simulation.  We  then  present  a  Markov  Decision  Process  (MDP)  formulation  and  a  machine  learning-based  selection  strategy  for  determining  which  volunteers  to  alert  and  when  for  each  incident,  effectively  balancing  patient  survival  and  volunteer  fatigue.We  include  a  case  study  for  both  the  CFR  model  and  CFR  dispatch  strategies  in  Auckland,  New  Zealand,  based  on  empirical  data  from  their  CFR  system,  GoodSAM.  This  comprehensive  study  provides  a  framework  for  improving  CFR  systems  globally.
■590    ▼aSchool  code:  0058.
■653    ▼aCommunity  first  responders
■653    ▼aMulti-class  classification
■653    ▼aOR  in  health  services
■653    ▼aOut-of-hospital  cardiac  arrest
■653    ▼aPoisson  point  process
■653    ▼aVolunteer  dispatch
■690    ▼a0796
■690    ▼a0769
■71020▼aCornell  University▼bOperations  Research  and  Information  Engineering.
■7730  ▼tDissertations  Abstracts  International▼g86-03B.
■790    ▼a0058
■791    ▼aPh.D.
■792    ▼a2024
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17163422▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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