Ambulance transport has been demonstrated to be hazardous, however there is limited research on the effectiveness of technologies to minimize these risks. This study evaluates the effectiveness and human factors impact of an aftermarket ambulance driver monitoring device with real time auditory feedback. The device was evaluated in an urban/suburban EMS group (>150 drivers and 16 medical transport vehicles). Data were collected via an aftermarket onboard computer system monitoring vehicle parameters every second. Penalty counts were recorded for exceeding set parameters with real time auditory feedback to the driver of both warning and penalty tones. Data are downloaded wirelessly daily for analysis. Data collected over a 24 month period included:​ System miles traveled, miles between incident. Driver specific behavior and miles between incidents, by age and gender and total miles traveled. Response times and vehicle maintenance were tracked. Incidents that occurred appraised for cost and injuries sustained. Over 950,000 miles of vehicle operations were recorded. System wide performance improved in excess of two orders of magnitude over the study period. There was a 20% cost saving in vehicle maintenance within 6 months. There was no increase in response times. There was sustained improvement in safety proxies over 24 months, with no inservice or retraining after the initial introduction period. A gradual implementation, with rigorous attention to defray any potential concerns of any punitive approach was key.

This real world evaluation of an after market electronic system wide safety technology demonstrated a marked improvement in ambulance transport safety and safety proxies in every measured area. These technologies should be encouraged for widespread implementation throughout the EMS system to optimize safety in addition to cost benefit.