INNOVATIONS IN AMBULANCE MANUFACTURING: A CASE STUDY OF ICU AUTOMOTIVE

INNOVATIONS IN AMBULANCE MANUFACTURING: A CASE STUDY OF ICU AUTOMOTIVE

1. Introduction to ICU Automotive and the Ambulance Manufacturing Industry

Innovations in Ambulance Manufacturing ; It has been shown that ambulances differed from vans in the aspects of used (or modified) solutions, but a very large share and the majority of technical solutions were common. There was a considerable difference in the level of eco-innovativeness of the customized and mass-produced vehicles. It has been confirmed that platforms of configurated design are highly critical for the implementation of mass customization strategy, giving customers the chance to configure the product to their specific needs and wants, thus also addressing green expectations. Currently, the mass production strategy may bring simultaneous benefits in terms of increased economic performance of the EMS and its total ecological footprint as it decreases the production and assembly costs of the EMS vehicles. Moreover, the production process is being sped up while technology risks are reduced, as these are allocated to standard parts, which are already being used and have a proven record.

The article presents a case study on the Elbląg-based Polish micro, small, and medium enterprise ICU Automotive sp. z o.o.: a manufacturer of various kinds of goods vehicles, including highly-customized ambulances and professional equipment vans, catering to a gap in the market for special purpose vehicles. The main objective of the paper is to identify eco-innovations in such special purpose vehicles as they offer a lot of space for new, green solutions, especially when they are to be used in public facilities. Therefore, the authors aimed to verify their hypothesis that customization significantly facilitates and influences eco-innovativeness and also to recognize if configured products based on the mass-produced platforms or unique ones yielded a different share of eco-innovations.

2. Design and Technology in ICU Automotive Ambulances

Innovations in Ambulance Manufacturing, opposite to the emergency room, must provoke a different degree of disaster in the event of fire thus requires that the research will assume the need to distinguish the work sections that perform activities with different levels of technological equipment that can potentially be at high risk of a more significant number of tools, from a minor risk, to define and study; in the metropolitan hospital center, the pre-exam unit would avoid the necessary patient transport for service from other isolated ambulances in areas with no med-tech support, benefiting from a new supply of 24-hour service, and worsen a situation of social disadvantage. The pre-exam unit, located in a strategic position (opposite the emergency room), assumed a structural solution for an ambulance vehicle aimed at the hospital (Appendix A), taking on the ambulatory boarding (green-light resources for ambulances all the days of the week: no distinction between work and holidays), and direct access to the emergency department (a different path from other units), allowing the treatment of patients with excellent meteorology or reduced health risks directly in the hospital. The importance of the hospital pre-exam unit implies that a different responsibility degree is given to evacuation vehicles and to the characteristics of stiffness that the safety systems will ensure premise constraint under high loading.

The following main functions of the ICU module are identified: positioning of the patient for an upper-gastrointestinal radiologic examination (X-ray machine and stretcher), monitoring of a patient who has already had a screening examination in a static patient positioning, auxiliary activities for the preparation of the patient for a screening examination (dress-changing made with the robot), pre-examination activities intended to familiarize the patient with the examination room (projection of outside scenes to make the patient “forget” the medical hospital environment). The result showed that the proposed system creates guidelines that contribute to the workflow and principle of creating new environments optimizing assistance requested by the health ministers. The function to prepare the patient for an examination conditions the positioning of the scanners. As the examination slide is not usually concurrent, the patient’s preparation speed itself becomes one among the department’s results. The fundamental issues are the high quality of the services. The diagnosis of consciousness and unconsciousness that lead to a level of priority to be given to the simulation of health-care-risk scenarios — for instance, the distinction between a single patient and a quantity of not ambulatory patients or patients with a level of risk; the consequences of patient evacuation in the presence of multiple, not protected from fire exterior horizontal passages; the complexity of patient flow in the hospital department in case of patient projection in just one type of diagnosis.

3. Safety Features and Regulations in ICU Automotive Ambulances

Defining the standards, monitoring the rules, fostering research, and conducting dissemination are the main tasks of numerous bodies, such as ABNT – Brazilian Association of Technical Standards and ISO – International Standardization Organization. National and international studies describe and propose the development of new rules or changing the existing recommendations of ambulance projects and managements. Because ambulances present at the same time the figures of vehicle and health unit, their management is always complex and ‘competes’ with the Emergency services – responsible for the major care to the patient. Today, 30 different items are applied in complete and incomplete modifications in projects of paramedical vehicles classified as N1 and N2. These items cover medical enclosures, electrical installations, climatization, windows positions, alignment standards, and so on. Among the extensive criteria of materials and finishes, equipment, and accessories applied in the ambulances, we would like to call attention to the conditions of vehicle usage in ultracold boxes applications, and monitoring and reserving of equipment for critical patients.

Road transportation and health activities have special issues that deserve careful attention, particularly when the most advanced technologies are applied together. Thus, the right choice and the most rigorous standards compliance are important concerns for all the systems that complete the Project ICU Automotive Ambulances. The most important issues to attend are the welfare and transport safety of the patient, and the safety of the technical and health teams. The literature indicates that ambulances are the first transportation used for patients and more than 80% of the transportation services during the emergency situation use ground transportation. Its proper condition should be mandatory considering the transportation safety standards.

4. Market Impact and Future Trends of ICU Automotive Innovations in Ambulance Manufacturing

One of the factors currently considered in Japan is the difficulty of having urban fleets operated under high costs that were designed and manufactured for a peak period of service that lasts for approximately 10% of a day. This suggests having small sub-fleet sizes and considering the use of a vehicle with dual functions as a possibility. The interest based on this suggestion concerns the possibility of a vehicle that can be useful and low cost during low-demand hours while still being able to perform high-charge rate ambulance tasks when and if such situations appear. Some of the future trends of ambulances, as we approach the 21st century, include diversification of design philosophies emphasizing specialized capabilities.

Innovations in Ambulance Manufacturing; The most positive prospect of our product in the industry is the significant reduction of the deadhead cost in ambulance service. The amount of money spent every day, making an ambulance run back to its base, contributes to part of the social evil we all must face and cannot be eradicated with more highly trained and aggressive EMS responders. Reducing these costs and further improving the already challenging rate of service expected from an ambulance will prove to be a very interesting tax-saving equation. The fact that our ambulance is based on a highly specialized modular design approach opens several new thought directions on the subject of ambulances in the 21st century.