1. Introduction to Ambulance Design
2024 Ford Transit Ambulance; Ambulance design remains inherently overlooked. However, not so much innovation in this specific field can directly impact patient outcomes, especially with the developing field of emergency medical services. It is crucial to design ambulances that grow in parallel with the advancement of medical practice and importance. Indeed, ambulances are no longer “just a means of emergency medical transportation” because they are increasingly seen as mobile emergency rooms instead. Rethinking the design of ambulances will have an impact on designing interior spaces to accommodate present technological products and medical staff requirements. Despite the important roles that ambulances have, it is interesting to see that only a few ambulances are presented in the innovation management literature. Therefore, research on the development and design of ambulances is direly needed. This research was motivated after three stages: 1) the need to observe the dynamics of an ambulance beyond being medically productive, 2) the market gap of modern ambulances, and 3) the need to raise public awareness on how ambulances have continuously developed.
An ambulance is a moving emergency room unit, and its function has evolved beyond the simple transport of the patient while preserving life. This results in an emergence of various urgent care services that are particularly dedicated to remote areas. As such, bringing telemedicine is seen as one of the many internal ways to innovate newly designed ambulances. This paper aims to explore the new emerging approach of an ambulance across different literature and practices, especially because of the medicolegal adoption. This paper reviews the uniqueness and the many milestones that modern ambulances have developed since their introduction. This paper is divided into a series of following argumentative points: 1) there is a need for a professionally designed ambulance, 2) the foundation of modern ambulances, and 3) the present firm indication to rethink their design.
1.1. Importance of Innovative Design in Emergency Medical Services
Innovative design in emergency medical services (EMS) is critical to how patients are cared for in life-threatening situations. Vehicles are functioning hospitals on wheels with life-saving medications, equipment, and monitoring devices. Current in-use ambulance designs significantly impact the functionality of in-vehicle operations, the ergonomics of user interfaces, the mobility and care of inside patients, and more. Ambulances must be designed to meet the needs of numerous different providers and patient populations in diverse environmental settings. Preferred design concepts enhance the operational functionality of EMS by allowing smoother transitions from pre-hospital treatment to inpatient emergency care. Collaborating with multiple stakeholder input sources will help ensure that emerging technology and vehicle designs meet the actual needs of pre-hospital healthcare professionals, patients, and families.
On-the-go EMS are available in various types of emergency medical vehicles: ambulances, basic life support units, advanced life support units, critical care units, and more. Emerging technologies are continually changing the majority of what is offered in ambulance care within emergency vehicles and provide additional options as continuous technological development occurs. Innovations in EMS often revolve around decreasing the amount of time it takes for a patient to be emergently treated. In other words, innovations increase patient treatment in the critical pre-hospital emergency care timeframe, also referred to as the Golden Hour. Technological advances in EMS also promise to increase the depth of patient care by offering new advanced life-saving interventions. The ergonomics of ambulance design impact more than its providers—the public and patients also expect vehicle design to support a variety of systems and services.
2. Historical Evolution of Ambulance Design
Through a historical retrospective, this paper traces the evolution of ambulance design and the factors that drove design changes throughout the years. Horse-drawn ambulances were among the earliest mobile medical units, developed into ambulant conveyances. The advent of the power motor saw the inception of the ambulance car; these vehicles began to be designed and stocked with equipment appropriate for performing medical procedures. Early motorized ambulances were adapted from ambulant trucks and buses, with room enough to bear gurneys carrying the prone. In the late 1960s, a cost-effective reconfiguration of step van bodies and newly developed ambulance equipment re-established the modular ambulance. This shift would return the ambulance to the form of basic transportation, although the potential for state-of-the-art mobile healthcare was unparalleled. Unlike previous eras, vehicles manufactured today are lighter, faster, and more efficient with each generation. Vehicle manufacturing has made substantial strides since the halcyon days of the 1970s, although the basic precepts upon which they are predicated have only been slightly swayed by technological innovations in the strictest vehicular tradition. The regulations to which ambulance manufacturers had to conform since 1917 demanded confrontation of the hard, obdurate armor of historical intransigence to the making of innovative stretchers and inventive storage cabinets, vehicle design and construction, along with every other detail of ambulance manufacture. The transition of motor vehicles—which ambulance cars are, whether or not they bear the word ‘ambulance’—from little more than motorized carriages to the ultra-modern ambulances of the new millennium has necessitated a change in the historical side of innovation.
2.1. From Horse-Drawn Carriages to Modern Vehicles
As time has progressed, so too has the ambulance – the vehicle designed specifically for patient transport. Before automobiles were the norm for transport, horse-drawn ambulances and litters were used for the swift transport of the sick and injured. It was common, during wartime, to see horse-drawn ambulances transporting several patients simultaneously. At any other time, the horsemen would transport just one person. The history of medical necessity has always had a portion dedicated to the efficient transport of patients in need. Innovations in technology have augmented our capabilities within the Emergency Medical Services spectrum. The use of motorized vehicles to transport patients expanded once the horse-drawn carriage was no longer the primary mode of transportation. This shift in focus would propel the evolution of expedient patient transport. A few historical examples of vehicles used for patient transport include the Knapp Expandable Van, which could travel at a blistering 40 miles per hour, and the Pontiac Ambulance, accommodating both patients and attendants with ease.
Today’s ambulances are squat and efficient machines able to travel at posted highway speeds with little drag on their engines. Patient transport has become a profession, and several manufacturers produce ambulances, largely based on heavy-duty truck platforms. The evolution from horse-drawn ambulances to purpose-built vehicles marked the beginning of the evolution of the modern ambulance. The advents of the radio and satellite communications systems of the future would allow the emergency medical team to have advanced notification via the communications hub of the receiving facility. In the 60s, EMS systems began to train non-physicians and medical support members to do three types of care: basic first aid, advanced first aid, and pharmacy. The following year, the two-tiered system began. The design changes of the ambulance mirrored the level of care that was being given. Public demand for high-performance CPR and advanced medical care for trauma and medical patients called for a change to the original design of the modern ambulance. Initial changes were made to the vehicle’s interior and layout, but there has been little change to the primary vehicle design.
3. Key Features of the 2024 Ford Transit Ambulance
The 2024 Transit Ambulance that is the focus of this case study will be released later in 2023 and includes a number of safety features and technologies. For example, it has an all-wheel-drive capability that is offered as a standard feature. AWD capability enables the vehicle to get better traction in difficult conditions and provides better off-road performance with a new AWD electronic system. Furthermore, the vehicle’s maximum payload capacity is 7,360 pounds, while providing up to 540.4 cubic feet of cargo space. In terms of safety, newly included airbags are seated on seats to avoid interfering with emergency responders’ access to the patient. This ambulance also features a unique addition, namely telematics. This telematics solution enhances care delivery through real-time insights, including vehicle location, mileage, fuel level, coolant temperature, and more. Based on this data, they can dispatch an emergency vehicle closer to the scene. Among several security technologies are a 360-degree camera to help avoid collisions with pedestrians, a collision avoidance sensor, pre-collision assist, and post-collision assist.
This ambulance integrates a number of communications features, as interior occupants can use a center stack that integrates several electronic connectors, such as USB Type C high-speed outlets and a 120-volt power outlet. The high-frequency radio allows for better communication range. In addition to making it easier for EMTs to do their work inside and outside the vehicle, it can be further enhanced with telematics that help the emergency services department better manage fleet assets. The cabinet system design, together with a single-outlet oxygen system, increases storage space while keeping the back open for personnel. A single-side-entry cabinet allows more space in the patient room for EMT care, minus the need for extra oxygen lines. These additions provide increased storage space and greater access to medical services for EMTs, reducing response times for patients by having what’s necessary more quickly at their disposal. The ambulance’s work lights, siren, and emergency lighting can be controlled wirelessly. These enhance the driver’s experience and give them a more comfortable and roomy environment. These features distinguish it from previous models. In sum, features of the 2024 Ford Transit Ambulance illustrate a commitment to modernizing ambulance design to improve patient care and the working environment for EMTs.
3.1. Enhanced Safety Features 2024 Ford Transit Ambulance
The 2024 Ford Transit Ambulance includes a wide array of enhanced safety features designed to minimize risk during ambulance transport. The vehicle is equipped with Ford’s Complete Safety Restraint, a personalized airbag system that incorporates information about crew and passenger seatbelt usage, seat position, and passenger size to customize the airbag deployment and ensure minimal injury during a collision. Additionally, the new model is equipped with a range of Ford Co-Pilot 360 Technologies offering collision avoidance features such as automated emergency braking, forward and side sensing systems, post-collision braking, and lane keeping and lane centering systems. Furthermore, additional zones of crumple are built into the vehicle to dissipate the force of an accident. This vehicle includes many advancements that hold promise for increasing the safety, and thus the survivability, of both patients and providers.
Over time, the mission of the ambulance has shifted to include both advanced resuscitative care and safe, rapid transport of the patient to the appropriate care center. In each modernization, ambulances have been asked to both keep not-yet-dead-and-dying patients and healthy individuals safe. This is in addition to the pressure of asking manufacturers to build a vehicle that can safely cover the miles, all the while being sparsely funded for maintenance and training over the operational lifetime of the vehicle. Training crews in the use of these new safety features, understanding the methodology that the system employs to bring the vehicle safely to a stop, and ensuring that if there is a crash, injury, or fatality, they or the patient are not at a higher risk for arrest or exacerbation due to airbag deployment is critical in the safe and effective use of these vehicles. Active safety features are helpful for preventing accidents and reducing the risks and injuries associated with crashes, as reflected in ambulance adverse events; advances like those featured in the 2024 Ford Transit Ambulance have the potential to continue to support the risk reduction efforts. In summary, building a safe ambulance is a process that requires continual review and continuous evolution as the trade-offs of vehicle design and safety mechanisms present through innovation like the 2024 Ford Transit Ambulance have a potential impact on the safety and health of air and ground EMS practitioners.
3.2. Innovative Technology Integration
The new 2024 Ford Transit is also designed with numerous cutting-edge technologies, purposefully integrated to enhance and expand its operational capabilities. The primary technology integration is the inclusion of a dedicated telemedicine system within the vehicle. This system includes a user-friendly interface connected to top-of-the-line vitals monitoring and recording devices. This system is also integrated with both the driver’s cab and the patient compartment. The 2024 Ford Transit includes several GPS navigation functionalities should an EMS scenario dictate application. These include the ability to display ambulance GPS location and speed on a vehicle display area, automatic polling for nearby possible helipads while driving, flight distances, and integration with a vehicle route surveying application that can alert to routes with difficult geometry.
Integrations include device management, vehicle state-of-health monitoring, and remote software updates, as well as vehicle interfaces for communication and data sharing in real-time with hospitals and other destinations such as stroke centers. Common features for all interfaces include functionality using voice control and activation and are cleared for ease of operation by a gloved hand. The 2024 Ford Transit was designed for usability by emergency medical personnel. The telemedicine tablet and all other integrated diagnostic equipment have gained a reputation as the best in class by EMS personnel. The tablet runs on a user-friendly interface designed for persons concerned primarily with patient care. For ease of reference, tables summarize the equipment and locations of innovative technologies within the vehicle. Like many other vehicles designed in 1967, the Ford Type III ambulance was originally designed to transport ambulatory, wheelchair, and litter patients. What sets the 2024 Ford Transit apart is our modern approach to emergency medical services. As previously mentioned, our ambulance incorporates significant convenience and comfort for the patient and law enforcement officer. However, the future of EMS is the data collection and the delivery of the best possible care for the patient.
4. Benefits and Challenges of the 2024 Ford Transit Ambulance
It is said that new ideas and investments in ambulance designs, understood as emergency vehicles, are needed to reduce the economic, environmental, and social costs of medical care and transportation. This paper focuses on the launch of the 2024 Ford Transit Ambulance as new emergent technology. However, this vehicle and similar investment strategies have marked diverse benefits and challenges for emergency services. By improving the capacity for essential and highly respected pre-hospital care, patient outcomes and health system productivity are located at the center of such strategies. Benefits include better medical interventions in transit, and in particular, the potential for more patients to access a computed tomography image integral to a stroke pathway. This leads to consumer confidence in medical services being transported in London, a source of reputational risk identified in annual assurances and risk registers. Operational benefits include speeding up the conveyance process at the emergency department, as patients may be delivered straight to a stroke cubicle rather than to the bed in Majors, as documentation is transmitted via Wi-Fi, which allows ambulance healthcare professionals to declare arrivals and vacancies. A quicker turnover of the ambulances will result in more ambulances being freed up to respond to the next emergency call. Finally, the improved clinical environment will have specific patient safety and comfort benefits and help reposition the capital as a state-of-the-art critical care transport service. The 2024 Ford Transit Ambulance also presents several challenges to the service, mainly budgetary, maintenance, and training. Improvements to the life-support systems are necessary. The reality of modern life is that we need to do more with less. This is our chance to begin that journey so we can meet the needs of Londoners in 2030 and beyond.
4.1. Improved Patient Care
Advances in technology and the concept of operations allow for substantial improvements in patient care. This is accomplished with an ambulance capable of interventional procedures at the level of a cardiac catheterization lab, operating room, or emergency department. The vehicle is designed to transport patients to the most appropriate hospital within a region for the continuation of definitive care. A spacious interior, incorporating advanced medical equipment, allows caregivers to be superheroes in addressing life-threatening medical emergencies.
Communication systems are required for the coordination of patient care with other hospitals and participating agencies. The objective of the communications system, when in transit, is to keep the physician engaged with the patient to prevent possible adverse events. The activation time delays may result in patient decompensation, which could directly impact the patient’s outcome. When cardiovascular emergencies are concerned, every second is vital. Time delays in transit could result in permanent loss of cardiac function. This is particularly notable with the onset of congestive heart failure and the higher risk of acute myocardial infarction. For patients with possible neurological emergencies, time delays in transit reduce the effectiveness of clot-busting medications. Those experiencing a possible stroke may also face cognitive and physical disabilities. The best outcomes are often possible when the patient receives care in a timely manner. Evolving the ambulance design to be timely-centric is needed because neither time nor life can wait. If healthcare in the region is approached from a patient-centric perspective, the ambulance concept would enhance the quality of patient care.
The interior is designed for patient comfort, with carefully designed seating and an ergonomic layout to minimize care provider efforts. This interior is intentionally dimly lit to improve patient comfort and clinical staff visibility while performing assessments or interventions. Providing comfort reduces the patient’s fear and anxiety, which can be particularly life-threatening to those with compromised cardiovascular health. A secondary benefit is to enhance the performance capabilities of the clinical team treating the patient. Jointly, the comfort of both patient and crew creates a safer, more methodical, and professional environment.
4.2. Operational Efficiency 2024 Ford Transit Ambulance
Thoughtful design and layout can enhance the efficient flow of EMS personnel throughout the ambulance as well as facilitate the installation and use of equipment. Research has shown that rear-entry ambulances can decrease pre-hospital time, which is of critical importance in patient care. “Forward” and “hot” mounted equipment can be integrated into the patient care space component for maximum efficiency. Product designers are soliciting input from ambulance workers to maximize the usable space and operate as effectively and efficiently as possible. They are also incorporating feedback loops for paramedics and dispatchers.
Interfacing with operational technology at the 911 center and communications with emergency departments is a necessary and time-consuming task for front-line emergency medical professionals. They need to coordinate directly with the 911 center and can also use an electronic patient care reporting system that feeds directly into reporting systems in receiving emergency departments. They can, depending on the case, go directly to the in-vehicle “telemedicine” system and coordinate their care with the receiving physicians. This kind of data processing performed “upstream” to an ED arrival can decrease ED time (or, at the very least, make better use of the existing surface interval). Efficient workflows with modern EMRs are an important aspect of the design. It also employs a concept called “rightsizing” at the design stage to limit waste and allow for customization while making smart use of the available space. Bringing the available resources to bear on the situation, essentially. There are many design elements that go beyond the graphs or tables and encompass the human interaction dimension as well. For example, design for space allocation dovetails with lessons learned from margins for error thinking and safe systems. In addition, from large system and agreement theory, we know that peer monitoring for compliance and performance is an important design element. The ambulance has design elements that relate very heavily to this concept that are strictly technical in nature and simply help get the job done more safely and accurately. Primarily, this has to do with the addition of strength to various components. This will help EMS workers allocate resources where they would be more appreciated, such as maybe EMS greater operation rather than theoretical reinforcement calculation breakdowns. Design also encompasses training on what to do with these new tools. EMS smarter design means smarter workers as they are given the tools to make our job easier. In brief, the above has shown how the ambulance uses the science of safe systems to protect our personnel, their patients, and the general public. Emergency medical services, when practiced at high levels of performance and safety, benefit society as a whole, as well as the individual. The design serves a higher purpose to be greater than the sum of its parts. It is a matter of design excellence.
5. Future Directions in 2024 Ford Transit Ambulance Design
The future of ambulance design is likely to be as innovative as the technologies emerging in the sector. Emerging technology will advance and will continue to be integrated into the design of vehicles, but some trends are clear given the rise of recent technologies currently in development: the integration of artificial intelligence, direct patient detection, and autonomous systems could be the next step in artificial intelligence on ambulances. Although this capacity may be a long way from technology in use, it is a signpost of what may be possible in the future. Sustainability is increasingly important when considering the design of ambulances. An emerging trend in design is ensuring the vehicle has a low carbon footprint and is designed with the end of life in mind. Sustainable design, including sustainable replacement parts, will soon become part of emergency services tenders.
Future ambulance construction must also consider changing patient demographics as the population ages and the reliance on the health system increases. Designed-use options such as bariatric patient capacity, multifunction ambulance rooms, power generation, and storage of medical oxygen will further consider the future of healthcare systems as they develop. New manufacturing technologies allow for greater adaptation to consumer-specific requirements. This means that ambulances and functions can be customized to exactly the design and wants necessary for that application. Such jobs could include remote and rural-based right through to urban-based with high population in dense areas. Engineers harness massive amounts of engineering and then use computer-aided design tools to model their automotive masterpiece. This forged a new trend going forward, allowing more complex products to be built. It is design thinking such as this that will likely forecast the future of the ambulance. Considering all these future trends together, we can reconcept the future ambulance as a very personalized, highly engineered, highly skilled piece of hardware that is also a remote medical aids hub by connecting to external resources. Ultimately, the question for the future would be what are the major implications for the effectiveness of ambulance service in a disaster and the severity of the hazard for each of the above trends. Clearly, this is an ambulance worth investing in, and as the trends now show, the get-ready route traveled cross-signals that progress starts here and now. So do invest in the now and be ready for the future – tools to believe are valuable in the discharge of duty to a community in need and in the future.
5.1. Trends in Vehicle Customization
Vehicle customization varies regarding vehicle type, but the market for fallouts points towards a general willingness among ambulance manufacturers to commit to customization. In trucks, for example, equipment requirements are held by few, as some units may require seating, storage, and an entirely interior environment for monitoring equipment and multiple computer systems. Similarly, a frontline transportation vehicle has several available interior layouts, equipment placements, and vehicle appearances from which an individual service may choose. Furthermore, trends in regulatory compliance drive even more demand for these specialized spaces, as new and separate environmental regulations require their own unique vehicle accommodations—not to mention additional ventilation requirements, new access panel needs, and enhanced insulation and dustproofing due to their environmental uniqueness. Increasingly, these vehicles have an interior ‘modular’ layout. While these interiors may be more expensive to construct, they are substantially more customizable at the customization center. Interior pieces such as the cot, patient compartment chairs, variable floor-track systems, and some airway devices are both easy and quick to install and remove.
Other possibilities for customization are largely aesthetic and often shift according to customer demands, such as color schemes for the outside of the vehicle that are consistent with the service’s markings and shields so that community members visually know at a glance which agency is responding to an emergency. Customers can choose to stock their ambulances with portable equipment and supplies from their preferred manufacturer with the desired color or size, as well as details such as functional vehicle graphics and vehicle lighting. On the inside, lighting types may be chosen to meet patient and working crewmember preferences. Community engagement is increasingly considered, with some ambulances being designed to safely accommodate animal transport. In the case of configurable equipment, ambulances are trending towards modularity as a mode for customization and require reconfiguring of some chairs and beds. To a limited extent, a trend engine manufacturers report is a need for more powerful systems suitable for use in hot and cold environments. Overall, ambulances are trending towards more individualized interior designs, primarily to account for dynamic medical environments reflecting both community health needs as well as those of sudden onset and ongoing disasters.
