Smaller Ambulance Design: An American Trend?

29 Nov Smaller Ambulance Design: An American Trend?

Transportation and urban planning fascinates me. I love dense cities with great public transportation. Today I came across an article by Eric Jaffe in The Atlantic’s CityLab titled: How Super-Small, European-Style Delivery Vehicles Could Make U.S. Streets Safer: A growing class of cargo vans enables smarter intersection design. In it, he talks about the emergence of more European style delivery trucks being used in the U.S. and the opportunities they provide for their owners and for city planning. We thankfully have been seeing this transition as well in the U.S. ambulance market as systems transition from gas guzzling, monster trucks to more appropriate options like the Sprinter.

The last ambulance I served on as a practicing paramedic was a monster Freightliner like this one:

This ambulance was a beast to navigate through urban streets and a rough ride for patients. From a design perspective, if you were to spec an ambulance based on the roads it would travel and the needs of the patients and paramedics that would use it, you would never reach this as the ideal design. It made no sense for an urban EMS system, running mainly low acuity or urgent call volumes, with short transports.

Recently Brendon Morris, Chief Operating Officer of the Hamad Ambulance Service in Doha, Qatar shared with me a paper he provides all new ambulance staff members. He describes the challenges of providing safe and reliable response time performance, in a rapidly growing city, with significant traffic congestion. He includes the following graphic of the old ambulances they’ve been phasing out that mirrors an American bus to the new, European style Sprinters.

Hamad Ambulances


Decisions like what ambulance to purchase often seem like a simple preference. Most systems bring together a project team of staff members that include operations, fleet, and field staff. Team members frequently develop purchasing specifications based on their experience, preferences, and what they are used to. Alternatively, a best practice system pulls data on actual utilization characteristics, talks to patients, and reviews the environment and then matches the design specifications to meet the need. Using the 80/20 rule and matching design specifications to need results in a final product that better serves all involved and for much longer. Which approach matches your last spec design process? How can you bring design thinking to redesigning your next purchase?

David M. Williams, Ph.D. is a researcher, consultant, & chief executive of the international consulting firm Medic Health. He is also an improvement advisor and faculty for the Institute for Healthcare Improvement. Contact him at


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