2018 AMBY
Priority Ambulance
Patient & Vehicle Safety
Patient & Employee Safety

Situational Analysis

At Priority Ambulance, every ambulance is a reflection of our commitment to safety and service. Our mission is to guard the safety to the best of our ability of every patient, crew member and community that we serve. Safety is a cornerstone of our core values, as we strive to deliver on our stated corporate mission to provide S.A.F.E—Safe. Accountable. Friendly. Efficient—services at all times.

An effective risk and safety program is only successful when it is adopted by every member of the company from the CEO to each EMT and paramedic in the field. Our CEO Bryan Gibson has championed safety as a No. 1 priority for our organization, and that has been key to building a solid, shared safety culture throughout our national family of companies.

National data on ambulance crashes and safety prove out our commitment to making significant investments in vehicle safety technology can, and will, reduce injuries and potential fatalities over time. Statistics show the majority of ambulance crashes occur on clear days with good visibility, in daylight hours, on dry roads, when making turns or at intersections. The resulting crash data is significant, with an average of 4,500 vehicle traffic crashes involving an ambulance each year, based on data collected between 1992-2011 by the National Highway Traffic Safety Administration. Of those incidents, more than a third—or 34 percent—resulted in injuries.

As a national provider of emergency and non-emergency ambulance services, the family of Priority Ambulance companies is not alone. The impact of traffic accidents and related injuries has affected our employees, fleet, insurance programs and financial results. In 2016, we noted an upward trend in traffic accidents, particularly related to distracted driving, fatigue and improper driving practices.

We also noted that most driver training programs in our industry focused on the employee’s actions, including safe driving techniques and evasive maneuvers in the event of a potential accident. What was missing was the technology aspect of driver safety, similar to what can be found in the commercial trucking and transportation industry. In that industry, safety is not only instilled in employees, but also is built into the trucks. We believe the EMS industry is behind the curve in this area, so we made the decision to invest considerably in vehicle safety features.

Priority Ambulance is committed to creating a culture of safety and raising the bar for vehicle safety standards in the EMS industry. In 2017, we developed a comprehensive, multi-year vehicle safety initiative designed to reduce risks associated with traffic accidents, unsafe driving behaviors, distracted driving, fatigued driving and patient safety. That initiative was approved, funded and launched in 2018.

Today, we are in the early phases of a three-year, nationwide rollout that will conclude in 2021. Our end goal is to equip every ambulance in our fleet with state-of-the-art safety systems, including:

  • StreetEagle behavior monitoring systems
  • Safe Driving Systems collision avoidance/lane departure warning systems
  • Guardian System Seeing Machines to track and prevent drowsy and distracted driving incidents
  • Cab cameras and backing safety cameras
  • Speed Governor technology
  • BuckleGarde patient restraint systems
  • Battery powered Stryker Power Pro stretchers

At Priority Ambulance, we have seized the opportunity to create a fleet of state-of-the-art vehicles with safety systems that focus on driver safety and fatigue mitigation to keep employees, patients and our communities safe. In the process, we have set the bar for a new industry standard in vehicle safety technology.


Reduce Vehicle Accident Rates

Priority Ambulance is among the nation’s largest and fastest-growing national private ambulance services. With that growth rate comes the responsibility to ensure safety is at the forefront of our values.

With approximately 500 ambulances and other emergency vehicles in our growing national fleet, our safety initiative was launched with a primary goal to reduce vehicle accident rates. We applied a root cause analysis methodology to determine the causal relationships between the traffic accidents and any environmental/behavioral influences that may have impacted the outcome.

The results of our analysis revealed four key strategies to meet that goal:
1. Enhance vehicle safety solutions
2. Implement driver behavior monitoring technology
3. Implement collision avoidance/lane departure technology
4. Reduce distracted driving incidents

Planning & Implementation

Armed with statistical data and a clear sense of each area in which we could proactively reduce traffic accident rates, we set about to define the tactics we would deploy to deliver on our goals, and ultimately reduce overall vehicle collision rates.

Strategy 1: Enhance Vehicle Safety Solutions

While all vehicles in the Priority Ambulance fleet are equipped with standard patient and crew safety features, our goal is to elevate our standards to a higher level. As a result, we immediately implemented the following enhanced vehicle safety features in conjunction with our national safety initiative:

  • Install amber LED flashing lights on exterior rear compartments that illuminate whenever ambulances are in gear and serve as a warning to other drivers.
  • Paint scheme on all safety equipment inside the patient compartment updated to safety yellow.
  • Set speed governor in all vehicles to 75 mph as maximum speed vehicles can travel.
  • Equip all bariatric units with Transafe ramp systems.
  • Install BuckleGarde technology to ensure patients are securely restrained.
  • Battery powered Stryker Power Pro stretchers.
  • Install driver cab camera to continuously monitor activity inside patient compartment.
  • Implement specific fatigue- and distraction-related driver training programs.


Strategy 2: Implement Driver Behavior Monitoring Technology

Understanding the circumstances and behaviors that may lead to a traffic incident was also vital to achieving our goals. Following a comprehensive assessment of the latest technology in driver behavior monitoring, we selected StreetEagle as our partner for in-vehicle notification and reporting. StreetEagle technology alerts drivers and supervisors whenever incidences of hard braking, hard acceleration, cornering violations and speeding occur.

With StreetEagle, our drivers receive continuous feedback during vehicle operation and receive a score on four critical criterias for safe vehicle operation. The technology takes it even a step further by providing a customized scorecard that drivers and their supervisors can use to assess driver rankings in real time.

During implementation, we conducted pilot testing of StreetEagle in our 911 operations in Chattanooga, Tennessee, with tremendous success. From that pilot, we deployed StreetEagle technology in 100 percent of our 911 fleet in Scottsdale, Arizona. This year, we plan to complete deployment of this driver behavior monitoring technology in our New York and Indiana operations.

Strategy 3: Implement Collision Avoidance/Lane Departure Technology

The technology that exists today in personal vehicles for detecting accidental lane departures, blind spot detection and collision avoidance is sophisticated and readily available. At Priority Ambulance, we knew that providing similar technology in our ambulances would provided added security and safety for our drivers.

We are very proud to be one of the first companies in the nation to utilize Safe Drive Systems (SDS) collision avoidance technology aboard ambulances and supervisor vehicles. SDS radar technology includes lane departure and rear-end collision avoidance systems that provide audible and visual alerts whenever vehicles are outside of safe ranges. The system provides 1.8 seconds of added reaction time for a driver to correct course or decelerate quickly.

According to Michael Justus, Safe Drive Systems Chief Operating Officer, “Priority Ambulance is the first ambulance fleet in the United States to incorporate this type of technology and to provide the added safety to the drivers, to the community, to the patients that they transport. So Priority is setting the gold standard for safety in the community.”


Strategy 4: Reduce Fatigue/Distracted Driving Incidents

At Priority Ambulance, we believe we are on the cutting edge of EMS vehicle safety technology. And research in our industry points to potential fatigue-related accidents. Both NAEMT and NHTSA have conducted multiple studies to this topic in an attempt to identify and reduce potential accidents through behavior modification programs, and we have responded by implementing specific employee training programs that address fatigue- and distraction-related driving.

To further underscore our commitment, we are pilot testing an additional driver feedback technology designed to mitigate drowsy and distracted driving incidents. We are testing Guardian’s Seeing Machines fatigue management systems in our Georgia EMS operations and will develop an implementation plan based on those results.

Guardian is a world-leading technology designed to prevent incidents related to driver fatigue and distracted driving. The system works through face- and gaze-tracking algorithms that measure drivers’ head positions and eye closure. When safety parameters are exceeded, audio alarms and seat vibration are immediately activated to alert the driver. Cameras capture road conditions at the time of any alarm, and all data is sent to a 24/7 Guardian monitoring center, which, in turn, alerts the company of the incident.


Year one results of the Priority Ambulance safety initiative demonstrate our dedication to providing the safest medical transport experience possible for our drivers, crew members, patients and the communities we serve. Our results to date include the following fleet and patient safety system enhancements that exceed standard industry configurations. These enhancements are being phased in over a three-year period in 100 percent of our ambulance fleet.

1. Installation of StreetEagle driving behavior monitoring systems to detect and alert us to incidences of hard braking, hard acceleration, cornering violations and speeding.
2. Installation of Safe Drive Systems (SDS) collision avoidance technology aboard ambulances and supervisor vehicles.
3. Installation of amber LED flashing lights on exterior rear compartments that illuminate whenever ambulances are in gear and serve as a warning to other drivers.
4. Paint scheme on all safety equipment inside the patient compartment updated to safety yellow.
5. Speed governor in all vehicles set to 75 mph as maximum speed vehicles can travel.
6. All bariatric units equipped with Transafe ramp systems for patient safety, comfort and dignity.
7. BuckleGarde restraint system installed to ensure patients are securely restrained.
8. Battery powered Stryker Power Pro stretchers.
9. Cab cameras installed to continuously monitor activity inside patient compartment.
10. Implement specific fatigue- and distraction-related driver training programs.
11. Pilot testing of Guardian’s Seeing Machines fatigue management systems in our Georgia EMS operations to mitigate drowsy and distracted driving incidents.


We expect the impact of our safety initiative will improve the overall health and well-being of our EMS personnel, mitigate risk to our patients and improve the safety of our communities. From employees and patients to fellow drivers on the road and the community at large, we believe operating a fleet of ambulances equipped with the latest safety technology reduces our risk of accidents.

Statistics from OSHA, NHTSA, National Safety Institute and the National Safety Council show emergency response vehicles are 13 times more likely to be involved in an accident. Furthermore, 40 percent of fleet accidents are preventable because they are due to driver distraction or negligence. Add to that the direct and indirect costs of accidents, and we know our ultimate investment will represent a significant impact to our overall safety record, operational efficiency, and the bottom line.

Our year one rollout of each safety feature began in select markets in April 2018. Full implementation of our enhanced safety and technology systems is slated for December 2021. In the interim, we plan to report yearly quantitative statistics and related risk and incident data following the close of each fiscal year.

While it is too early to present quantitative data on outcomes, our expectation is that we will experience an estimated 80 percent reduction in company-wide accidents within six months with the StreetEagle technology alone. This statistic is consistent with results experienced in fleet-intensive industries already using this technology.

To illustrate our confidence in the final outcome of this initiative, we point to our 9-1-1 fleet in Scottsdale, Arizona, where every ambulance was equipped with all safety initiative features and technology (with the exception of Guardian Seeing Machines) at the April 1, 2017 startup. In the first four months of operation, we have experienced zero accidents. Additionally, in the first 60 days of data collection from SDS collision avoidance systems we have experienced an 83 percent reduction in total events, a 40 percent decrease in acceleration events, a 54 percent decrease in braking events and a 48 percent decrease in cornering events.

To further illustrate the effectiveness of our SDS collision avoidance technology, we offer a success story from the Chattanooga, Tennessee, pilot study. In the first week of the pilot study, a field training officer was driving a supervisor vehicle and glanced down to change the UHF radio channel, a routine action that happens countless times a day throughout the country. In that moment, the driver in front of the field training officer’s vehicle braked abruptly, the SDS system alarm sounded, and the field training officer was able to stop in enough time to avoid a rear-end collision.

Our safety initiative has also prompted a renewed emphasis on fatigued driving and distracted driving management skills and training. Statistics from NHTSA tell us that during daylight hours, approximately 660,000 drivers are using mobile phones while driving, creating a significant risk for distracted-driving accidents, injuries and fatalities. Our multi-pronged approach to new employee orientation and continuing education training places a high value on mitigating fatigue- and distraction-related accidents.


The Priority Ambulance safety initiative was launched at the beginning of 2018 with a three-year project plan for comprehensive assessment, pilot project testing and final implementation. Our goal is to complete the initiative at the conclusion of the 2021 budget year. We intend to set a new standard for the configuration of EMS vehicles and operational safety through these efforts and have committed to a minimum total investment of $1.5 million. This figure is exclusive of our independent purchase of TranSafe systems for our specially equipped bariatric ambulances, which will add an additional ~$9,000 per unit to our total budget.

URL: https://youtu.be/5veCxNTAN7c

Files: EMS Building Culture Safety StreetEagle.pdf, Major Metropolitan Ambulance Service Deploys Unique Radar and Camera.pdf, NHTSA GroundAmbulanceCrashesPresentation.pdf