King County EMS SYSTEM (draft 4)

Anonymous
timer Asked: Nov 23rd, 2016

Question description

This paper is the 4th draft. so I need to continue writing on the same paper that I will upload it. The paper is about King County emergency medical service system.

APA format ( in text citation and references). And please cite every sentence you will take from website or other sources. 5 pages max.

what I need on this paper is below

1- Description of alternative system changes

2- Public Policy options to be considered

3- Evaluation of system efficiency and effectiveness

4- Selection and explanation of suggested action plan

5- Conclusion


Very important to cite every sentence you will take from website or other sources.

Running head: KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM Naif Alzahrani Instructor: Diane Flint MS, NRP, CCEMTP EHS 301 King County Emergency Medical Service System November 16, 2016 1 KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 2 Emergency medical services is the process of treating patients, transporting them to the hospital, and providing immediate care according to the patient’s condition. Also, the most important reason emergency medical services systems were established is to reduce the risk of loss of life with treatment by specialized medical providers and transporting to the hospital. There have been many concerns about the effectiveness of operation and the procedures of the emergency medical systems in providing care to patients. However, King County Emergency Medical Services have developed a system that improves the patient’s outcome through providing immediate medical care. The emergency care system works under the Seattle Fire Department and operates with emergency departments at local hospitals, dispatch centers, and private ambulance providers, as well as the fire departments (“About the EMS Division,” 2016). The system consists of many providers who are working as a team to provide the necessary treatment in both life threatening and non-urgent situations. Also, the system works under the policy of providing the best quality care to their residents. To ensure it is providing the best quality care, the system depends on doing proper research to improve the care outcomes. Also, the King County system provides community programs and education that involve training, and evaluations. Furthermore, the overall medical system in Seattle is considered to be the best in the world, in which the King County Emergency Services is the best system providing care to medical or trauma patients (Public Health Insider, 2016). However, despite being recognized as one of the best systems in the United States, the system is also facing financial and organizational challenges that require immediate attention to improve the system. KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 3 King County has one of the largest population densities in Seattle due to high-density urbanization and many towns. King County is the main county of Seattle, which is considered to be the largest city in the state of Washington. According to public health – Seattle and King County 2014, the emergency medical service provides care to one out of ten people who live in King County each year, and the system responds to approximately 50,000 calls each year (Public Health, 2014). In fact, the region has 8,164 people per square mile, so it has the highest population density in the state (King County, 2016). The majority of constituents in the county are between the ages 17 and 50, which is 50% of the entire population, and most of the people living in King County are white with nearly 40% to 50% of other ethnic races such as African American, Asians, American Indian, native Hawaiian, and Hispanics (King County, 2016). The King County is considered one of the counties in United States that has many ethnicities and that is what makes this county different from any other county in the United States. Education The King County emergency system offers many educational opportunities through community programs such as an emergency medical dispatch program, CPR education program, and basic and advanced life support programs (Public Health Insider, 2016). The King County region has a highly educated population when compared to the state and the country; more than half of the population has already graduated from high school and universities (King County, 2016). Overall System KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 4 The King County’s medical system is considered to be the best systems in the United States because it provides excellent services to patients. The King County mission statement is " to serve, educate and protect our community by shaping and implementing King County's development and environmental regulations" (mission statement,2016). And according to the King County mission statement 2016, the vision statement states " We are a national leader promoting responsible and sustainable development to foster environmental quality, economic vitality and social benefit". The system offers high quality care, that values both its customers and colleagues, serving them with courtesy, professionalism, and respect. They focus on working and serving their community together by establishing clear objectives, making information accessible and available for their residents, respecting diversity, using effective and new technologies and committing themselves to cooperative problem-solving (Mission Statement, 2016). The system offers new and operational technologies for advanced learning opportunities to enhance their achievement of the intended goals to perform in the public interest (Mission Statement, 2016). King County Medical Service offer an excellent cardiac arrest care compared to other emergency medical services systems which saves approximately 120 cardiac arrest people this year (Division of Medical Services, 2015). The county’s medical system is recognized for its excellent medical outcomes in patients, as seen by, the cardiac arrest survival rate of 52% a rate not surpassed by any other area of the world (Public Health Insider, 2016). The system works with all emergency department units including the police, fire departments and local hospitals. With the 29 fire departments, six paramedic stations, 20 hospitals, five EMS dispatch centers, and the pre-hospital emergency care services have been improving over the years (Enhanced 9-11 Dispatch, 2016). The system provides service 24 hours a day and serves the entire county with KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 5 a high level of care (Division of Medical Services, 2015). Most importantly, regional policies and standards have been put in place to ensure that patient care is delivered at the same level across the region. This collaborative system has ensured that there is medical training provided on a regional basis throughout the county (Stubbs, Culley & Eisenberg, 2016). Since most of the residents are highly educated, the services provided proceed from the highest standards of medical training and practices. The King County EMS system has unique quality improvement that evaluate any problems in the system and find the best solutions to have an excellent patient treatment (Public Health, 2014). Furthermore, there is universal access to the emergency system made through dialing 91-1 facilitate immediate responses, which increase survival rates (Enhanced 9-1-1 Dispatch, 2016). Each year, one out of ten residents will use the EMS providers and firefighters who respond to more than 17,000 calls in the entire region (Kudenchuk, 2015). Once 9-1-1 calls are made, professional dispatchers provide instructional steps for medical emergencies before the first response team unit arrives at the scene. Afterward, EMT, and paramedics provide supportive care before patients are transported to the hospitals for further treatment (Enhanced 9-1-1 Dispatch, 2016). System’s Challenges According to the King County City Health Profile 2016, cancer and heart diseases are the leading causes of death in the county and a high parentage of those who dies could not see physicians due to high medical costs. Individuals that receive low income are likely to report poor health status, which means that access to immediate care is still difficult due to transportation problems and high costs of medical treatment. Therefore, housing insecurity is KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 6 indeed a contributing factor to increased life threatening diseases. This applies in particular due to overcrowding, heating, hygiene, as well as high stress. So, since there is a high percentage in King County of seniors 65 years and older, there is an expected stress to social and economic resources in the region. It is also critical to note that the population of the region is continuous rising, which poses challenges for the medical system to overcome in serving its community. Problem statement Currently, King County, like much of the United States, spends a lot in medical costs when compared to other high and middle-income countries. Also, the King county healthcare costs still create barriers to seeking care which hinder the provision of best quality Emergency Medical Services. Finally, the system must receive enough funding to enable them hire enough employees as well as update to the best medical equipment (Health Budget Update, 2016). King County’s System Attributes Public Access Public Access in King County has been made easy and it is available through the numerous responders and collaborations with hospitals and community agencies. First, King County offers emergency services public access through a 911 Dispatch Centre which providess rapid access to emergency medical services, fire department, and police (King County, 2016).. The King County public access has collaborative partnerships with fire departments, medical services, and police, which makes it easy to reach quick care and help. Furthermore, the region has an effective communication system that assists and supports accessibility of emergency medical services to those who need it (King County, 2016). As discussed earlier, the region’s KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 7 system follows a rapid procedure when dealing with serious medical emergencies. First responders are often the EMT which is the first one delivering immediate care to people. This is effectively facilitated since they work together with firefighters who are well trained on responding to medical emergencies. Also, the 29 fire departments are spread out across the region increasing accessibility to the residents to reach emergency care quickly (King County, 2016). An addition to that, infrastructure in King County is equipped with the vital necessities for residents to gain public access. King County medical service offers the best cardiac arrest care because the system offers many CPR and automated external defibrillator programs to their residents to make it easy for their community to gain quick care. Many researches states that cardiac arrest patients who receive a quick CPR treatment and early public access to an EAD has higher chance to survive (of Medical Services, 2015). So the King County EMS system starts working on making the EAD available to their residents for early public access to save many people's lives (Division of Medical Services, 2015). Communication Systems Through communication systems, any emergency calls will guarantee the presence of emergency responders such as firefighters police, and rescue team. The King County Emergency Medical Service has five dispatchers spread throughout the county (Division of Medical Services, 2015). The county’s system also has a supporting radio service that has been upgraded to the newest technology. This is to increase reliability for emergency radio communications between many responders providing care. Additionally, several radio communication services support many users and cover a wide area. The radio connections also links about 30 fire departments, six paramedic stations, five EMS dispatch centers, and 20 locals hospitals KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 8 (“Overview of the Medic One,” 2014). In the same chain, calls will also be linked to medical physicians and the local hospitals to ensure they are prepared to take care of the ill or trauma patients. “Radio Communications Services also provides installation and support services to a wide variety of other local government agencies (Radio Service, 2016)”. “With a well-equipped shop and field service vehicles, we can deliver a full line of radio services, from bench level equipment repair, to shop and field radio installation and maintenance, to mountain-top transmitter site maintenance (Radio Service, 2016)”. Also, signals could be tracked and conversations recorded to ensure that everyone is attended to in a timely manner despite their locations (Radio Service, 2016). Human Resources Every region requires its team of personnel to make sure that the system and its plans are effective. An addition, various departments and levels of the region’s emergency medical system have highly trained staff who work round the clock to ensure the work is effective. This means that emergency services are ready and available both at night and during the day. King County encourages their residents to help and support the EMS system for providing a high quality of care by calling 911 when need it and provide basic care for patient until the medical providers arrive and patients are attended to within ten minutes limit to receive a medical care (King County Medic One, 2014). Citizens in King County region have a culture of being on a constant look out for the wellbeing of one another (King County Medic One, 2014). King County operates fully equipped medic units which help people to have early and a excellent care (King County Medic One, 2014). King County has human resources that form collaborative partnerships with public health and other agencies to spread and share the new programs they provide to their community in order to engage people in EMS system. KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 9 Clinical Care In 911 emergency response, BLS and ALS work together to provide high quality treatment and transport the patients to local hospitals. Medic one in King County offers EMT providers and paramedics opportunities to save people lives. The fire departments in that area are responsible for handling BLS-level care (King County Medic One, 2014). They work in collaboration with local vehicles which are managed by the region’s ambulance companies. Paramedics are providers of ALS in cases of emergency diseases or accidents (King County Medic One, 2014). However, the EMT and paramedics work under physician supervision to provide a high level of clinical care by making the right decisions when treating patients (Division of Medical Services,2013). King County has many medical facilities to ensure the care they provide to people; King County has 9 trauma centers, and about 9 medical hospitals, and three children's hospitals (King County Medic One, 2014). With a combination of public health centers in King County, the residents will receive a high level of care. Birth control and STD clinics, HIV and sexually transmitted diseases (STD) clinics, maternity support services and infant case management, teen clinics, and tuberculosis (TB) clinic are examples of why King County is clinically excellent (Public Health Centers, 2014). Additionally, clinical care works to make sure that it applies modern technology that will improve the care such as medical procedures, and use of defibrillators that have been approved for effectiveness. Medical Directions Emergency Medical Services Medic One works round the clock 24 hours 7 days a week to ensure that patients obtain health care efficiently by offering quality care to emergency situations. In 2016, reports indicate that treatment offered in Medic One to pateints in emergency cases has led to improved survival rates (Public Health Insider, 2014). The medical direction KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 10 works to regulate policies, procedures, and protocols provided to emergency medical providers to people (Division of Medical Services, 2015). Also, King County Medical direction has a partnership with regional trauma facilities and the EMS personnel to discuss the major issues related to the system, new plans, and other suggestions. The medical direction connects the emergency medical providers with physicians or medical directors to offer a high level of care and management. Also, one of the most important procedures that medical direction can provide is training and giving the general public instruction on how to give first aid and resuscitation to rescue breath in the case of a heart attack. Legislation and Regulation King County EMS system is provided by many scientific researchers from the University of Washington to improve the system and care they provided (Center for the Evaluation, 2016). They continue publishing cardiac information by publishing various scientific research as well as EMS journals (Center for the Evaluation,2016). The EMS administration is responsible for the overall running of King County health facilities (Center for the Evaluation, 2016). However, it works in collaboration with councils, county agencies and offices like Risk Management, King County Executive, King County Council and the Prosecuting Attorney (Center for the Evaluation, 2016). Furthermore, in King County, medication and emergency care attention provided on site and in hospitals have to be approved by the medical board. Continuity of Care Currently, King County is going to achieve high survival rates because they depend on doing research which can lead to more effective treatment. The first step is to assess major national studies. This involves identifying the most effective method of CPR (Stubbs, Culley & Eisenberg, 2016). It’s crucial to identify the most suitable medicine to gain a stable cardiac KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 11 pattern in the event of a heart attack. Discovering the best medication to traumatized cardiac patients is important. There are also plans to provide affordable defibrillators to everybody at home (Stubbs, Culley & Eisenberg, 2016). Evaluation King County have one of the best heart attack survival rates in the world (Eisenberg, 2016). This has been made possible by offering public education CPR. People can offer first aid before any medical providers arrive and take the patient to a hospital. The overall system has helped in managing cardiac arrest cases since it is now possible for medical direction to give instructions to caregivers by doing chest compression. The facility has a reputation for responding to emergency cases very fast and effectively. An addition, The Center for the Evaluation of Emergency Medical Services in King County offers much research related to prehospital care and treatment (Center for the Evaluation of EMS, 2016). The system supports students each year to do EMS research and develop the system components such as medical projects, cardiac arrest resuscitation, improve 911 dispatcher, and crash injury research (Center for the Evaluation of EMS, 2016). Information System The 911 Dispatch Centre is an emergency number that citizens use to contact this health system. It is effective and medics can reach out to patients as it avails details of their location as well as their phone numbers (Enhanced 9-1-1 Dispatch, 2016). On the other hand, caregivers can consult medical direction via radio communication in order to give first aid before taking the patient to the hospital (King County, 2016). System Finance KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 12 The Emergency Medical Services Administration section is responsible for their staff and their salaries. It prepares the facility’s budget; it’s involved in planning finances for use in the long-term as well as managing levy finances (King County, 2016). The Centre for the Evaluation of EMS is funded by grants from the University of Washington and the working population of EMS Division. At the same time, funds can be gained from neighboring counties for facilitation of the system (King County, 2016). In other cases, the entire state and the federal government may come into play particularly in projects that facilitate inter-county or state collaborative efforts (Public Health budget,2016). The finance and accounting department handles all financial affairs including audits and reporting. Public Education Education Systems CPR training which a form of first aid is offered in most high schools of that region. The facility has in the past offered CPR training to 80% of the citizens in this region (Stubbs, Culley & Eisenberg, 2016). This is crucial as it helps to reduce mortality rates due to cardiac arrests. Moreover, the same training is serve to the general public. This is possible through emergency dispatchers who are accessible through the digits 911 (Stubbs, Culley & Eisenberg, 2016). This training is compulsory for the majority of county high schools because teaching students would enable them to apply these skills when they grow up easily. As such, it is reflected to be one of the ways of ensuring that the public becomes alert in case of any health misfortunes that would occur. This would also reduce the challenges of the emergency response team in attending to case of emergency. After all, people require basic knowledge of taking care of themselves before having to receive help from outside. King County provides CPR education for people which saves patients from cardiac arrest to increase the chance for survive. Residents KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 13 perform CPR before the arrival of EMS personnels and medical direction who giving them instructor in rescuing breath and provide chest compression. Prevention The King County EMS system has an excellent prevention to reduce the chance of injury to people that can cause significant medical condition. The EMS system offers many programs such as Child Passenger Safety Program and home visit (Division of emergency medical services, 2016). EMS personnels can explore the causes of injury or diseases by doing home visits to people (Division of emergency medical services, 2016). EMS Research From time to time, there is ongoing research at the Emergency Medical Service Department (Center for the Evaluation,2016). This is because the system focuses on providing good quality emergency care to its residents in the best possible method. Therefore, research will demonstrate new technology and methods related to emergency situations. This research is important as it helps to come up with new knowledge which helps to increase survival rates. In 2016, research is being carried out to avail quick pocket-friendly defibrillation in every household to be able to manage cardiac arrest cases more efficiently (Center for the Evaluation,2016). SWOT Analysis Strengths The King County Emergency Medical System is recognized as being the best in the world, especially treatment of acute cardiac arrest (Public Health Insider, 2014). it becomes one of the best system that provide excellent treatment for cardiac arrest patients. In Addition, it has KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 14 excellent communication systems, and human resources that make the system works efficiently to provide the required services. Furthermore, the system employes have a high level of training to ensure that it provides quality care to the patients. Also, the available adequate facilities such as ambulances make the system work effectively to deliver the care to the patients (King County Medic One, 2014). The emergency care is provided at levels from first responders who are firefighters, EMT, and paramedic until patients are taken to the hospitals. Through this quick care response, patients will receive a high quality of care. Moreover, the system offers public education and service such as injury prevention that can help in reducing the overall health of residents (Division of Medical Services, 2013). Due to these efforts and adequate facilities, the EMS division has managed to safely reduce death and disease and to get positive outcomes of services provided. Additionally, the system gets advantages from doing proper researches that can be strength point to improve the overall system. The EMS system has performed several researches to ensure that the system effectiveness has been achieved. Weaknesses King County region is growing and its population increasing, considering its 8,164 people per square mile already accounts for the highest population percentage in the state of Washington (King County, 2016). This mean that the system has to increase their facilities, staff, as well as the quickness of response. Consequently, the system needs more financial resources and more researches to deal with this point. Also, there is also concern for the focus on cardiacrelated problems. The region is considered to be the best in delivering emergency cardiac services, but has not yet managed to improve on other emergency conditions (Seattle and King County, 2012). This is because emergency health situations take different forms and the level of care delivery. In short, basically that the residents are less informed on how to address the KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 15 emergency situations and first aid responders. Most people have been trained to do CPR on patients in cardiac arrest and first aid processes, but they do not have proper knowledge to provide basic emergency care to other health conditions. At the same time, people who have poor medical cover and financial capabilities, their access to proper medical attention is inadequate and that increase the chances of suffering from emergency health conditions. Opportunities There are several opportunities that raise the operations of the medical services. As the region grows and increasing of population, there are challenges to the county’s EMS division, the increasing number of people is a way of increasing medical operations and emergency responses. This means that emergency medical resources are readily, available, and can be used to respond and work with the system. At the same time, since the region has several educational programs, people could be educated on how to respond to emergency care for them to implement the skills in attending to patients (King County, 2014). Also, education that provided to the public should be on how to fully perform emergency care delivery. Through this, the challenges held by King County EMS would be extremely reduced to increase the medical operational effectiveness. At the same time, since police officers are often the first to respond to emergency cases, they could also be trained in delivering first aid care as they wait for first responders and medical providers. Furthermore, as the population growth and increases, it means that the number of providers must be increased and this will help to control the problem of speed in response due to increased medical operation. Additionally, the EMS system has partnership with other agencies such as fire department in other cities and other organizations (Pritchard, 2015). This means they will share limited resources and thus creating efficiency in service provision. KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 16 Threats The King County EMS system is faced with several challenges and threats. As stated earlier, the King County has a large population densities which means facing different emergency situations. So, the EMS system needs more emergency plans to deal with these different types of emergency situations such infectious diseases. This example of threat is the most common threat that the King County faces (Seattle/King County EMS, 2011). So, since the King County has a large population, the infectious diseases such as malaria can be transmitted from one person to another very fast. In addition to that, the level of EMS preparedness and public education by attending to emergency cases still needs improvement to become fully effective to deal with different aspects of emergency situations. This means that there is still threat to people that not knowing how to exactly handle emergency cases such as in car accidents, or fire situation. Furthermore, as the region has a large population densities, the region can face threat from natural disasters such as flood-threat (Welch,2009). This mean that can can cause a serious emergency situations to many people in King County in case of natural diseaster. KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 17 References King County (April 20, 2016). About the EMS Division. Retrieved September 29th, 2016 from http://www.kingcounty.gov/depts/health/emergency-medical-services/about-us.aspx King County (April 13, 2016).Center for the Evaluation of Emergency Medical Services (CEEMS). Retrieved October 12th, 2016 from http://www.kingcounty.gov/depts/health/emergency-medical-services/ceems.aspx King County (May 18, 2016). User agreement and Washington state AED legislation. Retrieved October 12th, 2016 from http://www.kingcounty.gov/depts/health/emergency-medicalservices/community/aed/agreement.aspx King County (October 12th, 2016). Radio services. Retrieved October 12th, 2016 from http://www.kingcounty.gov/depts/it/services/radio-services.aspx King County (March 10th, 2016). Mission, Vision and Values statement. Retrieved Octobr 19, 2016 from http://www.kingcounty.gov/depts/permitting-environmentalreview/about/DPERStatement.aspx King County (August 22, 2016). Public Health Centers and other office locations. Retrived October 19, 2016 from http://www.kingcounty.gov/depts/health/locations.aspx King County (April 20, 2016). Enhanced 9-1-1 Dispatch Centers. Retrieved September 29th, 2016 from http://www.kingcounty.gov/depts/health/emergency-medical-services/medicone/enhanced-9-1-1.aspx King County (September 27, 2016). Public Health Budget Update. Retrieved September 28th, 2016 from http://www.kingcounty.gov/depts/health/budget.aspx KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 18 Public Health Insider (2015). Why King County’s Ems is The Best in The World: Q&A with Mickey Eisenberg. Retrieved September 29th, 2016 from https://publichealthinsider.com/2015/05/22/why-king-countys-ems-is-the-best-in-theworld-qa-with-mickey-eisenberg/ PDF King County. (September, 2013) Division of emergency medical services: 2013 annual report to the King County Council. Retrieved October 12th, 2016 from http://www.kingcounty.gov/depts/health/emergency-medicalservices/~/media/depts/health/emergency-medicalservices/documents/reports/2013AnnualReport.ashx PDF King County. (September, 2016) Division of emergency medical services: annual report to the King County Council. Retrieved November 10th, 2016 from http://www.kingcounty.gov/depts/health/~/media/depts/health/emergency-medicalservices/documents/reports/2016-Annual-Report.ashx PDF King County. (January, 2016) King County City Health Profile Seattle. Retrieved September 29th, 2016 from http://www.kingcounty.gov/depts/health/data/~/media/depts/health/data/documents/cityhealth-profiles/City-Health-Profile-Seattle-2016.ashx Public Health - Seattle & King County (2014) Overview of the Medic One/EMS System. Retrieved october 17, 2016 from http://www.kingcounty.gov/depts/health/emergencymedical-services/~/media/depts/health/emergency-medicalservices/documents/EMSAdvisoryTaskForceOverview.ashx Pritchard, H. (2015). Public Health-Seattle & King County: Division of Emergency Medical Services. Public Health Seattle & King County. KING COUNTY EMERGENCY MEDICAL SERVICES SYSTEM 19 Stubbs, B. A., Culley, L., & Eisenberg, M. S. (2016). Dispatch-assisted CPR instructions: Time to measure and improve. Resuscitation, 102, e5. Seattle / King County EMS (2011). CBT 621-EMT 11-Infectious Diseases . Retrieved November 14th, 2016 from http://www.emsonline.net/assets/2011CBT621_2011_InfDis_PrintVersion.pdf Welch, C. (2009, September 10). King County declares flood-threat state of emergency. Retrieved November 15, 2016, from http://www.seattletimes.com/seattle-news/kingcounty-declares-flood-threat-state-of-emergency/

Tutor Answer

(Top Tutor) Studypool Tutor
School: Duke University
Studypool has helped 1,244,100 students
flag Report DMCA
Similar Questions
Hot Questions
Related Tags
Study Guides

Brown University





1271 Tutors

California Institute of Technology




2131 Tutors

Carnegie Mellon University




982 Tutors

Columbia University





1256 Tutors

Dartmouth University





2113 Tutors

Emory University





2279 Tutors

Harvard University





599 Tutors

Massachusetts Institute of Technology



2319 Tutors

New York University





1645 Tutors

Notre Dam University





1911 Tutors

Oklahoma University





2122 Tutors

Pennsylvania State University





932 Tutors

Princeton University





1211 Tutors

Stanford University





983 Tutors

University of California





1282 Tutors

Oxford University





123 Tutors

Yale University





2325 Tutors