Expanding the role of evidence-based practice (EBP) in emergency medical services is a matter of increasing importance to researchers and practitioners alike. However, this movement toward EBP has not yet been applied to one critical area of prehospital care: emergency dispatching. The primary reason for this gap is that emergency dispatchers (EDs) struggle to develop a research culture able to produce enough well-conducted studies to move toward true EBP. One starting point with documented potential for building the research capacity in a field is to develop...
Emergency Medical Services (EMS) agencies have a pressing need to understand call prioritization time (CPT), a key sub-component of call processing time in Emergency Medical Dispatch, as it impacts response time to specific cases and overall EMS agency response time performance. The objective of this study was to determine median CPT by dispatch priority level and Chief Complaint type. This retrospective study included data from six emergency communication agencies, each accredited by the International Academies of Emergency Dispatch (IAED)...
The value of dispatch in modern Emergency Medical Services (EMS) systems cannot be understated. Among many other roles, an Emergency Medical Dispatcher (EMD) is responsible for accurate response selection. Response is based on EMD-assigned dispatch codes upon completion of caller-interrogation questions in a dispatch protocol system. When two or more signs, symptoms, or situational conditions are encountered in a calltaker evaluation, but are assigned and reported as a single, dispatch-defined code descriptor during the call-taking process by an EMD, a data hiding...
Emergency Medical Dispatchers (EMDs), at emergency communication centers that have implemented the Medical Priority Dispatch System® (MPDS) protocols, use scripted questions to interrogate people calling 9-1-1. Based on this interrogation, case determinant codes are assigned– to identify the specific patient condition and enable optimal allocation and deployment of resources to ensure appropriate field responses. MPDS determinant codes for both OBVIOUS and EXPECTED DEATH exist for patients that are clearly and irreversibly dead, or have a terminal illness accompanied...
Telephone nurse triage at the 9-1-1 dispatch point is relatively new in the United States despite its ability to significantly reduce expensive and scarce Emergency Medical Services (EMS) resource use and emergency department visits. A previous study investigated the distribution of 9-1-1-triaged call incident types within the Emergency Communications Nurse System (ECNS) and found that 9-1-1 triage systems yielded a variety of low acuity complaints that were handled by the Emergency Communications Nurse (ECN). This study explored the current and potential utilization...
Research has shown that two-thirds of emergency visits occur after business hours (weekdays 9am – 5pm). Therefore, identifying primary healthcare providers available after business hours is one strategy for improving appropriate access to healthcare services. Previous studies have also shown a high and steady volume of secondary triage-eligible calls throughout the day and into the evening. However, because the Emergency Communication Nurse (ECN) performing the secondary triage has some discretion on selecting the Recommended Care Level (RCL) based on resource...
The job of an emergency dispatcher is inherently stressful. As a 9-1-1 dispatcher, it is expected to receive a call for a multi-system trauma victim, a child drowning, an assault, amongst thousands of others, will be answered. These stressors are encountered multiple times per shift. While answering the call is controllable, the stressor on the other end is not. To examine the relationships of emergency dispatchers' home and work life, and present perceived control (how one focuses energy on what can be controlled in an uncontrollable situation) on secondary traumatic stress (STS), the effects...
Recent estimates indicate that more than half of all Emergency Department (ED) visits could be avoided, reducing patient costs and increasing satisfaction with care. Since 911 is increasingly the first point of contact for many patients entering the health care system—even those with non-emergency conditions—one potential approach to decreasing emergency costs and ED overcrowding is to reinvent the 911 dispatch center as a clearinghouse for directing patients to alternative care providers. This study presents a cost avoidance analysis of two 911 dispatch centers that...
An examination of the Emergency Communications Nurse-determined Recommended Care Levels (RCLs), for calls transferred for secondary nurse-triage has not been performed. The outcome of such an investigation would help to gain a more complete picture of the type of care ultimately recommended for these patients. The Emergency Communications Nurse System (ECNS) studied contained 22 RCLs, ranging from urgent levels, including a country-specific 3-digit number Emergency response (911), and Emergency care as soon as possible to less time-dependent, low priority levels, such...
This study represents a first attempt to classify a subset of time-to-dispatch in a 911 center – the call prioritization time. This time is defined as the time required to gather critical case information, after the address is obtained, and prior to notifying responder units of the call. This study characterizes call prioritization time in nine different 911 centers, all using the Fire Priority Dispatch System (FPDS). Times were examined by individual agency, overall. This was a retrospective, non-controlled, descriptive study involving nine 911 and by FPDS...
