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...
Emergency dispatchers are exposed to potentially traumatic events at rates that likely exceed that of emergency first responders. Although not physically present at the time of the incident, it is likely that this repeated exposure in concert with highly stressful work conditions could lead to potentially negative emotional and physical outcomes. To date few studies have examined rates of stress related pathology and subsequent impairment in emergency dispatchers. The following study takes an initial step to investigate rates of Acute Stress Disorder, Secondary Traumatic Stress and...
911 agencies, Emergency medical services (EMS), and first responder agencies play a critical role in major disease outbreaks because they are a gateway to the overall healthcare system for a wide spectrum of patients who use 911 as their first point of access. For those patients, emergency dispatchers and emergency prehospital responders are the first professionals to communicate with, treat, and provide hospital transport for, patients who are infected with communicable diseases. Public health agencies such as the Centers for Disease Control and Prevention (CDC) at the national level, and...
The extent of fire emergencies in our communities is of great concern, not only to the public, but to the nation's fire departments, whose role is not only to respond to them, but to mitigate and, even earlier, to prevent them. The variety of types of fire-related emergencies reported to 911 is of significant interest to this ongoing mandate. The aim of this study was to characterize the distribution of calls handled using a Fire Priority Dispatch System (FPDS™) in the studied agencies. This was a retrospective and non-controlled descriptive study...
Time-to-dispatch in a 911 center continues to be a topic of much discussion in public safety. This study represents a first attempt to classify a subset of time-todispatch, call prioritization time, the time required to gather critical information prior to dispatching the call. The study characterizes call prioritization time in two Police dispatching agencies by determining overall median call prioritization time for all Chief Complaints (CCs) in the agencies studied, then by determining specific call prioritization times for the top five most commonly-used CCs...
This study examined the distribution of the MPDS® Chief Complaint protocols and determinant codes assigned by the EMD as eligible for nurse triage, as well as the distribution of the Chief Complaint protocols contained in the Emergency Communications Nurse System™ (ECNS™) secondary nurse triage process, as determined by the emergency communications nurse (ECN). Protocol distribution was also examined by patient gender. This study characterized protocol and gender distributions to provide a better understanding of the types of patients and their associated...
