Emergency Medical Services (EMS) systems often utilize a structured approach to 911 call-taking and emergency medical dispatch (EMD). One such system, Medical Priority Dispatch System (MPDS®), categorizes 9-1-1 calls into EMD codes based on problem and severity. Response priorities and resources dispatched are determined at the local level through a predetermined response matrix, which is often determined without utilizing outcome-based criteria. The primary objective was to use historical clinical data to develop a methodology to increase the number of patients with time-sensitive critical...
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)...
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...
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 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...
