Continuous Dispatch Education (CDE) is ongoing training for Emergency Dispatchers, Quality Improvement Specialists and Emergency Telecommunicators (ETC). Yorkshire Ambulance Service (YAS) wanted to improve current compliance performance to the Medical Priority Dispatch System™ (MPDS®) utilizing CDE. This study reports on the effectiveness of CDE efforts and staff motivation in completing CDE. The primary objectives in this study were to establish if structured CDE improved calltaker performance and to gather information about staff perceptions of CDE...
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)...
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...
Seizures are episodes of sudden, severe, disorganized neurological activity in the brain, characterized by uncontrolled movement and, in many cases, altered consciousness. Seizures account for 1% of all emergency department visits, and are a leading cause of Emergency Medical Services (EMS) activation and transport. Patients who experience a seizure with no medical history of seizure disorder challenge the prehospital provider to identify an underlying cause for the event and attempt to treat immediately. s:This study aimed to identify the clinical profile of...
9-1-1 telecommunicators are uniquely exposed to numerous occupational stressors on an ongoing basis. Yet little is known about the sources of occupational stress and symptoms of stress in these workers and even less is known about variables that can serve as stressors or buffers to stress in the 9-1-1 call center work environment. We sought to explore the inter-relationships amongst job stressors, potential risk and protective factors, and symptoms of stress in 9-1-1 telecommunicators. Our long-term goal was to use outcomes of this study to guide and...
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...
