Abstract

Introduction:

When evaluating the information provided by 911 callers, Emergency Police Dispatchers (EPDs) use scripted protocols to ensure that important details are not missed and that questions are not omitted. Specifically, at the beginning of the call, EPDs ask callers to "Tell me exactly what happened" (TMEWH). Since EPDs must select the correct Chief Complaint (CC) Protocol based on the caller's response, getting a complete response to TMEWH—and interpreting it correctly—is one of the most significant elements of an EPD's job. However, no studies have yet evaluated the use of TMEWH in gathering adequate information for CC selection or the impact of that selection on later information gathering by EPDs.

Objectives:

The primary objective of this study was to determine whether asking TMEWH and/or clarifying provides information that is useful later in the call (in terms of CC selection, Key Question (KQ) answers, and final coding). A secondary objective was to identify the effect of asking TMEWH on call prioritization time (CPT)—the elapsed time from the launch of dispatch system (ProQA®) to when a final dispatch code was assigned.

Methods:

This was a retrospective quantitative study involving review of audio of calls handled on the Police Priority Dispatch System™ (PPDS®) (Priority Dispatch Corp., Salt Lake City, Utah, USA). Calls were collected during normal quality assurance (QA) call review at the participating agencies: Morris County Department of Law and Public Safety and Williamson County Emergency Communications. Measured outcomes included whether TMEWH was asked, how many of the KQs were considered obvious, the total number of KQs, whether the correct CC was chosen, and the CPT.

Results:

A total of 422 audio files were reviewed. Overall, TMEWH was asked in almost half (48.9%) of cases. A majority of calls (94.1%) resulted in the dispatcher appropriately initially identifying the CC. Asking TMEWH did not have a statistically significant impact on the appropriateness of the initial CC selection (p = 0.6682), nor did using the clarifier (p = 0.6447). In roughly half of the calls the EPD utilized a clarifier (50.7%). The use of a clarifier did not have significant influence on the selection of an appropriate CC nor on the CPT; however, the occurrence of a spontaneous caller statement was significantly associated with less use of clarifiers (p < 0.001). CPT did not differ significantly by whether TMEWH was asked (p = 0.1568), nor by whether a clarifier was used (p = 0.1116); however, the total number of obvious KQs (or KQs that should have been obvious, given what the caller provided at Case Entry) varied significantly by whether TMEWH was asked (p = 0.003), with more questions being considered obvious or "already answered" when TMEWH was not asked.

Conclusions:

TMEWH does not significantly increase call times and provides important information when callers do not spontaneously present a sufficient problem description. When spontaneous caller statements made at the opening of calls are adequate, EPDs can effectively identify and select the proper CC. EPDs should err on the side of asking TMEWH and use clarifiers when the spontaneous caller statement is not sufficient to appropriately select the CC.