Abstract

ABSTRACT

Introduction: A fast response to an emergency call is one of the main objectives of an emergency medical communication center (EMCC). In 2011, a scripted logic-based dispatch protocol system, the Medical Priority Dispatch System™ (MPDS®), was implemented in the five Liguria Region EMCCs in Italy, to manage emergency medical calls. However, response delay time (RD) (i.e., time from when the call rings to when emergency medical dispatcher [EMD] picks it up) and duration of emergency call (DEC) (i.e., time from call pick up to when the call is closed) have not been previously studied.

Objective: The primary objective of the study was to evaluate whether the use of the MPDS has reduced the RD. The secondary objective was to evaluate the change in the DEC after the implementation of the MPDS.

Methods: The analysis of the response delay (RD) took into account all the calls received from the EMCCs in the period from 2010 to 2015. The analysis of the call duration was performed on emergency calls (i.e. the calls linked to a potentially critical situation and so excluding all the others calls, such as requests for information, requests for patient transportation, and so on). The nonparametric Mann-Whitney U-test was used to assess differences between two independent study groups: WO-MPDS (without MPDS) versus W-MPDS (with MPDS). The outcome measures were the response delay to the calls and the duration of the emergency calls received at the EMCCs.

Result: 420,530 cases (WO-MPDS: 55,962 calls vs. W-MPDS: 364,568 calls) were analyzed from all the EMCCs. A statistically significant difference was observed between the mean response delay for WO-MPDS and W-MPDS (mean (99%CI): 7.32 (7.30-7.34) and 6.24 (6.23-6.25) seconds, respectively). 167,269 cases of emergency calls (WO-MPDS: 25,293 calls vs. W-MPDS: 141,976 calls) were analyzed and a sharp increase in the duration of the emergency calls was detected between the WO-MPDS period and W-MPDS period (mean (99%CI): 69.6 (69.4-69.8) and 99.6 (99.5-99.8), respectively).

Conclusion: Implementation of the MPDS significantly reduced the response delay time in Liguria EMCCs. The duration of the emergency calls instead increased heterogeneously with respect to the priority dispatch. However, further research should establish other potential benefits of MPDS implementation such as standardized, quality, and quantity of data gathered.