Dispatch * EMS Best Practices Survey Discussion

Report
Dispatch – EMS Best Practices
Survey
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THANK YOU TO ALL WHO WERE ABLE TO
PARTICIPATE!
•
16 RESPONDENTS, WHICH INCLUDES
STATE RADIO
Discussion
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FROM DISPATCH CENTERS
•
•
•
FROM EMS PERSPECTIVE
•
•
What are needs of PSAPs?
What direction do we want to take?
What would be nice to have.
DOH DEMST
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What’s reasonable and realistic for both
EMS and Dispatch Centers
Paging
When multiple pages are required to dispatch an
ambulance, how frequently do you re-page?
18.2%
Every 1 minute after
the initial page
Every 2 minutes after
the initial page
54.5%
27.3%
Every 3 minutes after
the initial page
Question 3
Status Checks
Does Dispatch do status checks while an Ambulance is on scene? Check all that apply.
Rarely
26.7%
As needed
Sometimes
46.7%
Rarely
0.0%
6.7%
Most of the
time
Most of the time
All of the time
As needed
Comments:
There has never been a request from
the ambulance services to do so.
However, we routinely do status checks
while the ambulance is in route to
assist them in getting to the correct
location.
20.0%
Sometimes
Question 5
Factors contributing to routinely not doing status checks.
What other factors contribute to not having safety checks routinely performed by dispatch?
Check all that apply.
Comments:
90.0%
EMS personnel either do not routinely carry portable
radios or they may be using a portable and be out of
1 range of the radio repeater
84.6%
80.0%
70.0%
60.0%
50.0%
38.5%
40.0%
30.0%
20.0%
It has never been requested by the ambulance
3 services we serve
7.7%
10.0%
Medics carry portable radios, EMT-Basics do not.
Generally, if a call is very serious, there is law
enforcement response also, so status is checked
through officers rather than the ambulance personnel.
Occasionally we will check with ambulance personnel
2 for status on things such as LZ.
4 LE is sent on medicals
0.0%
It’s not necessary on
all calls.
Dispatchers are too
busy.
Our EMS personnel
do not carry portable
radios therefore
dispatch cannot reach
us when we’re outside
of the ambulance.
All services routinely do not carry a portable on
scene; they bring the radio on scene only if they have
concerns about the call. Dispatch has on occasion
performed radio checks only when trouble may be
5 perceived.
SR doesn't send EMS into an
6 unsecured scene
Question 6
Address and/or common sense directions
Are the address and/or common sense directions provided to Ambulance Services either
during the page or shortly thereafter? Check all that apply.
Comments:
46.7%
50.0%
45.0%
40.0%
33.3%
35.0%
30.0%
25.0%
20.0%
20.0%
All Ambulances
have the County
911 system on a
2 laptop in the rig.
15.0%
6.7%
10.0%
5.0%
0.0%
0.0%
Rarely
Sometimes Most of the time All of the time
Address always
provided, but not
common sense
directions in order to
keep paging message
brief. EMS asks for
1 directions if needed.
As needed
Question 7
Pre-arrival instructions
Is the nature of the call and pertinent medical information
relayed to Ambulance Services either during the page or shortly
thereafter? Check all that apply.
13.3%
Rarely
Sometimes
Most of the time
All of the time
86.7%
As needed
Question 8
Reporting Service anomalies
ND Administrative Code requires that Ambulance Services be enroute to calls within 10
minutes 90% of the time. If there are Ambulance Services routinely not able to meet this goal,
would you be willing to fill out the online form to help identify which Ambulance Services need
assistance in gaining compliance with this standard?
Comments:
1
2
80.0%
70.0%
69.2%
3
4
60.0%
We would be unwilling to comply with request,
unless somehow the compliance was
We have not had this
mandatory
issue
None
Yes, but right now all ambulances are in
compliance.
Have not had that problem
5 This has never been an issue here.
yes, however we have none that routinely exceed this time
6 frame
50.0%
40.0%
30.8%
30.0%
15.4%
20.0%
10.0%
0.0%
Yes
No (Please Explain)
Other (Please
Explain)
I would report only after I’ve exhausted all other possibilities. For
example, if there were consistent problems with a service not responding
to pages, and there have been with one service many years back, I
spoke to the squad leader and explained to them the predicament the
Dispatchers are placed in when there is not a timely response to a page.
I also called them monthly for their monthly on-call schedule. This built
7 rapport, and over many months the problem was resolved.
8 I will and I have before.
Yes if it happens routinely. Most of the ambulance services that SR
9 serves are volunteers and we want to help them
Question 13
Sending ALS with BLS calls for trauma criteria
Although it’s not required, does Dispatch have a policy to automatically send ALS with BLS if
one of the previously mentioned critical criteria is met?
5 Comments:
(6 skipped the question)
We provide dispatch based upon
1 NAED protocols
It is not policy to dispatch ALS with
BLS; however, many of our
dispatchers will ask the responding
BLS service if they would like ALS
2 intercept at the time of dispatch.
30.0%
3 said Yes
Yes
No
70.0%
7 said No
We do not have a policy, but it is
3 often initiated by the dispatcher
Some of the BLS are beginning to
routinely prompt Dispatch right away
to notify ALS they’re needed when
BLS first learns the problem. This has
been a good change, and something
the Services are working out between
4 themselves.
Dispatch makes that
determination through ND EM
5 Card questioning.
* Question 14, 15
EMD trained Dispatchers
Are all Dispatchers EMD trained that work in
your dispatch center?
Answer
Options
7.1%
Yes
No
92.9%
Response
Percent
Response
Count
Yes
92.9%
13
No
7.1%
1*
Other (please specify)
1
answered question
14
skipped question
2
* One provided comment that
there are 3 new dispatchers
that need to go to training.
Question 16
EMD – Dispatch stay on phone after page
How often does your Dispatch Center stay on the phone with
callers after the initial page and use EMD Cards?
0.0%-Rarely
26.7%
4 - as needed
33.3%
5 - Sometimes
Rarely
Sometimes
Most of the time
All of the time
As needed
20.0%
3- All the time
20.0%
3 Most of time
Question 17
Quality Assurance
Is someone reviewing medical dispatch instructions provided by Dispatch to ensure they’re
appropriate for signs and symptoms described and/or do you have a formal Quality Assurance
Program?
3 Comments:
46.7%
7 said Yes
53.3%
8 said No
We have discussed
starting this type of
1 program
Yes
No
We are now gathering
information for a QA
program. As of now,
instructions are reviewed if
2 there are questions.
We are currently
working on creating a
3 QA program
Question 19
Quality Assurance Comments
Please describe what quality assurance program or method you are using.
Comments:
(10 responded, 6 skipped question)
1
2
EMS calls are routinely and informally discussed with the Dispatchers as to how a particular call
was handled.
Peer review and Supervisor review
3
We have a primary case reviewer and our supervisors are also EMD-Q certified. Cases are
reviewed mostly at random however we do review calls of individual personnel if necessary.
4
5
6
7
8
9
10
The 911 Coordinator lists daily to all 911 Calls to ensure calls are done properly. I will notify the
Dispatch Supervisor if a problem is found, then we go from there. All Dispatchers are also 1st
Responder trained.
We do not have a QA program as of yet. Am in the information gathering stage.
We are currently in the process of creating a QA program for our dispatch center.
National Academy's Quality Improvement Program
All shift supervisors are Medical Priority Quality Assuance certified.
No quality assurance program at this time; we lack the resources both in time and money.
The ambulance, doctors and myself meet quarterly to review calls.
Question 20
Review of EMD cards in between updates
Does your Medical Director review the EMD cards periodically in between published
updates?
4 Comments:
Yes
No
46.2%
6 said No
53.8%
7 said Yes
We don't have a Medical
1 Director at this time
Not unless I ask him to and I
haven't asked him to review them
since we first got them. If we
have an issue with something,
then we would contact our
2 Medical Director.
It is requested, but not
3 always completed.
board of doctors review
4 cards for my PSAP
Question 21
Notification if primary paging system goes down
Does Dispatch have a secondary means of
notifying responders if the primary paging
system goes down?
9.1%
9.1%
CityWatch
Global Connect
eDispatches
Phone ‘calling
tree’
81.8%
No secondary
means of
notifying
Comments:
We are currently working on
1 additional alternatives
Radio, DCC Communicator
2 NXT, telephone
We have a reverse 911
system that could also be
3 used.
4 CodeRED
eDispatches "Priority Blast"
because it's fast and can be
initiated over a phone
system quickly. CityWatch
can also be used, but it
involves more time to
5 initiate.
Some services use
eDispatches, other services
have back up paging
systems and others use
6 backup telephone numbers
Question 22
Identification of needs / ideas
1
Needs:
2
EMS personnel need to do a better job of informing Dispatch of their status. We are willing to keep track of the information,
but it is not always provided. EMS crews also need to have a better understanding of both city and rural addressing
schemes.
3
Understanding of each others job and activity level proper radio operation
Help fund technology to support smaller dispatch centers to improve efficiency and capabilities
Ideas:
1
2
Invite EMS staff into the Dispatch Center to see how Dispatch operates and why we ask them so many questions.
create a dispatch users group
3
I think that standardizing the emergency medical dispatch process would be a wise direction in the State. As a long time
user of the NAED protocols, we have found that the ongoing training is very beneficial to gain a deeper understanding of
the importance of the EMDs role in delivery of EMS services.
4
On stressful calls, we should automatically have a meeting to review how it went on both sides, Ambulance & Dispatch.
5
Open dialogue, whether it's an Atta boy or a complaint.
6
Work with EMS to form a committee consisting of key people, such as Ambulance leaders, Hospital representative, 911
Coordinator, possibly the Sheriff and any other community members that could contribute to focusing on EMS needs
together. This builds communications and helps Ambulance Services understand they don’t have to ‘make it on their own’.
Pool resources together to come out stronger and gain ideas from one another.
Question 31, 32
Collection of time data as required
Check all items that Dispatch collects time data for as stated in statute
57-40.6-10.
105.0%
100.0%
100.0%
100.0%
93.3%
95.0%
93.3%
100.0%
93.3%
90.0%
93.3%
86.7%
85.0%
Date and time of
request for
service
Name and
address of
requester
Type of incident
reported
Location of
incident reported
Description of
resources
assigned
Time of dispatch
Time of resource
arrival
Time of incident
conclusion
80.0%
Date and time
Name and
Type of
Location of
Description of
Time of
Time of
Time of
Question 23
Collection of time data for EMS
Does Dispatch also collect time data
specifically for EMS? Check all that
apply.
120.0%
100.0%
100.0%
100.0%
86.7%
93.3%
86.7%
Paper
80.0%
28.6%
(4)
60.0%
57.1%
(8)
40.0%
13.3%
20.0%
Access
database
CAD
Return to base
Available
Destination
Departure from
scene
Patient Contact (i.e.
Ambulance may
arrive at scene but
take 3 minutes to…
Enroute
0.0%
14.3%
(2)
Excel
Question 24, 25
Meetings with Ambulance Services
Comments:
70.0%
How often do you meet with Ambulance
Services that you provide dispatching
services for? Check all that apply
1 Every other month
60.0%
60.0%
We have monthly meetings with our 911 Advisory
Board and ambulance is on this board. Any issues
have always been discussed at these meetings
3 unless it is something more urgent.
50.0%
40.0%
40.0%
Our county has monthly emergency service
resource meetings. All ambulance services are
welcome to attend. This affords opportunities for
4 communication and discussion.
30.0%
20.0%
20.0%
20.0%
5 Semi-annually for rural BLS
13.3%
10.0%
0.0%
When there
is a complaint
We hold quarterly operational meetings and
monthly meetings focused on Emergency Medical
2 Dispatch issues.
Dispatch
meetings
Monthly
Quarterly
As needed
Complaints are submitted by EMS as needed, so
they can be responded to in a timely manner.
Ambulance Services have met with Dispatch for
training, and as needed. Quarterly meetings are
held between all Ambulance Services, Hospital
member, 911 Coordinator and a community
6 member. Needs and opportunities are addressed.
Question 29

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